Decline to Take Full Premium Part A to Stay on Marketplace

[traceyemoon]

Successful until now to get people to explore their Medicare insurance options when they turn 65.

Talked to a client who is turning 68 this year. He and his brothers had a scrap hauling business for many years many years ago and never paid into Medicare. He has not signed up for Medicare, as he would have to pay full-price for A

He has a fiar-sized subsidy in a Marketplace plan.

Can he just roll with that?

 

[jlallgier]

I could be wrong but I thought when you were eligible for Medicare you were no longer eligible for subsidies and it was illegal for an agent to sell them a policy. As along as they don't have A or B they can keep the plan but no subsidies. No sure anyone would want to do that.

 

[Chazm]

Yeah, pretty sure if you're eligible for Medicare then you can't get a subsidy. You can get a ACA plan though, just no subsidy. But I only do Medicare so there may be some other stipulation out there.

 

[yorkriver1]

Yeah, pretty sure if you're eligible for Medicare then you can't get a subsidy. You can get a ACA plan though, just no subsidy. But I only do Medicare so there may be some other stipulation out there.

Medicare for Dummies says: "you may be able to buy a Marketplace plan rather than Medicare if you'd have to pay a premium for Part A". That is what occurred to me, as the insureds with a tax credit probably would find it hard to pay Part A costs if not qualified by 40 quarters of work. Not that logic is what counts in the rules.

I have come across several situations like that, insured is working, over age 65, won't have 40 quarters for 2 or 3 years. One had qualified for Medicaid and Part B, some have Marketplace plans with tax credits that they will change once they have 40 quarters and enroll in Part A & B.

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Successful until now to get people to explore their Medicare insurance options when they turn 65.

Talked to a client who is turning 68 this year. He and his brothers had a scrap hauling business for many years many years ago and never paid into Medicare. He has not signed up for Medicare, as he would have to pay full-price for A

He has a fair-sized subsidy in a Marketplace plan.

Can he just roll with that?

If the current rules of Marketplace allow it--which they appear to do--, they may be able to keep on with tax credits as they are now until the new rules with more restrictive tax credits are in effect. I hear predictions of 2020 effective date for new rules, if voted in.

If this client's finances take a turn for the worse, they could eventually qualify for Medicaid, assuming it still exists in similar form to today.

 

[jlallgier]

https://www.healthcare.gov/retirees/
What if I’m 65 or older but not eligible for Medicare?
You may be able to buy insurance in the Marketplace and get lower costs on monthly premiums and out-of-pocket costs based in your household size and income. If you don’t have health coverage, you may have to pay the penalty that most people without coverage must pay.

https://www.healthcare.gov/medicare/changing-from-marketplace-to-medicare/
In most cases it’s to your advantage to sign up for Medicare when you’re first eligible because:

Once your Medicare Part A coverage starts, you won’t be eligible for a premium tax credit or other savings for a Marketplace plan. If you kept your Marketplace plan, you’d have to pay full price.
If you enroll in Medicare after your Initial Enrollment Period ends, you may have to pay a Part B late enrollment penalty for as long as you have Medicare. In addition, you can enroll in Medicare Part B (and Part A if you have to pay a premium for it) only during the Medicare general enrollment period (from January 1 to March 31 each year). Coverage doesn’t start until July of that year. This may create a gap in your coverage.