If you are not eligible for Medicare (due to 40 quarter work requirement), you can apply for marketplace insurance on exchange. For low income folks, marketplace insurance is pretty cheap. I'm wondering how the benefits of exchange insurance compares with Medicare on average. Should one try to get on Medicare by completing 40 quarter work requirement? Does Medicare cover things that Obamacare doesn't cover?
Medicare vs Health Insurance Exchange
- Thread starter Rjx42
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this obviously depends on the state and are you referring to MAPD?
If it was in FL, a low income person could get a low premium silver plan and have CSR. If they were on Medicare, they could get a plan with low copays and a $130-164.90 part b refund.
Both options will have tight networks.
In general the medicare plans will be the better option. Plus, they won’t have a part b and D LEP
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Does the prospect not care about LEP?
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Aca far superior to a regular mapd for low income . If your eligible for the silver with big cost sharing your looking at $1200-$1400 max out of pocket and that includes your drug coverage . Believe me I’ve moved a ton of you younger ssdi people off aca to Mapd when they get there pary A and B after 24 months . Since they don’t qualify for extra help the plans are terrible compared to aca . Everyone asks “ can’t I just stay on aca “ . Nope you can’t . So your saying when someone turns 65 and has to pay for part A they can opt to stay on aca for life ? They never push them off ? I’m pretty sure the vast majority of people who don’t qualify for paid part A are on Medicaid.
Enrollees age 65 and over who have fewer than 40 quarters of coverage and certain persons with disabilities pay a monthly premium in order to voluntarily enroll in Medicare Part A. Individuals who had at least 30 quarters of coverage or were married to someone with at least 30 quarters of coverage may buy into Part A at a reduced monthly premium rate, which will be $278 in 2023, a $4 increase from 2022. Certain uninsured aged individuals who have less than 30 quarters of coverage and certain individuals with disabilities who have exhausted other entitlement will pay the full premium, which will be $506 a month in 2023, a $7 increase from 2022.
https://www.cms.gov/newsroom/fact-s...s-2023-medicare-part-d-income-related-monthly
Some providers of creditable coverage include:
- your job or your spouse’s job, provided the employer meets certain qualifications
- group health plans, such as those provided by unions
- TRICARE, for Part D only
- Veterans Affairs, for Part D only
- Indian Health Services, for Part D only
- Federal Employees Health Benefits (FEHBs)
How many quarters of substantial earnings do they have?
Yes, there will be a penalty. But because she isn’t eligible for premium free part A, she is eligible for a subsidy if she has limited income. ACA is not creditable coverage to Medicare B and D.
Rock, meet hard place . . .
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The prospects aren't eligible for Medicare because they just immigrated here as a permanent resident. Looks like they need to be present for 5 years before they become eligible for Medicare. By then they will 82 yr old. I think if they sign up for Medicare then, it shouldn't result in LEP. They have never worked here so don't have any quarters of earnings.
BUT, covered CA explicitly allows folks to remain on their health plans if they have to pay a premium for part A: [EXTERNAL LINK] - People With Medicare
There is an exception for people eligible for premium Part A. If you must pay for Medicare Part A, you may purchase a Covered California health plan instead of enrolling in Medicare Part A.
Does the above mean that they can be on ACA for forever or at least until some new law is passed?
BUT, covered CA explicitly allows folks to remain on their health plans if they have to pay a premium for part A: [EXTERNAL LINK] - People With Medicare
There is an exception for people eligible for premium Part A. If you must pay for Medicare Part A, you may purchase a Covered California health plan instead of enrolling in Medicare Part A.
Does the above mean that they can be on ACA for forever or at least until some new law is passed?
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