Timing of Medicare (3m < 65 < 3m)

[xdafly]

Trying to determine if there is any benefit or pitfall in timing medicare enrollment. Appreciate any experience shared here. So, I know that Initial Enrollment Period starts 3 months before the 65th birthday and ends 3 months after the 65th birthday. Example: Person born last day of Sep. Can enroll Jul,Aug,Sep,Oct,Nov,Dec Assuming current coverage under ACA and I already know that I can have both ACA and Medicare during the transition and I assume that if enrolling in December, with just a few days until January starts, Medicare may take a little time to kick in. In my case, that transition would amount to a 24 hour period (having both ACA and having enrolled in Medicare A,B). In reality, I would likely not wait until last day of December and would enroll some day during December. I read healthcare.gov/medicare/changing-from-marketplace-to-medicare/ What I don't know and am unsure about is : Assume some type of need for medical care, emergency, how does one go about presenting proof of insurance on January 1 of the new year if Medicare enrolled in December the week before ACA terminated ?

 

[ivinsfan]

No you can't have both ACA and Medicare at the same time...ACA coverage. and subsidy stop the day you are eligible for Medicare. There is no point in waiting because you can't buy a Medicare supplement without verification of being enrolled in Medicare.

 

[Telly]

You can "sign up" for Medicare, and set the actual "start" date. For instance, one can start "signing up" for Medicare starting 3 months prior to the month you turn 65. And set the actual benefit start date to the start of your birth month. You will get your Medicare card, but it won't be active till the "start" date.

Having the Medicare # on the card then allows you to sign up for supplement(s), whether you go Original Medicare + Plan whatever + Part D drug plan, or go the MA route. Your supplement provider needs your Medicare # to set it up, and they check with the Medicare database to be sure that it is valid. Your supplement(s) will become active on your Medicare "start" date.

So you can get Medicare and supplement(s) set up in advance, and kill your ACA effective your Medicare "start" date. No need to get iffy about processing times of turn off and turn on.
Ending an employer health insurance plan and starting Medicare works the same way.

 

[mn54]

No you can't have both ACA and Medicare at the same time...ACA coverage. and subsidy stop the day you are eligible for Medicare. There is no point in waiting because you can't buy a Medicare supplement without verification of being enrolled in Medicare.

+1
I was also thinking of keeping the aca coverage as long as possible, at the end of my initial enrollment period, but found out the month you turn 65 the aca and any subsidy are gone.

 

[xdafly]

You can "sign up" for Medicare, and set the actual "start" date. .

Since Dec 31 is 3 months (there is a 6 month enrollment window) from my DOB so I am still inside that window so I sign up last week of Dec with a Jan 1 Start Date. I am still following the Initial Enrollment signup rule(s). Now Jan 1 rolls up the next day -- how do I show I have insurance ? ---> OR --> I do the enrollment sometime earlier from Jul---Dec with a Start Date Jan 1. Then on Dec 31/Jan1, ACA rolls off into sunset automatically and Medicare kicks in automatically with plenty of time to actually have ID card(s) and anything else ready before Jan 1. Background: My current ACA payment for a Silver Plan is just $15/mo so I would rather not pay more than I have to since I am eligible to pass 3 months after my DOB and remain on ACA for those 3 months.

 

[xdafly]

I was also thinking of keeping the aca coverage as long as possible, at the end of my initial enrollment period, but found out the month you turn 65 the aca and any subsidy are gone.

According to the .gov link I posted in the original message, the enrollment window is 6 months long, 3 before 65 and 3 after 65. In my case, I plan to ride that to the end of the 3 months AFTER turning 65 while I am still inside the 3 months-after-turning-65 which takes me to end of year.

 

[xdafly]

Please read healthcare.gov/medicare/changing-from-marketplace-to-medicare/ ---> It states partially --> If you have a Marketplace plan, you can keep it until your Medicare coverage starts. Then you can end your Marketplace plan without penalty. If you like, you can keep your Marketplace plan too. But once your Medicare Part A coverage starts, you’ll no longer be eligible for any premium tax credits or other cost savings you may be getting for your Marketplace plan. So you’d have to pay full price for the Marketplace plan.

