If you have access to health insurance through your employer, you may assume that's automatically your best option. And often, it is — but not always. Here's a breakdown of how employer coverage and ACA Marketplace plans compare, and when one might make more sense than the other.
Employer-sponsored insurance
Employer health plans are typically funded partly by your employer and partly through payroll deductions. The employer's contribution is a significant benefit — effectively extra compensation — so if your employer covers a meaningful portion of the premium, staying on the employer plan usually makes financial sense.
ACA Marketplace plans
If you don't have access to employer coverage — or if your employer's plan is unaffordable — you can shop for individual or family coverage through the ACA Marketplace. Depending on your household income, you may qualify for premium tax credits that significantly reduce your monthly cost.
When Marketplace plans might be a better fit
- Your employer's plan is very expensive or has a high deductible - Your employer doesn't cover dependents at an affordable rate - You're self-employed or a freelancer - You've recently lost employer coverage and need a bridge plan
The key thing to know
You can't receive premium tax credits for a Marketplace plan if you have access to "affordable" employer coverage (as defined by the ACA). This is an important nuance — and it's one of many reasons working with a licensed agent helps. I can help you assess your actual options and make the decision that makes the most financial sense for you and your family.