Who is HealthSherpa?
HealthSherpa is a simple way to compare plans and enroll individuals and families in Federal Marketplace health insurance available through the Affordable Care Act. It is free to use HealthSherpa to shop plans and fully complete your enrollment application. You can typically make your first insurance payment directly through HealthSherpa, with subsequent monthly payments made directly to your insurance company, but there is no cost to use the HealthSherpa platform to shop or enroll.
HealthSherpa is a private enrollment platform that helps you compare options and complete enrollment, but it is not an insurance company. HealthSherpa also has a team of dedicated Consumer Advocates who can assist you with your enrollment journey. To reach them please call 855-772-2663
Is HealthSherpa an insurance company?
No, it is a private platform that helps you shop for and enroll in Marketplace health insurance plans, and it is free to use for your enrollment.
Who can buy coverage through the Marketplace?
Consumers may be able to buy Marketplace coverage if they:
Live in the United States
Are a U.S. citizen, U.S. national, or lawfully present immigrant
Are not incarcerated (other than pending disposition)
Do consumers have to reside in the U.S. to purchase Marketplace coverage?
Yes. Consumers must be a U.S. citizen, U.S. national, or have an eligible lawful presence status and must physically live in the United States (and intend to reside here) in order to purchase Marketplace coverage.
A U.S. citizen living abroad does not meet the residency requirement and therefore cannot enroll in a Marketplace plan until they return to live in the U.S.
Am I eligible for a Marketplace plan if my employer offers insurance?
If your employer offers health insurance you can still enroll in a Marketplace plan, but you may not qualify for subsidies (premium tax credits) unless your job-based plan is unaffordable or does not meet minimum value.
A plan is considered unaffordable if the share you pay for coverage is more than a set percentage of your household income. For the 2026 plan year, the affordability limit is 9.96%.
In the past, affordability was only based on the cost of coverage for the employee. Now, Marketplace rules also look at the cost of coverage for your spouse and children. This means family members may qualify for savings even if the employee does not. You may also still qualify for Marketplace coverage if:
The employer plan does not provide minimum value (doesn’t cover enough services or costs)
The employer only offers an HRA or arrangement that isn’t considered affordable
To see if you or your family might qualify for Marketplace savings:
Find the monthly premium you would pay for the lowest-cost plan your employer offers (employee-only and family coverage, if needed)
Divide that premium by your household monthly income
If the percentage is higher than 9.96% (for 2026), you may qualify for Marketplace subsidies
The Marketplace will check this when you apply, but having these numbers ready makes it easier to compare.
Who should I include in my application?
When applying for health coverage, it's important to include everyone in your "tax household" on your application. This includes the tax filer, their spouse, and any tax dependents, even if some members don't require coverage. Information about your entire tax household is needed to determine your eligibility for financial assistance, such as tax credits and cost-sharing reductions.
Be sure to include:
Yourself: The primary applicant must include their own information.
Your spouse: Include your spouse if you have one, even if they are not applying for health coverage.
Note: If you are married, you must file jointly with your spouse in order to be eligible for financial assistance.
Your tax dependents: This includes anyone you claim as a dependent on your federal income tax return, whether they live with you or not and even if they have their own income.
Your children: Any children who live with you should be included, even if they make enough money to file their own tax return.
Other dependents: You may need to include other people under 21 whom you are taking care of and who live with you.
Relationship | Include in household? | Notes |
Dependent children (including adopted and foster children) | Yes | Always include any child you claim as a tax dependent, regardless of their age. |
Children, shared custody | Sometimes | Include children whose custody you share only during years you claim them as tax dependents. |
Unborn children | No | Do not include a baby until it's born. You can enroll your baby up to 60 days after birth. |
Non-dependent child or other relative living with you | No | Include them only if you’ll claim them as tax dependents. |
Dependent parents | Yes | Include parents only if you’ll claim them as tax dependents. |
Dependent siblings and other relatives | Yes | Include them only if you’ll claim them as tax dependents. |
Spouse | Yes | Include your legally married spouse, whether opposite sex or same sex. In most cases, married couples must file taxes jointly to qualify for savings. |
Divorced spouse | No | Don't include a former spouse, even if you live together. |
Spouse, living apart | Yes | Include your spouse unless you’re legally separated or divorced. (See next row for an important exception.) |
Spouse, if you’re a victim of domestic abuse, domestic violence, or spousal abandonment | Not required | In these cases, you don’t have to include your spouse. See rules for victims of domestic abuse, domestic violence, or spousal abandonment. |
Unmarried domestic partner | Sometimes | Include an unmarried domestic partner only if you have a child together or you’ll claim your partner as a tax dependent. |
Roommate | No | Don’t include people you just live with — unless they’re a spouse, tax dependent, or covered by another exception in this chart. |