Individuals & Families
Marketplace Health Insurance
Major medical plans through HealthCare.gov — we help you find the right plan, check your tax credit eligibility, and walk you through enrollment.
Is a Marketplace Plan Right for Me?
If you don't have access to health insurance through an employer, Marketplace plans are worth reviewing, especially when:
- You need major medical coverage because you're managing a health condition, such as cancer or a heart condition.
- You take prescription drugs that are expensive without insurance.
- Your gross household income* is within the below income limits, and you would qualify for a tax credit lowering your monthly premium. Household income includes everyone in your tax household.
What every Marketplace plan covers
- Pre-existing conditions, from day one
- Preventive care, such as annual checkups and screenings
- Doctor visits, hospital care, prescriptions, and more
When can you enroll?
- During Open Enrollment (Nov 1 – Jan 15). Enroll by Dec 15 for coverage starting Jan 1.
- Within 60 days of a qualifying life event, such as:
- Losing employer insurance
- Moving to another area or state
- COBRA coverage ending
- Subsidized COBRA premium ending
- A change in household size, due to marriage, a new baby, divorce, or death
Other situations may apply. Just ask.
Could you qualify for a tax credit to lower your premium?
Depending on the size of your household (everyone on your income tax return) and the gross household income* for your household size, you might qualify for a tax credit, which would reduce your monthly premium.
| Household size | Below minimum – No tax credit | Between min and max – You may qualify | Above maximum – No tax credit |
|---|---|---|---|
| 1 | Less than $15,960 | $15,960 – $63,840 | More than $63,840 |
| 2 | Less than $21,640 | $21,640 – $86,560 | More than $86,560 |
| 3 | Less than $27,320 | $27,320 – $109,280 | More than $109,280 |
| 4 | Less than $33,000 | $33,000 – $132,000 | More than $132,000 |
| 5 | Less than $38,680 | $38,680 – $154,720 | More than $154,720 |
| 6 | Less than $44,360 | $44,360 – $177,440 | More than $177,440 |
| 7 | Less than $50,040 | $50,040 – $200,160 | More than $200,160 |
| 8 | Less than $55,720 | $55,720 – $222,880 | More than $222,880 |
| Each add'l person | +$5,680 | +$5,680 / +$22,720 | +$22,720 |
Minimum = 100% of the federal poverty level (FPL). Maximum = 400% of FPL. Annual income for 2027 coverage, based on the 2026 federal poverty guidelines.
Example: A household of 2 with a gross (MAGI) income of $50,000 falls between $21,640 and $86,560, so you may qualify for a tax credit.
🚩 Important: If your actual income ends up higher than the maximum (400% of FPL), you have to pay back the full tax credit at time of your income tax return. Update your application right away if your income changes.
*Gross household income is your Modified Adjusted Gross Income (MAGI). For the full definition and how to calculate it, see HealthCare.gov: How to estimate your expected income
When you would not qualify for a tax credit
- Your employer offers major medical insurance. In most cases, you then don't qualify for a tax credit. Not sure? Just ask, and we'll check it with you.
- Your household income is below the minimum income (100% of FPL).
- Your household income is above the maximum income (400% of FPL).
Without a tax credit, you can still buy a Marketplace plan at the full price.
Estimating your household income
Use the income you expect for the year you want coverage, not last year's income. Include everyone in your tax household who is on your income tax return.
Counts as income
- Wages, salary, and tips (after pre-tax 401(k), Health Savings Account, and health insurance deductions)
- Self-employment net profit
- All Social Security benefits, taxable or not (incl. SSDI)
- Pensions, annuities, and taxable IRA or 401(k) withdrawals
- Unemployment
- Interest (including tax-exempt), dividends, and capital gains
- Net rental income
- Alimony, if your divorce was final before 1/1/2019
- Foreign income
Does not count as income
- Child support, paid or received
- Life insurance death benefits
- Supplemental Security Income (SSI)
- Veterans disability payments
- Workers' compensation
- Gifts and inheritances
- Loans (student, home equity, bank)
- Qualified Roth IRA withdrawals
- Alimony, if your divorce was final on or after 1/1/2019
- Child Tax Credit payments
See the full list on HealthCare.gov: What's included as income
Estimate your income with HealthCare.gov's income calculator
How the tax credit works with your income tax return
At time of application
- You estimate your household income when you apply.
- Based on that estimate, you can decide to take the full tax credit or only part of it.
- You’ll understand your monthly premium and tax credit amount.
During the year
- You pay the monthly premium incl. any tax credits.
- Make a note to yourself to review your annual income in September. If your income is going to be higher, update your application.
At tax time
- You must file a tax return when you had a Marketplace plan on the exchange.
- Early in the new year, you’ll get Form 1095-A from the Marketplace. It shows how much tax credit was paid for you.
- When you (or your tax preparer) enter Form 1095-A on your tax return, Form 8962 is created. It compares the tax credit you received with the tax credit you qualify for, based on your actual income.
What happens next
Actual income
Lower than estimated
You may get the difference back as a refund.
Actual income
Higher than estimated
You pay back the difference, with no limit.
Actual income
Above the maximum (400% of FPL)
You have to pay back the full tax credit at time of your income tax return (New as of plan year 2026).
🚩 Important: If you don't file your tax return, or forget to include Form 1095-A (which creates Form 8962), you could lose your tax credit for the next year. If you already filed your taxes, you can amend your tax return.
How we help
Choose what works best for you:
Let's work together
Schedule a Marketplace ConsultWe'll walk through everything with you:
- Checking your eligibility
- Estimating your household income and tax credit
- Comparing plans, doctors, and prescriptions
- Enrollment and annual re-enrollment
- Reporting income changes during the year
Review your options yourself
Shop Marketplace plansHere you can compare and shop plans yourself, through HealthSherpa, a website that works with HealthCare.gov.
Fill in your name and contact information, and we can help you whenever you need it.
Note: Access to your account is fully locked. We do not have access to your account without your prior consent for your protection.
We never have access to your application without your formal electronic consent.
This page is a summary for general information only. Errors may occur, and no rights can be derived from it. The official rules from HealthCare.gov and the IRS always apply. We are not tax advisors. For questions about your tax return, please talk to your tax preparer.