Your Job's Health Plan or HealthCare.gov: How to Choose

If your job offers health insurance, you may wonder whether a plan from HealthCare.gov (the Health Insurance Marketplace) could be cheaper or better. Sometimes it can. But for most people with a job offer, the Marketplace won't give them help with the monthly premium. This guide explains the dates, the "affordable" and "minimum value" tests, how to compare costs, and when it can make sense to say no to your job's plan. Everything here is as of November 2, 2026.

Key dates for 2027 coverage

HealthCare.gov lists these dates for Marketplace Open Enrollment:

• November 1, 2026: Open Enrollment starts.
• December 15, 2026: Last day to enroll or change plans for coverage that starts January 1, 2027.
• January 15, 2027: Open Enrollment ends. If you enroll from December 16 through January 15, coverage starts February 1 (once you pay your first premium).

After January 15, you can only enroll or change Marketplace plans if you qualify for a Special Enrollment Period. Some states run their own Marketplace websites and may use different dates, so check your state's site if you don't use HealthCare.gov.

Your job's open enrollment is separate. Your employer sets its own dates, and they are often earlier. Don't let your job's deadline pass while you're still comparing.

The big question: can you get help with Marketplace premiums?

The Marketplace's main help is the premium tax credit, a tax credit that lowers your monthly premium. If you have an offer of job-based coverage, HealthCare.gov says you won't qualify for these savings if the job's plan is "affordable" and meets the "minimum value" standard. It adds that most job-based plans meet these standards.

The IRS says the same thing: you can get the premium tax credit only for months when you weren't eligible for affordable employer coverage that provides minimum value. HealthCare.gov also says you can't get Marketplace savings for any month you're enrolled in a job-based plan.

Test 1: Is the job's plan "affordable"?

HealthCare.gov says a job-based plan counts as "affordable" if your share of the monthly premium for the lowest-cost plan your employer offers is less than:

• 9.96% of your household income in 2026
• 10.22% of your household income in 2027

The 10.22% figure for plans starting in 2027 comes from IRS Revenue Procedure 2026-26.

A few details matter:

• For the employee, affordability is based only on the premium for self-only (employee-only) coverage, even if you'd want family coverage.
• For family members offered coverage through someone else's job, HealthCare.gov says affordability is based on the premium to cover everyone in the household. So the employee may not qualify for savings, while the spouse and children might.
• "Household income" includes the income of everyone in the household who has to file a tax return.

Made-up example: Dana's household income is $60,000. 10.22% of that is $6,132 a year, or $511 a month. Her job's cheapest plan costs her $150 a month for employee-only coverage. That is well under $511, so her job's plan counts as affordable for her, and she wouldn't get a premium tax credit on a Marketplace plan in 2027. Her family members could still be checked separately using the family premium.

Test 2: Does the plan provide "minimum value"?

HealthCare.gov says a plan meets the minimum value standard if it's designed to pay at least 60% of the total cost of medical services for a standard population, and it includes substantial coverage of doctor and inpatient hospital services. To find out, ask your employer. You can also ask them to fill out HealthCare.gov's Employer Coverage Tool.

Other limits on Marketplace help

Even if your job's plan fails these tests, you still need to meet the other rules. The IRS says that, for years other than 2021 and 2022, your household income generally must be between 100% and 400% of the federal poverty line, among other requirements. Above 400%, you don't get the credit and must pay the full premium.

If you get the credit in advance and your income ends up higher than you estimated, you may owe money back at tax time. KFF notes that starting with the 2026 tax year, the old limits on how much some people had to repay were eliminated. That makes a careful income estimate more important.

How to compare the costs

HealthCare.gov suggests these steps:

1. Get the details of your job's plan. Find the premium for each coverage level and who in your family can be covered. Your employee portal, a benefits letter, or your plan's Summary of Benefits and Coverage can help. See How to read your SBC.
2. Fill out a Marketplace application. HealthCare.gov says there's no risk in applying: you won't be enrolled automatically, and you can still choose your job's plan. The application checks whether you or your family qualify for savings.
3. Compare the plans side by side. Log in to see Marketplace prices with any savings you qualify for.

When you compare, look at more than the premium:

• Your total yearly cost: premiums for 12 months plus a realistic guess at deductibles, copays, and coinsurance. See Health insurance terms explained.
• The employer's share. HealthCare.gov points out that with most job-based plans your employer pays part of the premium. If you choose a Marketplace plan instead, your employer won't help pay it.
• Pre-tax pay. Many employers let you pay your share of the premium before taxes. Ask your HR team how it works at your job.
• Doctors and drugs. Check that your doctors are in the network and your medicines are on the drug list. See Prescription drug costs.
• Extras tied to the job plan, such as an employer HSA deposit or an FSA. See What is an FSA?.

When it can make sense to waive your job's coverage

Turning down your job's plan is a big decision. It may be worth a closer look if:

• Your share of the lowest-cost job plan isn't "affordable" under the test above, or the plan doesn't meet minimum value, and your Marketplace application shows you qualify for savings.
• Your family members don't pass the affordability test using the family premium, so they may qualify for Marketplace savings even if you don't.
• You're covered under another job-based plan, such as a spouse's, that fits your family better.

It's usually not a good idea to waive your job's plan just because a Marketplace premium looks lower before you apply. That price may not include savings you can't actually get, and you'd lose your employer's share of the premium.

Before you decline, get the Marketplace decision in writing on your account, and check your job's deadline.

Special enrollment cautions

• Waiving at work usually locks you out until the next open enrollment. Most job plans only let you join mid-year after certain life events. See Life changes and special enrollment.
• Dropping coverage on purpose doesn't open a Marketplace window. HealthCare.gov says voluntarily dropping COBRA or stopping your COBRA payments doesn't qualify you for a Special Enrollment Period. Choosing to drop coverage you have as a dependent also doesn't qualify on its own, unless your household income dropped or your dependent's coverage change made them eligible for savings.
• Losing job coverage does open a window. HealthCare.gov says you may qualify if you lost qualifying coverage in the past 60 days, or expect to lose it in the next 60 days.
• Different open seasons. HealthCare.gov notes that if your employer's open season is at a different time of year, or if you newly qualify for savings, you may qualify for a Special Enrollment Period.
• If you have a Marketplace plan and get a job offer, you may lose Marketplace savings even if you don't accept the job's coverage. Update your Marketplace application. If you accept the job's plan, you may want to cancel the Marketplace plan for anyone covered by the new plan.

HealthCare.gov also notes that it's against the law for your employer to fire or retaliate against you for getting a premium tax credit on a Marketplace plan.

Quick checklist

1. Write down your job's open enrollment deadline and the Marketplace dates.
2. Find your share of the premium for the lowest-cost employee-only plan at work.
3. Ask HR whether the plan meets minimum value (or ask for the Employer Coverage Tool).
4. Fill out a Marketplace application to see whether anyone in your family qualifies for savings.
5. Compare total yearly costs, networks, and drug lists, not just premiums.
6. Decide before the earlier deadline.