 

[xdafly]

I still do not see a problem with doing an Initial Enrollment 3 months after my end of Sep DOB. That means I sign up last week of Dec while I still have ACA. That ACA will drop off in the next few days and Medicare start date will be Jan 1 of the next year, also in the next few days. If there is a problem with that, please advise ?

 

[MissMolly]

One question and one comment.

The question - why do you prefer the ACA coverage over Medicare?

The comment - it is actually 7 months to sign up for Medicare - 3 months before your birth month, your birth month and 3 months after your birth month.

 

[Crabby Mike]

One question and one comment.

The question - why do you prefer the ACA coverage over Medicare?

The comment - it is actually 7 months to sign up for Medicare - 3 months before your birth month, your birth month and 3 months after your birth month.

+1 - you beat me to it.

 

[xdafly]

ACA costs me $15/mo for the last 3 months of the year. Why would I pay more for Medicare/month if enrollment rules allow me to apply 3 months after turning 65 ? Essentially I lose no coverage (excellent Blue Cross Silver Plan until EOY) and I would have a clean start Jan 1 of the new year on Medicare. Something wrong with that ?

 

[MissMolly]

ACA costs me $15/mo for the last 3 months of the year. Why would I pay more for Medicare/month if enrollment rules allow me to apply 3 months after turning 65 ? Essentially I lose no coverage (excellent Blue Cross Silver Plan until EOY) and I would have a clean start Jan 1 of the new year on Medicare. Something wrong with that ?

I was simply curious. I was not trying to upset you. I just wanted to understand your goal in keeping ACA. I'm astonished that you have an ACA policy for only $15 a month. I would want to keep that also. I didn't realize unsubsidized ACA policies could be had so cheaply. Good for you.

 

[Animorph]

Looks like ACA through the end of the year and Medicare Jan 1 next year should be possible with the right birth date. My birthday is in November and I'm enrolling enrolling this year. But my ACA is more like $1000/month. I'll be off ACA ASAP.

The one catch I could see was if you are taking SS benefits already. If you are taking SS, medicare enrollment in Part A is automatic at 65, no action from you. That gives no choice on ACA stop date unless you want to pay full freight.

 

[Octogirl]

+1. thanks for the info. Just Checking ...

So DH has DOB = 11.30. so he can enroll in August and set date for 11.30 or later if he wants to stay on my employer based HI.
Am I correct ?

 

[MissMolly]

Also, I'm sure you understand that if the $15 you are paying is after subsidies, you will lose those subsidies once you turn 65. Even if you wait until the very last moment of the 7 month eligibility period to sign up for Medicare, they will backdate your eligibility for Part A to your 65 birthday which then makes you ineligible to collect the premium subsidies on the ACA. On late enrollment, they automatically backdate either 6 months or to your 65th birthday, whichever is shorter. Or, if you are already collecting Social Security, you will be automatically enrolled in Part A Medicare when you turn 65. So, either way, the subsidies end at 65.

 

[FargoI]

Apologies if it appears I am hijacking this thread. Are you permitted to maintain an ACA plan, as well as, an employer sponsored retirement plan where the employer plan has no participating clinicians with a reasonable distance (>50 miles)?

 

[Telly]

I still do not see a problem with doing an Initial Enrollment 3 months after my end of Sep DOB. That means I sign up last week of Dec while I still have ACA. That ACA will drop off in the next few days and Medicare start date will be Jan 1 of the next year, also in the next few days. If there is a problem with that, please advise ?

I encourage you to spend time at Medicare.gov the official Medicare site. And use search there, too.

There's something about Initial Enrollment, that once you reach your birth month and after, the delay between signing up and possible start date of benefits increases.

A book I have mentioned before "Get What's Yours for Medicare" by Philip Moeller (real cheap on Amazon) has your exact birthday month (September) example. Page 34 & 35: With a September birth date, signing up in October slips to December 1st. Signing up in November is January 1st, and signing up in December is February 1st.

He warns to make sure your health coverage does not end before your Medicare coverage begins.

It would be good to cross-check this effect with Medicare.gov

 

[MBSC]

ACA costs me $15/mo for the last 3 months of the year.

Please see post #7 in this thread. Once Part A starts, you are no longer eligible for ACA subsidies and would pay the full premium starting September 1. Since your birthday is not on the first, Part A is retroactive to the first day of your birth month (9/1).

