Should a Medicare Recipient Have Odumbocare Too?

[wehotex]

I am working with an U65 Medicare mb (eff 7-1-14) who has had an Odumbo Aetna plan since Dec 2013. Per this guy, Aetna reps have told him that he could have both. If this is not correct, does Aetna have to reimburse him retroactively to July 2014? He is 55 yr old male who pays $113/mo to Aetna.

 

[goillini52]

I am working with an U65 Medicare mb (eff 7-1-14) who has had an Odumbo Aetna plan since Dec 2013. Per this guy, Aetna reps have told him that he could have both. If this is not correct, does Aetna have to reimburse him retroactively to July 2014? He is 55 yr old male who pays $113/mo to Aetna.

I'm pretty sure you can't have both and he will be better off with Obamacrap, as all that's available in Texas for U65 is Plan A(and that doesn't cover squat). Aetna/Continental Life is over $700 a month. Mahattan Life is half as much.

 

[BeeSelective]

Aetna rep didn't read the rules.

 

[WCMason]

I am working with an U65 Medicare mb (eff 7-1-14) who has had an Odumbo Aetna plan since Dec 2013. Per this guy, Aetna reps have told him that he could have both. If this is not correct, does Aetna have to reimburse him retroactively to July 2014? He is 55 yr old male who pays $113/mo to Aetna.

Would not bet on a refund. If he's lucky the IRS won't go after him to pay the premium credit back.

 

[G.Gordon]

Taking the APTC while eligible for Medicare is against the rules. He better dis-enroll ASAP.

 

[sshafran]

Taking the APTC while eligible for Medicare is against the rules. He better dis-enroll ASAP.

Curious - haven't looked this up yet - do they make a distinction between being eligible for Medicare and being enrolled in Medicare?

i.e., eligible but not taking it because they chose obummer insurance?

 

[G.Gordon]

I don't think so. To not enroll in Medicare would mean they'd also have to drop part A which is automatic and free and I believe that action would stop their SS disability benefit payments. Not sure on the last part.

Basically, if they are eligible for one type of government insurance they are not eligible for the tax credit to buy insurance.



Can I choose Marketplace coverage instead of Medicare?

Generally, no. It’s against the law for someone who knows you have Medicare to sell you a Marketplace plan.

But there are a few situations where you can choose a Marketplace private health plan instead of Medicare:

If you’re paying a premium for Part A. In this case you can drop your Part A and Part B coverage and get a Marketplace plan instead.

If you’re eligible for Medicare but haven’t enrolled in it. This could be because:
◦You’d have to pay a premium
◦You have a medical condition that qualifies you for Medicare, like end-stage renal disease (ESRD), but haven’t applied for Medicare coverage
◦You’re not collecting Social Security retirement or disability benefits before you’re eligible for Medicare

If you’re getting Social Security retirement or disability benefits before you’re eligible for Medicare, you’ll automatically be enrolled in Medicare once you’re eligible.

Before choosing a Marketplace plan over Medicare, there are 2 important points to consider:
◦If you enroll in Medicare after your initial enrollment period ends, you may have to pay a late enrollment penalty for as long as you have Medicare.
◦Generally you can enroll in Medicare only during the Medicare general enrollment period (from January 1 to March 31 each year). Your coverage won’t start until July. This may cause a gap in your coverage.

Learn more about Medicare enrollment rules.

 

[WCMason]

Curious - haven't looked this up yet - do they make a distinction between being eligible for Medicare and being enrolled in Medicare? i.e., eligible but not taking it because they chose obummer insurance?

Eligibility rules. Though it doesn't matter in cases like this. Because he--and everyone under 65 eligible for Medicare--is receiving SS benefits he can't decline Medicare.

 

[Tkruger]

It states during the enrollment process that if found eligible for other coverage that the HC.gov coverage will be lost.

During the enrollment when you get to the determination letter does it ask to show proof that they are not eligible for Medicare?

We've seen this multiple times and it was due to the fact that Medicare coverage was already in place/client was eligible due to disability.

 

[bluediamond]

If you’re eligible for government-sponsored health insurance like Medicare, Medicaid or Tricare, you won’t qualify for a subsidy. This is true even if you’re not actually enrolled in the government-sponsored health insurance. It’s your eligibility that disqualifies you for a subsidy.