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HC Exchange Eligibility if Retiree Coverage Available
Old 10-01-2013, 08:17 AM   #1
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HC Exchange Eligibility if Retiree Coverage Available

Sorry if I missed any previous threads that may have answered this question.

My spouse is retired and is covered by a retiree health insurance plan. I am currently employed and have coverage through my employer. If I retire early I am eligible to be added to my spouse's plan.

All the ACA materials I've read refer to eligibility on an "employer's" plan. I'm just wondering if my spouse's retiree plan counts as an "employer." Common sense tells me that it does and that I am not eligible to purchase insurance on the exchanges, but I've never seen this explicitly answered.
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Old 10-01-2013, 09:07 AM   #2
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Common sense tells me that a retiree plan is not from an employer. I'm assuming this until I find out otherwise.

My spouse is also retired and our insurance is through the retiree health plan but the pension system has made changes that increased our costs substantially (currently 16.8% of gross income) and they are eliminating coverage for spouses in the near future.

Even if you have employer or other insurance my understanding is that if your premium is more than 9.5% of your income you can shop for less expensive insurance on the exchange and get a subsidy if you qualify, income wise. If I'm incorrect on that I'm sure someone more informed will correct me.
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Married, both 62. DH retired June, 2010. I have a pleasant little part time job.
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Old 10-01-2013, 12:56 PM   #3
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Quote:
Originally Posted by GalaxyBoy View Post
Sorry if I missed any previous threads that may have answered this question.

My spouse is retired and is covered by a retiree health insurance plan. I am currently employed and have coverage through my employer. If I retire early I am eligible to be added to my spouse's plan.

All the ACA materials I've read refer to eligibility on an "employer's" plan. I'm just wondering if my spouse's retiree plan counts as an "employer." Common sense tells me that it does and that I am not eligible to purchase insurance on the exchanges, but I've never seen this explicitly answered.
I don't know the answer (and am curious about it since I have insurance only through DH's retiree insurance. I do work very limited hours so no eligibility for insurance through that).

However, as I understand it at a minimum you would be eligible to purchase insurance on the exchange. The question is whether you get a subsidy if you would otherwise be eligible due to income. That is what I don't know.

Of course, I think you could also buy an off-exchange ACA compliant policy without subsidy.
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Old 10-02-2013, 08:17 AM   #4
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Just wondering if any of the ACA experts on the forum had an opinion...
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Old 10-02-2013, 08:58 AM   #5
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I've been wondering the exact same thing, and don't have definite answers, but here are my educated guesses based on ambiguous information that I've read:
- Retiree insurance is NOT considered employer insurance
- Having access to a spouse's employer plan is equivalent to having access to your own employer plan.
Now someone correct me if I'm wrong, which I well may be.
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Old 10-02-2013, 09:10 AM   #6
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Originally Posted by GalaxyBoy View Post
Just wondering if any of the ACA experts on the forum had an opinion...
Not an expert, just doing my own learning. You can use the exchange if you want. Some employers payed for the retirees premiums in the retiree plan but few do that today. Most have to pay full costs now. Also if your on COBRA you can drop it. See the link

https://www.healthcare.gov/what-if-i...-for-medicare/
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Old 10-02-2013, 09:18 AM   #7
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Quote:
Originally Posted by GalaxyBoy View Post
All the ACA materials I've read refer to eligibility on an "employer's" plan. I'm just wondering if my spouse's retiree plan counts as an "employer." Common sense tells me that it does and that I am not eligible to purchase insurance on the exchanges, but I've never seen this explicitly answered.
You are eligible if you are lawfully in the US and not in jail. Regarding subsidies, this is not an employer plan for you, so you are most likely eligible if total household income is between 100% and 400% of the FPL. see here A Reader Asks: When I Retire Can My Husband Get Coverage On The Marketplace? - Kaiser Health News
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