Part A Only and ACA Subsidy

Fisher

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I do exactly zero ACA biz and had this situation come up recently. Person on SSDI qualifies for Medicare but wants to keep her $25 (after subsidy) ACA plan. Tells me that she was told that if she opts out of Part B she would be able to do this.

Now I'm 100% positive that a Medicare beneficiary with both A and B canNOT also have a subsidized ACA plan (why would you?) but with Part A only is it doable? I've been Googling but results are conflicting.
 
I do exactly zero ACA biz and had this situation come up recently. Person on SSDI qualifies for Medicare but wants to keep her $25 (after subsidy) ACA plan. Tells me that she was told that if she opts out of Part B she would be able to do this.

Now I'm 100% positive that a Medicare beneficiary with both A and B canNOT also have a subsidized ACA plan (why would you?) but with Part A only is it doable? I've been Googling but results are conflicting.

From IRS,

Who Qualifies

You are eligible for the premium tax credit if you meet all of the following requirements. You:
•Have household income that falls within a certain range.
•Do not file a tax return using the filing status of Married Filing Separately ◦There is an exception to this rule that allows certain victims of domestic abuse and spousal abandonment to claim the credit using Married Filing Separately; for more information, see the Premium Tax Credit questions and answers.

•Cannot be claimed as a dependent by another person.
•Meet these additional requirements: In the same month, you or a family member: ◦Have health insurance coverage through a Health Insurance Marketplace.
◦Are not able to get affordable coverage through an eligible employer-sponsored plan that provides minimum value.
Are not eligible for coverage through a government program, like Medicaid, Medicare, CHIP or TRICARE.
◦Pay the share of premiums not covered by advance credit payments.


I believe that if you have to pay a premium for Part A, this is now an exception.
 
$25 is a lot of money to be spending on a health insurance plan. Hopefully it works out.
 
I'm almost positive that unless you are paying premium for Part A or don't qualify for Part A then you DO NOT QUALIFY for subsidy under the ACA.

You won't be kicked off or automatically disenrolled from your ACA plan, and you may not even lose your subsidy, but when you go to pay your taxes you will have to pay all that subsidy back. The IRS always gets its due.
 
I'm almost positive that unless you are paying premium for Part A or don't qualify for Part A then you DO NOT QUALIFY for subsidy under the ACA.

You won't be kicked off or automatically disenrolled from your ACA plan, and you may not even lose your subsidy, but when you go to pay your taxes you will have to pay all that subsidy back. The IRS always gets its due.

Yep, that has always been what I thought I knew as well - including incurring the payback of the ACA subsidy when tax returns are filed. I just haven't been able to find anything that specifically states this would also be the case for a person that chooses to only have Part A.
 
From Healthcare.gov:

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.
 
In addition to the issues with ACA tax credits, they are late enrolling in Part B and will have trouble with that + Part B late enrollment penalty.
There is a deadline coming right up, where if they apply to Medicare for relief before 9/30/17, they can enroll in Part B without penalty from Medicare.

http://www.aarp.org/politics-societ...are-fd.html?intcmp=AE-ALRT-ACA-MEDICARE-91817

Some Late Sign-Ups For Medicare May Be Able To Get Penalties Waived : Shots - Health News : NPR

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From IRS,

Who Qualifies

You are eligible for the premium tax credit if you meet all of the following requirements. You:
•Have household income that falls within a certain range.
•Do not file a tax return using the filing status of Married Filing Separately ◦There is an exception to this rule that allows certain victims of domestic abuse and spousal abandonment to claim the credit using Married Filing Separately; for more information, see the Premium Tax Credit questions and answers.

•Cannot be claimed as a dependent by another person.
•Meet these additional requirements: In the same month, you or a family member: ◦Have health insurance coverage through a Health Insurance Marketplace.
◦Are not able to get affordable coverage through an eligible employer-sponsored plan that provides minimum value.
Are not eligible for coverage through a government program, like Medicaid, Medicare, CHIP or TRICARE.
◦Pay the share of premiums not covered by advance credit payments.


I believe that if you have to pay a premium for Part A, this is now an exception.

Re: the last line about exception granting ACA tax credits and eligibility for those who would have to pay a premium for Part A. They must not sign up for either one.

New IRS guidance will impact people eligible for Medicare based on End Stage Renal Disease (ESRD) and those who must pay a premium for Part A*||*CMA
 
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