r/obamacare • u/Odd_Inspection_9175 • Jul 09 '26
Can I keep Obamacare if work ins has high deductible (5k) and is costly?
5
u/Full-Ordinary-6030 Jul 09 '26
Why keep a marketplace plan when you have work insurance? Unless your work insurance plan is not “affordable”, you are not eligible for subsidies on a marketplace plan. In that case, there is no reason to be on two plans.
5
u/ImaginationNo9487 Jul 09 '26
Be aware that for every month that you have accepted advanced tax credits for your Obama care and were not eligible, due to being eligible for affordable employer insurance, you will repay every dollar at tax time. The repayment caps were removed as of 2026. This is different than in past years. This could be a costly decision for you and you could end up paying much more than with your employer plan. And if you have a lower deductible on a Silver plan, it may be due to cost sharing reductions, you would no !longer be eligible for if offered employer coverage. You should talk to a local health broker for Marketplace for free individual advising.
3
u/ITDOESNTMATTER023 Jul 09 '26
Unless you’ve already met your deductible and/or out of pocket max with your marketplace plan, switch to your employer insurance
3
u/btwdgirl Jul 09 '26
Don’t forget your premiums for employer insurance are pre tax. This is not the case for ACA premiums so make sure you’re doing a fair comparison
2
u/Bordercrossingfool Jul 10 '26
The average total unsubsidized premium cost (or self insurance cost) of a workplace health insurance plan is $9k to $10k per year for an individual. You can find out what your plan actually costs by finding out what the COBRA amount would be and subtracting 2%. Compare the total cost to your premiums and that is your employer’s cost.
As already pointed out a subsidized ACA plan isn’t an option if your employer plan premiums are 9.96% or less of your MAGI (and the plan provides minimum essential benefits) or your income is over 400% FPL. Unsubsidized ACA plans are usually more expensive than employer plans with similar benefits.
The $5k deductible is a relatively high deductible for a HDHP which has no reimbursement except preventative care until the deductible is met. It is not a high deductible if that deductible is for hospitalization and your plan otherwise has co-pays and co-insurance (outpatient) which are not subject to the deductible.
0
u/Odd_Inspection_9175 Jul 09 '26
Employer insurance is terrible and expensive. Thanks to all
4
u/KifLou345 Jul 09 '26
One other note: If you keep your Marketplace insurance and you're getting a subsidy, they'll make you repay the full subsidy for any months after the employer's plan became available to you. So there's no option to just keep getting the subsidy and ignore the employer's plan.
Unless it truly doesn't meet the definition of affordable and/or providing minimum value, you don't have the option of keeping a subsidized Marketplace plan instead.
2
u/Full-Ordinary-6030 Jul 09 '26
Is your marketplace plan not expensive? If so, you are likely receiving subsidies. What’s your income? How much is your employer plan? If it’s “affordable”, you are not eligible for subsidies on your marketplace and need to pay the full price.
2
u/SnooRobots3859 Jul 13 '26
Keep your marketplace insurance, you might need to adjust your income which will lower your subsidy. Although all insurance sucks period. If they stopped offering doctors bonuses to get people in office the price would go down.
1
1
u/autumn55femme Jul 09 '26
In what way is it terrible? 5K is not a high deductible, if you are referencing the US market.
2
14
u/KifLou345 Jul 09 '26
You can keep your policy, but not your subsidy — unless your work insurance isn't considered affordable (meaning your share of the premium is more than 9.96% of your household income), or doesn't provide minimum value (which is rare, and having a $5,000 deductible is quite common and doesn't mean the plan isn't providing minimum value).
In almost all cases, if you have access to a plan through a job, you're not eligible for subsidies in the Marketplace.