Is it possible to be enrolled in a Medicare and ACA (Affordable Care Act) Plan?
Generally speaking, no, you cannot be on Medicare and ACA Plan.
Why would anyone want to consider this? Cost. For lower income people it may appear to be cheaper to buy an ACA plan with a big tax credit than to purchase Medicare, particularly if you have to pay anything for Part A.
Most Nevadans, once they reach their sixties start thinking about collecting Social Security and going on Medicare. For most of us, age 65 is the Medicare age.
Medicare is comprised of two basic parts, Part A (Hospital Insurance) and Part B (Medical Insurance).
For people who have paid into the system for 40 quarters, Part A comes without cost. But for those who haven’t, the premium can be expensive, hundreds of dollars a month. Add that to a typical Part B premium of about $105 a month and you could have a monthly cost that could exceed $500 per month.
This is why some lower-income seniors are thinking about signing up for an ACA plan because they think they might be able to save on monthly premium via tax credits offered in the ACA.
Here’s the problem. Per government regulations… “Consistent with the longstanding prohibitions on the sale and issuance of duplicate coverage to Medicare beneficiaries (section 1882(d) of the Social Security Act), it is illegal to knowingly sell or issue an Individual Marketplace Qualified Health Plan (or an individual market policy outside the Marketplace) to a Medicare beneficiary”.
However, if you are already on a Qualified Health Plan, approaching age 65 and wondering if you can remain it instead of signing up for Medicare, you can. But this also has potential downsides such as paying late enrollment penalties once you do sign up for Medicare.
Bottom line, get good advice on the subject if this is something you are considering. Every situation is unique and yours probably is too. Give us a call here at the office and we’ll point you in the right direction.
Jake Young – Individual and Family Specialist