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Kaiser Family Foundation

I am covered by Medicare and my annual income is $30,000. Can I qualify for a premium tax credit to help me pay for my health insurance coverage through Medicare?

No.  People on Medicare are not eligible for the premium tax credits, no matter what their income level.

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Kaiser Family Foundation

Are Medicare Advantage plans, Medicare Part D drug plans, or Medigap policies sold through the Marketplace?

No.  Medicare Advantage plans (such as Medicare HMOs and PPOs), Medicare Part D prescription drug plans, and Medigap policies are not sold through the federal or state Marketplaces.  You can enroll in a Medicare Advantage plan or a Medicare Part D plan on the Medicare website (www.Medicare.gov) or by signing up…

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Kaiser Family Foundation

I work and am eligible for health benefits. Do I have to sign up for my job-based plan or will my employer do that for me?

You generally are responsible for enrolling in a health plan offered by an employer, so it’s up to you to sign up for coverage under the rules and procedures established by your employer health plan. Some employers may use auto-enrollment, which means that your employer will enroll you in a…

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Kaiser Family Foundation

If I have a Marketplace plan and then become eligible for Medicare, will my Marketplace plan be cancelled automatically when my Medicare coverage starts?

No, your Marketplace plan will not be canceled automatically when your Medicare coverage starts. You must contact your Marketplace insurer directly to cancel your Marketplace policy.

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Kaiser Family Foundation

What are the penalties for me, as an employer, if I don’t provide health benefits to my seasonal workers?

If you are a large employer, you will face a penalty if you do not offer affordable coverage that meets minimum value to all of your full-time employees and their dependent children. If, as an employer, you’re unsure whether or not your seasonal workers are full-time employees, you can use…

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Kaiser Family Foundation

When can I enroll in my employer health plan?

Usually, you can sign up for health benefits when you are first hired. Most employers also have an annual open enrollment period, or open season, when you can sign up for coverage or (if your employer offers a choice of plans) change your enrollment to a different health plan. In…

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Kaiser Family Foundation

Will getting health insurance through Medicaid, CHIP, or Health Insurance Marketplaces put undocumented family members at risk?

Federal and state laws protect the privacy of people who apply for or receive health care coverage or other public benefits.  Under these rules, federal and state Medicaid and CHIP and Marketplace agencies may share information with other government agencies only for purposes of administering their programs, with limited exceptions. …

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Kaiser Family Foundation

I work for a large employer (more than 50 full time employees) but my hours vary during the year. I work full-time during the summer but part-time the rest of the year. Does my employer have to offer me health benefits?

Large employers must offer health benefits to employees who work, on average, at least 30 hours per week, or else pay a tax penalty. Check with your employer/human resources department to find out if your hours worked over the year meet this threshold. If your hours vary during the year, your…

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Kaiser Family Foundation

The Marketplace said I must submit additional information to document my eligibility for premium tax credits. I submitted the information, but kept getting more notices to send information. Now 90 days have passed and my tax credit has been reduced. What should I do?

You can appeal the Marketplace’s decision to reduce your tax credit.  Information on how to appeal will be included on the final determination notice.  If your appeal is successful, your tax credit will be restored retroactively.

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Kaiser Family Foundation

The Marketplace said I must submit additional information to document my eligibility to buy coverage or to qualify for premium tax credits. They gave me 90 days, but I missed the deadline. Can I request an extension?

Generally, if the Marketplace hasn’t received the requested information within 90 days and you didn’t already ask for an extension, the Marketplace will make a determination based on the information it has.

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The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.