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Kaiser Family Foundation

I’m enrolled in COBRA now but I want to drop it. Does that affect my eligibility for Marketplace subsidies?

No, having COBRA doesn’t affect your eligibility for premium tax credits. However, you can only drop COBRA and sign up for a Marketplace plan and premium tax credits during Open Enrollment. You will have to drop your COBRA coverage effective on the date your new Marketplace plan coverage begins. After…

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Kaiser Family Foundation

My 24-year-old daughter, who is working, lives near me and my spouse. We do not claim her as a tax dependent. She is eligible for premium tax credits and a cost-sharing reduction. We are not eligible for any subsidies, but we would all like to enroll in the same plan. Can we do that?

You can all enroll in the same family plan, because the ACA requires insurers to offer dependent health coverage to adult children up to the age of 26. Because you no longer claim your daughter as a tax dependent, she is considered to be in a different tax household from…

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Kaiser Family Foundation

I’m divorced and I pay alimony to my ex-spouse. Should I deduct that from my income in determining my eligibility for subsidies?

For divorces after December 31, 2018, alimony payments are no longer deductible for the paying spouse and alimony is not included as income for the recipient spouse. For pre-2019 divorces, old tax rules apply.  The paying spouse can deduct alimony payments from income and the recipient spouse must report alimony…

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Kaiser Family Foundation

Is the value of my house counted in determining my eligibility for premium tax credits in the Marketplace?

No, assets are not counted. So the value of your house, car, retirement savings, etc. will not affect your eligibility for premium tax credits. Only your income is considered.

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Kaiser Family Foundation

I’m under 26 and eligible to be covered as a dependent under my mom’s job-based policy. Mom no longer claims me as a tax dependent – I file my own taxes, though my income isn’t very high. If subsidized Marketplace coverage would be even more affordable to me can I sign up for that instead?

Yes. Although the general rule is that people are not eligible for Marketplace subsidies when they are also eligible for affordable job-based health coverage, there is a special rule for young adults. As long as a young adult is not claimed as a tax dependent by her parents, the availability…

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Kaiser Family Foundation

What income is counted in determining my eligibility for premium tax credits?

Eligibility for premium tax credits is based on your Modified Adjusted Gross Income, or MAGI. When you file a federal income tax return, you must report your adjusted gross income (which includes wages and salaries, interest and dividends, unemployment benefits, and several other sources of income.)  MAGI modifies your adjusted…

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Kaiser Family Foundation

I live in State A but my small business is in State B. I want to buy group coverage for my employees through the SHOP Marketplace. In what state should I buy health benefits?

You should buy group coverage through the SHOP Marketplace in State B, where your business is located.  If your business is located in a HealthCare.gov state, there is no SHOP Marketplace website.  Instead, you should contact insurers directly or work directly with a broker to buy a small group policy. …

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Kaiser Family Foundation

I like my Marketplace plan just the way it is. Will it stay the same next year?

It depends.  Insurers are allowed to make changes to policies each year.  Most likely, the premium for your current policy will change next year.  There may be other changes as well, for example, changes in the deductible or copays for some services.  In some cases, an insurer may stop offering a…

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Kaiser Family Foundation

Will private enrollment websites sell plans other than qualified health plans?

Yes.  A number of private enrollment websites will also sell short-term health insurance and other products that do not cover all the benefits and provide all the protections of Marketplace plans.  These plans can turn you down or charge you more if you have a pre-existing condition.  Some private sites…

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The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400
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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.