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If I cannot afford my employer coverage, can I apply for premium subsidies through individual or family ACA plans?

Use our 2025 ACA Affordability Calculator to see if you might be eligible for ACA premium subsidies – and your potential savings if you qualify.

You may be able to avoid the "family glitch" which used to prevent an employee's spouse and dependents from qualifying for premium subsidies even if the employer provided little or no contribution to premiums for family members. Now, if the total family premiums (including the employee, spouse, and/or dependents) are more than 9.12% of MAGI, the employee's family members may qualify for premium subsidies via an ACA Marketplace plan even if the employee's coverage is deemed affordable. If employee-only premiums are more than 9.12% of modified adjusted gross income (MAGI), then the employer coverage is deemed unaffordable, and the employee and any family members are eligible to pursue savings via an individual ACA plan during open enrollment. Depending on income, some families will find that some family members are eligible for Medicaid or CHIP, which is available regardless of an offer of coverage from an employer.
Source: healthinsurance.org

ACA Affordability Calculator

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Modified Adjusted Gross Income (MAGI)

Modified Adjusted Gross Income (MAGI)

For most taxpayers, your MAGI is close to AGI (Line 11 of your Form 1040 in 2021 and 2022)

$0$75,000$150K$150,000
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Includes your spouse, and children claimed as dependents on your taxes. To calculate this value subtract the cost of employee coverage from the cost of family coverage.

You may be able to avoid the "family glitch" which used to prevent an employee's spouse and dependents from qualifying for premium subsidies even if the employer provided little or no contribution to premiums for family members. Now, if the total family premiums (including the employee, spouse, and/or dependents) are more than 9.12% of MAGI, the employee's family members may qualify for premium subsidies via an ACA Marketplace plan even if the employee's coverage is deemed affordable. If employee-only premiums are more than 9.12% of modified adjusted gross income (MAGI), then the employer coverage is deemed unaffordable, and the employee and any family members are eligible to pursue savings via an individual ACA plan during open enrollment. Depending on income, some families will find that some family members are eligible for Medicaid or CHIP, which is available regardless of an offer of coverage from an employer.
Source: healthinsurance.org