About Insuring Your Health
KHN contributing columnist Michelle Andrews writes the series , which explores health care coverage and costs.
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A. He likely is. Almost anyone can buy a health plan on the health insurance marketplaces, also called exchanges, which will open next month. The real question is whether he would be eligible for a premium tax credit to make the plan more affordable.
In general, people who have access to good health coverage that meets standards for affordability and adequacy under the Affordable Care Act aren’t eligible for subsidized coverage on a marketplace. A plan is considered affordable if it costs less than 9.5 percent of income, and adequate if it pays for at least 60 percent of allowed medical costs, on average.
You don’t say whether your husband is 65 or older and . If he is, he wouldn’t qualify for subsidized coverage on a marketplace if he opts against your retiree spousal coverage.
But assuming he’s not eligible for Medicare and doesn’t enroll in your retiree health plan, he could qualify for a premium tax credit on the marketplace if your household income is less than 400 percent of the ($62,040 for a couple in 2013). Â
In contrast to regular employer coverage, “if you’re eligible for early retiree coverage but choose not to take it, you ,” says Timothy Jost, a law professor at Washington and Lee University who’s an expert on the Affordable Care Act.
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This article was produced by Kaiser Health News with support from .