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On Private Health Insurance Coverage & The Health Insurance Marketplace

Individuals with no coverage
Individuals with coverage
Coverage for small employers
Post enrollment issues
Preguntas frecuentes sobre la inscripción a la cobertura de salud
Transitions from Medicaid to Private Insurance
Transiciones de Medicaid a seguro médico privado

QUESTION

I’m married. I work full-time for a large employer that offers me health benefits, but won’t cover spouses. Is that allowed? Can my spouse apply for coverage and subsidies in the Marketplace?

Individuals with no coverage | Eligibility for Premium Tax Credits and Cost-Sharing Reductions |

ANSWER

Yes, that is probably allowed. Large employers (with 50 or more employees) who do not offer health benefits to full-time workers and dependents under the age of 26 could face a penalty, but they will not face a fine for failing to offer health benefits to employees’ spouses.

If your spouse is not offered health benefits through your job, they may be eligible to apply for coverage and premium tax credits through the M arketplace. (26 U.S.C. § 4980H; 42 U.S.C. §300gg-14.)