Can I Enroll Kids and I in ObamaCare if Spouse Has Employer Plan?
I will be reducing to 50% time at my job and losing all healthcare benefits. My husband is covered by his employer, but the healthcare plans to add me and our children are very expensive and with poor coverage. Am I able to sign up myself and our kids with an Obamacare plan, even though we have access to my husband’s (poor) plan? I haven’t been able to find answers to this specific question on the site.
A spouse or dependent can't get cost assistance on the Marketplace if they have access to an affordable employer plan that costs less than 9.56% household income per person.
Learn more about affordable employer-sponsored coverage.
9/30/2015. Her question was NOT answered. She didn’t ask if she could get “cost assistance” (a subsidy), she asked if she could purchase insurance for just her and her children. I’d like to know the answer as well. I find it odd that in order to get premium quotes at healthcare.gov I have to put my husband in the calculator (appearing to make it a plan for 3) when I only want/need a quote for 2. It makes a difference: I got cheaper quotes with just my son and myself.
You can most certainly enroll in a Marketplace plan if you have access to employer coverage, you just can’t get cost assistance. You need to include everyone who files together in the income and family size part of the application to get information on cost assistance eligibility. You don’t have to get coverage for all of those family members or request coverage for all family memebers.
The application process is different than the enrollment process. You won’t see exact quotes for your family until after you have applied and start shopping for plans while logged in.
I want to make sure I understand the answer to this question, b/c I was told that it is illegal to purchase health insurance through the health connector, if the insurance plan offered to my husband – through his employer – is also available to me. I was told that it is illegal regardless whether I get financial assistance or not.
Based on what I’m reading here, it sounds like I can enroll in health insurance through Obamacare – that it is NOT illegal, but I can’t get financial assistance.
Can somebody please clarify. Thank you.
You can’t break the law by enrolling in the marketplace. But, it is illegal if you have Medicare for an agent to sell you a private plan.
The worst that can happen is that you won’t qualify for subsidies. See here: https://obamacarefacts.com/2016/11/03/affordability-exemptions-for-2017/
Needing coverage for my kids.
I want further clarification on this issue. If I have family health insurance offered through my employer (at a VERY high rate) and my husband and son both have full time contract jobs (1099) that do not provide health insurance coverage, can they enroll for their own policy and NOT be included on my policy through my employer?
For clarification, anyone can buy insurance on the marketplace for full price without “cost assistance.” But yes, you could be eligible for for cost-sharing silver plans and the premium tax credit even though you have access to insurance through your spouse’s employer. To know whether you qualify, fill out an application–it’s the only way to know for sure. To guess whether you qualify, simply reverse the answer above. You CAN get cost assistance on the marketplace if YOUR premiums on your spouse’s plan would exceed 9.56% of your household income. They will ask you for these numbers on the application. Additional note: when you apply on the marketplace be sure to enter your estimated MAGI (https://www.healthcare.gov/glossary/modified-adjusted-gross-income-magi/), not your gross income. (Of course, none of this may be true much longer…)