Employer-Sponsored Health Coverage and the Marketplace

My employer offers a plan with very limited benefits. It only covers preventive services and a few doctor visits each year. I want better coverage. Can I apply for coverage and subsidies in the Marketplace?

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You can apply for coverage in the Marketplace and you may qualify for premium tax credits if your employer plan doesn’t meet the Affordable Care Act’s standard for minimum value. This is met if a plan covers at least 60% of covered services for an average population. If your employer plan only covers preventive services and a few doctor visits, it probably doesn’t meet the minimum value standard, and so you could be eligible for premium tax credits to help buy a Marketplace plan. However, if another plan option your employer offers would be affordable and meet the minimum value standard, then you will not qualify 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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