Then on Dec 31/Jan1, ACA rolls off into sunset automatically...

Medicare does not terminate ACA Marketplace plans. You must call the ACA Marketplace or log in to your Marketplace account and cancel the plan. If you purchased the Marketplace plan through an insurance agent, the agent can cancel the plan for you.

Since Dec 31 is 3 months (there is a 6 month enrollment window) from my DOB so I am still inside that window so I sign up last week of Dec with a Jan 1 Start Date.

That is not how it works. See below.

You can sign up for free Part A (if you’re eligible) any time during or after your Initial Enrollment Period starts. If you sign up within 6 months of your 65th birthday, your coverage will start at one of these times:

*The first day of the month you turn 65
*The month before you turn 65 (if your birthday is the first of the month)

After that, your coverage start date will go back (retroactively) 6 months from when you sign up.

When will my Medicare coverage start?

If you sign up for Part B in this month: 3 months after you turn 65.

Your coverage starts: 3 months after you sign up.

Source: https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b/when-will-my-coverage-start

Understanding the Rules for People Age 65 or Older

Part A coverage begins the month the individual turns age 65, provided he or she files an application for Part A within 6 months of the month in which he or she becomes age 65. If the application is filed more than 6 months after turning age 65, Part A coverage will be retroactive for 6 months.

NOTE: For an individual whose 65th birthday is on the first day of the month, Part A coverage begins on the first day of the month preceding their birth month. For example, if an individual's birthday is on December 1, Part A begins on November 1.

Source: https://www.cms.gov/Medicare/Eligibility-and-Enrollment/OrigMedicarePartABEligEnrol/index.html

 

[SheitlQueen]

I still do not see a problem with doing an Initial Enrollment 3 months after my end of Sep DOB. That means I sign up last week of Dec while I still have ACA. That ACA will drop off in the next few days and Medicare start date will be Jan 1 of the next year, also in the next few days. If there is a problem with that, please advise ?

I just went through this. Your ACA subsidy will end the month you are eligible for Medicare even if you do not sign up for it. Medicare will start Sept 1 for you and that is when your subsidy will end. If you keep the ACA past that date you will be paying the full price of the policy. It does not make sense to keep it. This helped me when I made the change over from my ACA plan to Medicare: https://www.healthcare.gov/medicare/changing-from-marketplace-to-medicare/

 

[xdafly]

I just went through this. Your ACA subsidy will end the month you are eligible for Medicare even if you do not sign up for it. Medicare will start Sept 1 for you and that is when your subsidy will end.

Ok. Did you have to do anything on your side to terminate ACA,... ie. Call them, Write them, Logon to Marketplace and check/uncheck/upload something for documentation ? Also, if you had autopay turned on, did Marketplace have to be notified months in advance to turn it Off ?

 

[Golden sunsets]

I think the suggestions were quite clear. Apply for medicare in advance of your birthday and stipulate the start date as your eligibility date. Then arrange on line for your ACA to end the same day.

 

[SheitlQueen]

Ok. Did you have to do anything on your side to terminate ACA,... ie. Call them, Write them, Logon to Marketplace and check/uncheck/upload something for documentation ? Also, if you had autopay turned on, did Marketplace have to be notified months in advance to turn it Off ?

I called my insurance company and I also terminated it on the Marketplace website. No documentation was required. I didn't use autopay, I sent a check in every month to the insurance company.

 

[ivinsfan]

I think the suggestions were quite clear. Apply for medicare in advance of your birthday and stipulate the start date as your eligibility date. Then arrange on line for your ACA to end the same day.

It's been crystal clear on my end..I think we have answered this question several times over...

 

[pb4uski]

So if someone has a March birthday then ACA ends Feb 28/29 and Medicare starts Mar 1?

+1
I was also thinking of keeping the aca coverage as long as possible, at the end of my initial enrollment period, but found out the month you turn 65 the aca and any subsidy are gone.

 

[pb4uski]

One question and one comment.

The question - why do you prefer the ACA coverage over Medicare?

The comment - it is actually 7 months to sign up for Medicare - 3 months before your birth month, your birth month and 3 months after your birth month.

In our case we are healthy, have little claims and unsubsidized ACA is only $250/mo so Medicare will cost more so I'd prefer to milk a few extra months.