ACA & Medicare???

[reubenray]

For the last two years my wife and I have been getting our health insurance using ACA. I will be turning 65 next September/2016 and I have no idea what the medicare setup will be. So I have a few questions.

1) What happens when I do turn 65?

2) Will medicare start taking money from my SS when I turn 65 in September or the beginning of next year?

3) What happens to my ACA plan when I turn 65?

4) Will I still making monthly payments for something I may not be able to use.

5) How would we plan on getting the insurance for 2017?

6) Will the ACA plan be based on my wife's income or still both of us? We file jointly.

 

[MichaelB]

1) What happens when I do turn 65?

Magical things happen

2) Will medicare start taking money from my SS when I turn 65 in September or the beginning of next year?

You need to enroll in Medicare, you can do so begining 3 months before your 65th big-day, and then I believe you need to sign up for Medicare Easy Pay.

3) What happens to my ACA plan when I turn 65?

Nothing. It goes on without you. On your 65th birthday you are no longer eligible for an ACA plan. Just to be sure, though, if the insurer does not notify you that your plan coverage ends on the first day of the month you celebrate 65 years, you should notify them.

4) Will I still making monthly payments for something I may not be able to use.

No

5) How would we plan on getting the insurance for 2017?

The ACA policy for your DW needs to be renewed (or reapplied for) during the open enrollment period in November. Medicare also has a yearly enrollment period when you can change plans, subject to any underwriting conditions.

6) Will the ACA plan be based on my wife's income or still both of us? We file jointly.

You are referring to premium assistance? It is based on total household income, so if your DW is currently eligible for assistance, that should continue in 2017.

 

[reubenray]

If my ACA plan stops when I turn 65 how will the DW be insured? We have a joint plan.

 

[lemming]

I'm surprised your mailbox is not full of brochures for medicare supplements. I even had people knocking on my door to sell me insurance.
If you want part D-prescription drugs or supplemental coverage you have to sign up for that. Those are not covered by ACA marketplace although you carrier might have that type of plan. I chose Kaiser because they came with a network of doctors.

 

[MichaelB]

If my ACA plan stops when I turn 65 how will the DW be insured? We have a joint plan.

Your DW will be eligible for special open enrollment when your coverage ends. It is good you are planning well ahead of time. One option to consider is, for 2016, having separate individual policies for each of you. The cost should be the same as one joint policy, that way your DW will not have to deal with special open enrollment. She also will not have a risk of her yearly deductible and total out of pocket limits being reset to 0 when you leave the policy and hers is reissued as an individual one.

 

[reubenray]

Your DW will be eligible for special open enrollment when your coverage ends. It is good you are planning well ahead of time. One option to consider is, for 2016, having separate individual policies for each of you. The cost should be the same as one joint policy, that way your DW will not have to deal with special open enrollment. She also will not have a risk of her yearly deductible and total out of pocket limits being reset to 0 when you leave the policy and hers is reissued as an individual one.

If we do separate policies how will the income for the supplement work? We are living right now only on my SS and retirement being she is only 59. She will start drawing some of her retirement next year.

 

[Bestwifeever]

DH had not started SS when he turned 65 and went on Medicare. He was billed for and paid for Medicare each month. At 66, his FRA, he started his Social Security, and Medicare then automatically switched to being deducted from that--DH had no choice.

So re No. 2 above, if OP has already started SS before Medicare, it sounds like Medicare will be deducted from his SS payments each month.

 

[MichaelB]

DH had not started SS when he turned 65 and went on Medicare. He was billed for and paid for Medicare each month. At 66, his FRA, he started his Social Security, and Medicare then automatically switched to being deducted from that--DH had no choice.

So re No. 2 above, if OP has already started SS before Medicare, it sounds like Medicare will be deducted from his SS payments each month.

Good to know. Thanks.

If we do separate policies how will the income for the supplement work? We are living right now only on my SS and retirement being she is only 59. She will start drawing some of her retirement next year.

Do you mean the premium assistance? It works the same way for two individual policies as it does for one joint policy. For the individual policies, it applies the assistance in equal parts to each of you.

 

[meierlde]

Note that if you are receiving SS benefits you will be automatically enrolled in Medicare and receive your cards about 2 months earlyier (Medicare starts on the first day of the month you turn 65 except if you are born on the first when it starts a month earlier. You will need to select a part D plan or go to medicare advantage plus some medigap for the 20% of part B that you have to pay.

 

[MBSC]

About 3 months before turning 65, contact a local SHIP counselor. They can help you select a Medigap and Part D plan.

Turning 65: Turning 65? What You Need to Know about Signing up for Medicare | ElderLawAnswers

ACA to Medicare transition: https://www.healthcare.gov/medicare/changing-from-marketplace-to-medicare/

 

[rodi]

Good to know. Thanks.

Do you mean the premium assistance? It works the same way for two individual policies as it does for one joint policy. For the individual policies, it applies the assistance in equal parts to each of you.

If the OP is in California this is not the case. The exchange there does not allow separate policies and still qualify for the premium assistance in advance. But you can get it back at tax time if you pay full premium during the year but qualify based on household income. Hopefully covered California will fix this for 2016.