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

[cadylou]

I have a former client who is a business owner with a bad health history, who just got her new ACA policy with a huge subsidy. She's paying $0 premium. She's about 3 months away from Medicare. She asked me why on earth would she go into Medicare if she can keep this ACA plan at $0? I tried to explain to her about penalties around not taking part B when first eligible, but I'm not clear on the rules around how ACA plans will be treated. Is the ACA plan going to be treated the way group plans are today - as an acceptable form of insurance allowing the Medicare eligible sign up for Part B at a later date? Or will penalties apply for not joining B when eligible?

As far as I know there is no mechanism to formally kick someone out of their ACA individual plan when they turn 65.

Does anyone here know how that will work?

 

[hamben]

im not aware of any individual policy that does not cancel upon eligibility for Medicare at age 65.

 

[cadylou]

We were told here in this market (MO & KS - which are both on the Federal Exchange) by Blue Cross Blue Shield of Kansas City that if they already possessed an ACA plan, they would not be forced off at age 65. They just would not be allowed to "apply" for one after the age of 65.

 

[bluediamond]

If she remains on the aca plan I can almost bet the farm on this that her rates will be quite hefty next year and therefore reducing her subsidy.

 

[Yagents]

If she paid in 40 quarters, she will be enrolled in part A Medicare automatically.

Once on or eligible for Medicare, no more subsidies.

She can keep exchange plan at full price as secondary to medicare

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If client not paid in 40 quarters, then can keep on or off exchange policy after 65 full price

 

[hamben]

I would suggest reading the policy brochure. anthem in Missouri clearly states in eligibility section 8. not be entitled to or enrolled in Medicare A/B not sure who told you the opposite but I would bet they are wrong.

 

[cadylou]

Actually, on the rate sheets I have from the carriers the rates for plans at the age of 64 & then 65 & over are the same. That's the way the rate structures worked - they could have rates that were the same for ages 0-20, different each year between ages 21-64 & then rates stabilize.

I got on Healthcare.gov to see if I could get the question about incurring a part B penalty answered & here's my exchange with the "live chat" agent, who was named "Molimoli" (really?)

[12:45:30 pm]: Thanks for contacting Health Insurance Marketplace Live Chat. Please wait while we connect you to someone who can help. [12:45:37 pm]: Please be patient while we're helping other people. [12:45:41 pm]: Welcome! You're now connected to Health Insurance Marketplace Live Chat.

Thanks for contacting us. My name is Molimoli. To protect your privacy, please don't provide any personal information, like Social Security Number, or any other sensitive medical or personal information. [12:46:09 pm]: CALLER When I turn 65 will I be able to keep the ACA plan I just bought & keep my subsidy? or will I be forced to go to Medicare? [12:47:21 pm]: CALLER hello? [12:51:12 pm]: Molimoli The Affordable Care Act would still be available to you as an insurance provider. [12:52:03 pm]: CALLER What??? So, if I turn 65, I can keep my individual plan? I wouldn't be kicked off & forced into Medicare? Do you know how Medicare works today? [12:55:52 pm]: Molimoli It is an option to you wheather you want to move to Medicare or not but you will not be kicked off of the ACA insurance health care plan. Medicare is a health insurance program for people age 65 and older. People younger than 65 years of age may qualify for Medicare if they have certain disabilities, permanent kidney failure, or Lou Gehrig's disease. Medicare has 4 parts that cover various health care services, such as inpatient hospital care, skilled nursing home care, doctors' services, and prescription drug coverage. The health care law does not affect your eligibility for Medicare or your access to care. In addition, the Medicare Advantage program isn't changing as a result of the health care law. No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage plan, you'll still have the same benefits and security you have now. [12:57:13 pm]: CALLER So, if I opt not to take part B when I turn 65 & then wait, will I incur the penalty if I pick it up later? [12:57:45 pm]: CALLER That's if I keep my ACA plan & then decide I want Part B? [1:01:24 pm]: Molimoli As long as you have insurance either ACA or Medicare you should not incur a penalty. If you have any further questions about Medicare or Part a,b,c,d you are more than welcome to contact them and assure your questions. "

So, it appears that they do not know . . . .

If they do not incur the penalty, this could be bad. If people opt not to move to Medicare, there goes that aspect of my business over time . . . .

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Thanks Yagents - that would make sense that they'd have to pay full price - I guess my question is whether or not they need to take part B, or if they can delay & not be subject to the penalty if they keep the ACA plan?

 

[bluediamond]

If she paid in 40 quarters, she will be enrolled in part A Medicare automatically.

Once on or eligible for Medicare, no more subsidies.

She can keep exchange plan at full price as secondary to medicare

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If client not paid in 40 quarters, then can keep on or off exchange policy after 65 full price

Oh, that's right, damn I had a brain fart.

 

[Yagents]

Thanks Yagents - that would make sense that they'd have to pay full price - I guess my question is whether or not they need to take part B, or if they can delay & not be subject to the penalty if they keep the ACA plan?

I'm not a 100% sure on all this. But, nobody has to take Part B. Once enrolled in Part A, she is exempt from the penalty. The ACA plan would act as secondary supplement with medicare primary.

This is just my thought process, putting together pieces of the puzzle.

I have one client that is not eligible for medicare, and will be keeping her ACA Off exchange Assurant policy, as it's cheaper than buying into medicare and with high income penalties.

 

[hamben]

here is a link to the bcbs mo brochure . they will not be allowed to keep the plan upon eligibility for Medicare. http://file.anthem.com/03261MOMENABS.pdf
it states clearly in the eligibility section.