My employer’s health plan doesn’t cover brand-name drugs, only generics. Does that mean it doesn’t have minimum value? Can I shop for better coverage and subsidies on the Marketplace?

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

Whether your employer’s health plan meets minimum value will depend on a number of factors. The Marketplace application includes a form with questions about job-based coverage. You can take this form to your employer and ask them to fill it out. Alternatively, your employer plan is required to provide you a Summary of Benefits and Coverage. This document should tell you whether or not your employer plan meets the minimum value standard. If it doesn’t, you may be able to qualify for premium tax credits to help pay for Marketplace coverage. (45 C.F.R. §156.145; 26 C.F.R. §1.36B-6.)

Individuals with no coverage
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