Employer-Sponsored Health Coverage

The prescription drug benefit under my employer’s health plan only covers generic drugs. Does that mean it doesn’t have minimum value? Can I shop for better coverage and subsidies on the Marketplace?

Whether your employer’s health plan meets minimum value will depend on a number of factors. Some employer plans might be able to meet the minimum value standard even if they don’t provide coverage for brand name prescription drugs.  The Marketplace application includes a form with questions about job-based coverage. You should take this form to your employer and ask them to fill it out. With that information the Marketplace will determine whether the plan meets minimum value. If it doesn’t, you may be able to qualify for premium tax credits to help pay for Marketplace coverage.

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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The independent source for health policy research, polling, and news, KFF is a nonprofit organization based in San Francisco, California.