Employer-Sponsored Health Coverage

My employer offers health benefits but doesn’t contribute much toward the premium. I can’t afford my share for employee-only coverage. Can I apply for coverage and subsidies in the Marketplace instead?

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You can always shop for health coverage in the Marketplace. However, if you’re offered employer health benefits, you can’t qualify for premium tax credits in the Marketplace unless your employer coverage is considered unaffordable. If your share of the premium for self-only coverage in your employer plan is 9.02% or more of your 2025 household income, it is considered unaffordable, and you can apply for premium tax credits in the Marketplace.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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