QUESTION

What happens if we have different plans for different family members?

Individuals with no coverage | How Premium Tax Credits And Cost-Sharing Reductions Work
ANSWER

Assuming you are part of one application, the members of your family can enroll in separate plans in a health insurance marketplace; for example, because a grown child lives in another part of the state or because your spouse needs a plan with a different provider network than the one you choose. The premium tax credit will be allocated to the plans in which different family members enroll. However, you may have higher out-of-pocket costs if you have separate plans (for example, with separate deductibles) as opposed to one family plan (with one deductible for the entire family). (45 C.F.R. § 155.305; 26 C.F.R. § 1.36B-2).

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