Will Medicare Eligibles Stay with ACA Rather Than Move to Medicare?

[cadylou]

They don't have to pick up part B, but if they don't do it when they are first eligible, there are hefty penalties if they pick it up later. If they are on an employer based group & have part A with the group as the primary payer, then when they lose the group plan & pick up B, there is no penalty since the group plan is considered a qualified plan/creditable coverage. I guess the ACA plan would be considered the same way & if they wanted to get rid of it & move to part B, there would be no penalties? I'm just trying to understand it fully. There would be many reasons why someone might want to go to full Medicare - less expense for one, and the freedom to go to any doctor or hospital that takes Medicare. I just think it's weird that they'd allow people to stay on the ACA plan after 65 . . . .

 

[hamben]

in the 20 years I have been selling individual policies. I have never read one or worked with a company that did not terminate upon eligibility for Medicare. employees can stay on group sponsored plans but not individual. The ACA mandates what must be covered but the client still must maintain eligibility just as any other policy prior to the ACA. I would recommend calling the carrier direct and if you are told otherwise ask where it is written and reference the product barouche eligibility section of the company you are working with. The great part about insurance is it must be in writing some were...

 

[houcoogster]

If you are eligible for medicare part A you will get dropped from the indiv plan if you don't buy Part B when first eligible and decide to buy it later you will get popped with a hefty fine tacked onto the Part B premium.

Group plans are different no penalty for not taking Part B when first eligible.

Now take a person that is not eligible for Part A they should have the choice to stay on the indiv plan or BUY into Part A. I think this is the way it works, at least today anyway.

 

[cadylou]

Well, maybe it's different for them, but BCBS of KC told us in their big meeting before this O-Care enrollment started was that a Medicare eligible person would not be able to "enroll", but if someone who had a plan turned 65, there would be no trigger to terminate their plan, the way there is today in the individual market.

 

[houcoogster]

Well, maybe it's different for them, but BCBS of KC told us in their big meeting before this O-Care enrollment started was that a Medicare eligible person would not be able to "enroll", but if someone who had a plan turned 65, there would be no trigger to terminate their plan, the way there is today in the individual market.

Well that could be true. In almost all cases the cust. would be better off with Medicare A and B even if they had to buy into Part A. After comparing the cost of the two options that is.

 

[hamben]

how many times have we worked with home office people that had no idea what they are talking about. They can not keep individual plans upon eligibility for Medicare. its in writing in there brochures. it will be in the policies if we ever get to see one. at least none of my clients have gotten a ACA policy yet. Clients have gotten cards but no policies to speak of.

 

[cadylou]

Well, I agree with you there hamben - "if we ever get to see one . . ." I'd love to see an actual policy with all of the legal terms & conditions attached. At any rate, the ACA doesn't treat someone turning 65 the same way as individual plans have to date, so understand that if someone does have a plan, they can keep it if the provider allows it. The carriers here that are on the exchange (BCBS and Coventry) both have rates for people over the age of 65 on their rate sheets & no verbiage that says they would automatically terminate once someone is Medicare Eligible. There was a lengthy discussion about this on an insurance group on LinkedIn too - can't remember which one, but the consensus was that the ACA doesn't allow someone over 65 to purchase a plan, but will allow someone to keep one. I'm just telling you that we've been told that too & it complicates things with Medicare rules if that's truly the case.

 

[hamben]

I realize what you have been told. however the plan brochure link I pulled from healthcare.gov says they are not eligible for the insurance if they are eligible for Medicare. I have talked to home offices at a few BCBS and they still don't understand why the kids are getting kicked to Medicaid plans. So for them to give you wrong information would not be uncommon. ask them to clarify the language in there brochure. I could see a company not saying anything so they could collect gov premiums for a few months and if any claims come in saying nope your Medicare sucker! no really im trying to help. I just have never heard of a individual policy not terminating upon some one being eligible for Medicare. Think of the mess it would cause with HSA plans if people over the age of 65 were allowed to keep them but were not allowed to fund the HSA by law..They are wrong I would bet the farm..

 

[cadylou]

Your plan brochure was specific to Anthem. I have different information & rates that are published for people over the age of 65 from companies here. There was a lengthy discussion on this out on LinkedIn previously that may interest you. I found it:
http://www.linkedin.com/groupItem?v...bc5c084ee&trk=groups_search_item_list-0-b-ttl


Hopefully you can see it. Not sure if you have to belong to the group or not .. .


Anyway, just one more thing to be confused about & not have complete information that we can pass along to a client while being certain that the information we give is sound . . . .ugh! Frustrating.

 

[houcoogster]

Hey, you know this may just be the precursor to the "New Medicare" for the gen X-ers and later.

They might just close the door to new medicare enrollees altogether and say go to the exchange and see what you qualify for you old geezer.