When you apply for Marketplace coverage, you'll be asked if you (or anyone else on your application) currently have health coverage. If you plan to keep another type of coverage, you generally won’t be able to also get savings on a Marketplace plan.
Select “No” if:
- You don’t have other health coverage.
- You have other coverage but you know it's ending in the next 60 days.
- Your Medicaid coverage pays for only limited benefits, like services only for family planning services, emergency services, outpatient hospital services, or treatment of tuberculosis.
- Your Medicaid coverage doesn’t pay for inpatient hospital services.
Select "Yes" if you have other health coverage. You'll then be asked if you have health coverage through any of these sources:
- Medicaid (coverage that provides full benefits)
- Children's Health Insurance Program (CHIP)
- Medicare
- Coverage through an employer: Select this if you have health coverage, including COBRA, through your job or through another person's job (like a spouse or parent/guardian).
- Marketplace coverage: Select this if you have coverage through a Marketplace plan.
- TRICARE: A health care program for uniformed services members, retirees, and their families. Don't choose this if you have Direct Care or Line of Duty.
- VA health care program: Health coverage for veterans (and, in certain circumstances, their dependents or survivors) who served in the active military, naval, or air service and were honorably discharged or released.
- Other full-benefit coverage (which covers benefits like doctor's visits, hospitalizations and prescription drugs)
- Other limited benefit coverage (like a school accident policy)
What's my policy number or member ID?
If you currently have health coverage, you may be asked for your policy number or member ID. This number is usually on your insurance card. On the Medicare care example below, the policy number/member ID is the "Medicare number."
What if I'm offered a state employee health benefit plan?
You may be asked if you're offered a state employee health benefit plans through a job or a family member's job. Most people who work for the state or local government have the option to be covered through the state employee health benefit plan. These workers can usually cover their spouses and children through the plan. People who work at state universities may also be able to get this plan. If you could get that state employee plan because of your job or your relative's job, select "Yes."
Did I have health coverage through a job that ended recently?
You'll be asked if you recently lost health coverage. Many children get coverage through a parent's job, but coverage may end for different reasons, including:
- The parent loses their job.
- The employer stops offering coverage.
- The parent thinks the plan is too expensive and stops paying or cancels the coverage.
If your coverage ended, select "Yes." Then, you may be asked why. We're asking this because sometimes children have a waiting period between ending employer-sponsored coverage and starting coverage through CHIP. There may be exceptions to that waiting period, based on the reason that the employer-sponsored coverage ended.
Can I have more than one type of coverage?
Yes, you can have more than one type of coverage, but some people who have other coverage may not be able to get help paying for coverage through the Marketplace.
If you're currently enrolled in a Marketplace plan with the premium tax credit or other cost savings, you won't qualify for savings anymore if you're:
- Found eligible for Medicaid or CHIP
- Eligible for Medicare Part A (Hospital Insurance)
- Have other qualifying health coverage (like COBRA or VA coverage)
- Offered affordable job-based coverage that meets minimum standards
If you keep using the premium tax credit to lower your Marketplace plan premiums, you (or the person who claims you on their taxes) may need to pay back some or all of the amount you used when you file your federal taxes.
Get details if you have: