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Use the free tool — Marketplace Subsidy Check FL

Your job offers insurance, but you can't afford it — now what?

Having a job offer of health insurance doesn't automatically mean you have to take it, and it doesn't automatically block you from marketplace help. It depends on whether the offer is considered "affordable" under the rules, and on your household income. This page walks through what to check — it is not insurance, legal or tax advice.

What "affordable" means

The law looks at the employee's share of the cost for the lowest-cost self-only plan the employer offers — just for you, not your whole family. If that amount is under the year's set percentage of your household income, the offer is generally considered "affordable," and that can affect whether you get marketplace subsidies. If it's over that percentage, the offer may be considered unaffordable, which can open the door to subsidies. The exact percentage changes by year, so ask a navigator or check current guidance rather than guessing.

The "family glitch" fix

For years, this affordability test was applied using the cost of self-only coverage even when a whole family needed a plan — which sometimes locked families out of subsidies even though covering everyone through the job would have cost far more than the affordable share. A 2023 fix changed how this is calculated for family members. Because the details matter and can be easy to get wrong, check with a free certified navigator before deciding.

If the job offer doesn't work for your family

• Preview what a marketplace plan would actually cost, and get an estimate of any subsidy, at HealthCare.gov — See plans & prices.
• Get an independent second estimate by household, income and county at the KFF Health Insurance Marketplace Calculator.
• Remember: what counts is your projected annual household income, including cash income. Under-estimating can mean repaying credits at tax time; over-estimating can mean leaving money on the table. A navigator can help you get this right, for free.
• If your children aren't on the job plan, check whether they qualify for lower-cost coverage through Florida KidCare.

Florida's coverage gap — could this matter here too?

Florida has not expanded Medicaid. Adults without dependent children generally do not qualify for Florida Medicaid no matter how low their income is, and parents qualify only at very low income. That leaves some adults under 100% of the federal poverty level with no Medicaid and, in some cases, no marketplace subsidy either — this is called the coverage gap. Read more at KFF's brief on the coverage gap. If your income is low and the job offer isn't affordable, a navigator can tell you exactly where you stand.

Can you enroll right now?

Outside of open enrollment, you generally need a qualifying life event — losing other coverage, moving, marriage, birth or adoption, or losing Medicaid/CHIP — to open a 60-day special enrollment window. Loss of Medicaid/CHIP has had extended windows in the past, so confirm the current rule. See HealthCare.gov — Special enrollment for your exact deadline; this page does not set or guarantee it.

What to do next

Use the free tool above and enter your own household, your job offer's actual employee cost, and roughly what you'll earn this year. It reads your numbers — not a hypothetical example — and tells you whether the offer likely counts as affordable, whether the coverage gap might apply, and whether a life event opens enrollment today. Then confirm the real numbers with the official HealthCare.gov preview or the KFF calculator, and talk to a free certified navigator at HealthCare.gov — Find local help before you enroll or decline coverage. Nothing you type here is stored, and none of this is insurance, legal or tax advice.

Marketplace Subsidy Check FL explains ACA and Florida coverage rules in plain language from official sources; it can be wrong, and it is not insurance, legal or tax advice. Eligibility and amounts are determined only by HealthCare.gov and Florida agencies. Nothing you type is stored.