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Coverage Options:

Health care coverage and Employer-provided Insurance
Health care coverage and the Marketplace
Health care coverage and Medicaid CHIP
Health care coverage and medicare
Health care coverage and tricare
Health care coverage and veterans health

Your decision depends on what type of employer-sponsored health insurance your employer offers.

Employers must make decisions about what type of employer-sponsored health insurance plan they will offer and to which employees the plan will be offered. You should be aware that your decision to select employer-sponsored health insurance depends on what your employer offers. Depending on your circumstances, you may have more than one option available to you. The following are possible scenarios and aren’t necessarily ones that match your current situation. Discuss your health insurance options with your employer.

You may find yourself in one of these scenarios:

  • You work at ABC Company, a large employer that falls within the scope of the ACA. ABC Company decides to offer some OR none OR all of its employees the opportunity to participate in its health insurance plan.
  • You work at DEF Company, a large employer that falls within the scope of the ACA. DEF Company decides to offer a health insurance plan that is not affordable.
  • You work at GHI Company, a small employer that, by definition, does not fall within the scope of the ACA. GHI Company decides to offer some, none or all of its employees the opportunity to participate in its health insurance plan.

In ANY of these scenarios, you may choose to:

  • Participate in the employer-sponsored health insurance, if available,
  • Buy health care coverage in the Marketplace* or in the existing commercial market, or
  • Participate in a public health insurance program, like Medicaid, if you are eligible.

Examples: You might have access to employer-provided insurance and be eligible for Medicaid. You may have employer-provided insurance, and your children may be covered under your plan. Your spouse or partner may get his or her health insurance in the Marketplace.

BUT keep in mind that which decision you make may impact whether you qualify for subsidies or tax credits.

  •  If your employer offers the opportunity to participate in its health insurance plan, but it is not affordable, and your income qualifies you, you will be eligible to receive a subsidy or tax credit in the Marketplace.
  • If your employer fails to offer health insurance and your income qualifies you, you will be eligible to receive a subsidy or tax credit in the Marketplace.
  • If your employer offers the opportunity to participate in its health insurance plan, it is affordable, and your income qualifies you, you will not be eligible to receive a subsidy in the Marketplace.
  • Compare what your employer has (or will have) with your other options.

Disclaimer. This website is a resource only and should be used for information purposes. Please work with your health care providers, insurance councilors, etc. to determine the best solution for you.

 


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