Dear Addy: Employer-Sponsored Insurance

Dear Addy,

I am confused about whether the Health Care Marketplace is right for me and my family. We have insurance through my work but it is not clear if I have to use the Marketplace to get coverage starting next year. Who is supposed to use the Marketplace?



Dear Confused,

The Marketplace is intended for people who are self-employed, employed by small businesses that do not offer health insurance, and who are otherwise under-insured or uninsured. This is not to say that people who have health insurance through their employer can’t use the Marketplace. It all depends on which option, Marketplace plan or employer provided plan, is the best and most cost-effective choice for you and your family.

Most people who choose to sign-up with a Marketplace plan will get some help with costs. Other people may qualify for lower costs on their monthly premiums and out-of-pocket costs or get free or low-cost coverage from Medicaid or CHIP.

You will need to look at your current plan, its benefits, and out-of-pocket costs (premiums, deductible, copays, etc.), and compare it to plans available on the Marketplace. When making the comparison, some things to consider are whether you can keep your doctor on a Marketplace plan, if and how your medications are covered, and weigh monthly premiums verse deductible costs carefully.