ACA health insurance
The ACA family glitch fix: when family members can get Marketplace savings
Before 2023, if your employer's plan was affordable for you alone, your family could not get Marketplace savings even if adding them was very expensive. Now the affordability test for family members looks at what family coverage costs.
What changed
Affordability for the employee is still judged on the employee-only premium. For spouses and children, it is judged on the cost of covering the whole family through the employer. If that cost is above the affordability threshold, family members may be eligible for savings on the Marketplace.
When to look into it
- Your employer offers coverage, but adding your family would cost a large part of your paycheck.
- You were told your family could not get savings because of your job's offer.
- Your household income is within the range where savings are available.
Have this ready when you call
- Your employer's plan costs for employee-only and for family coverage
- Household income estimate
- Names and birthdates of family members
Common questions
Can I get savings for myself too?
If the employer plan is affordable for you alone, you generally cannot get savings for yourself, even if your family can.
Where do I find the family cost?
Your employer's benefits office or enrollment guide lists the premium for each tier, such as employee only and employee plus family.
Related answers
Rather talk it through?
Call 855-367-1095 and a licensed agent will go through your situation with you. There is no charge to ask, and no obligation to enroll.
- Licensed insurance help
- No guaranteed eligibility, pricing, or availability
- Educational starting point
Information on this site is educational and does not guarantee eligibility, enrollment, pricing, or availability. It is not a recommendation to buy any specific plan or policy.