Employer-sponsored coverage: If you are eligible for coverage through an employer (yours, or a household member’s) that is affordable and provides minimum essential coverage, then you are not eligible for financial assistance through the Marketplace. Please see the “How do I know if my employer-sponsored plan is affordable?” FAQ to find out more about affordability of employer-sponsored coverage.
Health First Colorado (Colorado’s Medicaid Program): If you are eligible for Health First Colorado, then you are not eligible for financial assistance through the Marketplace. You are welcome to purchase a health insurance plan through the Marketplace at full price. If you are receiving financial assistance and become eligible for Health First Colorado , your eligibility for financial assistance will end and you may want to cancel your private insurance plan to avoid being charged full price.
Medicare: If you are enrolled in either Medicare Part A or Medicare Part B, you are ineligible to purchase a plan through the Marketplace. However, if you have Premium Part A Medicare (not free Part A Medicare), you may choose to drop your Premium Part A (or choose not to enroll when eligible) and can then enroll in a plan through the Marketplace.
The choice of dropping Part A Medicare when an individual is entitled to it is an important decision and should be carefully considered. Individuals who do not enroll in Medicare when first eligible may have to pay late enrollment penalties if they later apply for both Premium Part A and Part B. Also, if an individual is entitled to free Part A Medicare and drops it, this could result in loss of retiree benefits and paying back all retirement benefits received and costs incurred by the Medicare program. Please also be aware that Medicare enrollment periods and start dates for coverage are not the same as those available on the Marketplace.
Retirement Benefits or Other Coverage: If you are enrolled in a retiree health plan or other minimum essential coverage, you may not be eligible for financial assistance through the Marketplace. For a list of other types of minimum essential coverage options, please see the “What is Minimum Essential Coverage?” FAQ.