Question: Can someone’s dependents qualify for Medi-Cal or subsidies for coverage if the parent has coverage through a small employer that offers affordable coverage and meets minimum standards?
Answer: Dependents under 19 with access to employer-based group health insurance can qualify for Medi-Cal assuming other requirements are met, but those dependents cannot qualify for a subsidy in Covered California.
The response above is inaccurate. According to IRS Rules published in document 2012-12421:
“Under section 36B(c)(2)(C), an individual who may enroll in an eligible employer-sponsored plan may nonetheless be eligible for a premium tax credit if the employer-sponsored coverage either is unaffordable or fails to provide minimum value.”
Additionally, it should be understood that premium tax credits are available whether a person purchases insurance through the Exchange or not. “ADVANCE” tax credits, payable directly to one’s health insurer, are only available when a consumer enrolls in an individual health plan through the Exchange.
Because the premium tax credit is refundable, a taxpayer could choose not to accept advance payments and receive the credits at the time he/she files the tax return for the year.