Can Medicare beneficiaries buy a plan on Health Exchange?

There is nothing in most health exchange applications to prevent people having Medicare from applying for Individual or Family Health Coverage. The same is true for paper applications. But the affirmative response to the question “Can Medicare beneficiaries buy a plan on Health Exchange?” does NOT mean that people should do it. Read below.

Can Medicare beneficiaries buy a plan on Health Exchange? – Typical Scenario

As a rule people with Medicare SHOULD NOT buy individual or family health coverage either through exchange or directly from insurance vendors. Here are the reasons:

  • Affordable Care Act (ACA), known as Obamacare, will not replace Medicare or other governmental health care programs
  • People having both Medicare parts, Part A and Part B, have coverage that is compliant with ACA requirements for the health plans.  They don’t need to enroll in additional health coverage, and they will not need to pay a penalty for lack of coverage.
  • Rumors and speculations that Obamacare may affect Medicare Supplement (Medigap) plans are nothing more than rumors and speculations. There will be no changes in Medigap plans in foreseeable future.
  • The ACA compliant plans are for people who don’t have health insurance, who buy their own insurance, or for owners of small businesses. Most Medicare beneficiaries have pretty good coverage and don’t need to consider Obamacare plans (normally more expensive than Medicare).

Can Medicare beneficiaries buy a plan on Health Exchange? – Exceptions

There are some exceptions from the above rule. Only the last of them is actual exception; the first two are not exceptions because deal with people expecting to be on Medicare soon but who are not actually yet on Medicare.

  • Disable people eligible for Medicare who actually need to wait 48 months (since disability) before the Medicare coverage will be available to them
  • People who are close to 65 but not there yet. They may use Obamacare to get health coverage until they will be entitled to Medicare at 65.
  • People who are older than 65 and not entitled to Medicare, or small number of people who currently pay the Part A premium. For the an alternative of Exchange plans may be considered; nevertheless even then Obamacare premiums may exceed Part A.

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