Elder Law: “Do I Need To Sign Up In The ACA’s Insurance Marketplace If I Am Already Covered By Medicare?”

In short – no.  I was recently alerted that many seniors are confused about whether they needed to sign up by the January 1, 2014 deadline in the new ACA’s (Affordable Care Act) insurance marketplace if they were already covered by Medicare.  I read a great article in NAELA News’ recent publication (Dec. 2013/Jan. 14) by Judith Grimaldi (link to article below), in which she quickly outlines the causes of the confusion and dispels a few myths while she’s at it. Ms. Grimaldi is an experienced Elder Law attorney and the editor of the regular CAPsule column in NAELA News.

http://www.naela.org/Public/Library/Publications/Publications_Main/NAELA_News_Archive/NAELA_News_2013/Dec2013_Jan2014/CAPsules.aspx

Ms. Grimaldi reminds seniors that Medicare is considered qualified coverage and, therefore, seniors are not required to sign up in the ACA marketplace exchange. As a matter of fact, if you do sign up, they won’t stop you – you’ll just end up with unnecessary double coverage.

We all know that confusion abounds around the implication of the ACA, especially because the Medicare Open Enrollment start date and the ACA Insurance Marketplace enrollment date were so close together (both this last October). But, they’re not connected. Additionally, Ms. Grimaldi reminds Elder Law attorneys and seniors that the ACA changes are almost entirely to seniors’ benefit.  You do get to keep your doctor if you wish, your prescription costs won’t go up, and your Medicare premiums are rising more slowly than they would have if not for the ACA. She does outline some increase in premiums for high-income seniors, and some concern over potential shrinkage of Medicare Advantage plans and/or benefits in those plans. But, CMS (Center for Medicaid and Medicare Services) provided funding to slow some of those changes/cuts and make them somewhat more gradual.

Ms. Grimaldi also carefully outlines concerns for those currently transitioning or transitioning in the future from Medicaid to Medicare at age 65. But, since that affects such a specific category of seniors, I would suggest reading the article in full in order to be informed on your own or on your loved one’s behalf.

As scary as the unknown can be – and we’re all jumping in together here — it’s nice to be re-assured that our Medicare covered family and friends are set for this transition and that most should experience better coverage with increased benefits at an affordable rate.

ALL READERS:   This blog is not, nor shall it be deemed to be, legal advice or counsel. This blog does not create an attorney-client relationship with any reader.  It is designed to encourage thoughtful consideration of important legal issues with the expectation that readers will seek professional advice from a licensed attorney.