Another ACA to Medicare question

[ivinsfan]

Anyone reading here that has access to a broker use the broker and save yourself some hassle

 

[xlf11]

We did twice from ACA to Medicare: first myself while DW remained in ACA then DW from ACA to Medicare alone with the same agent. Everything went smoothly especially DW got Medicare approval 3 days before starting Medicare starting day (delayed due to SSA local office semi-closed during Covid).

 

[pirsquared]

Anyone reading here that has access to a broker use the broker and save yourself some hassle

We did twice from ACA to Medicare: first myself while DW remained in ACA then DW from ACA to Medicare alone with the same agent. Everything went smoothly especially DW got Medicare approval 3 days before starting Medicare starting day (delayed due to SSA local office semi-closed during Covid).

So maybe I should have done everything with an agent. However, the problem started when I involved a human being other than myself. On 6/1, the marketplace rep just went through the life change application (with all the same info but with only DD and I included), just as I have been doing myself whenever we had an income change. I remember thinking that I could have done that myself back in May and it would have been effective 6/1. I thought there was something different that needed to be done to remove DH and that's why everyone keeps saying to call instead of doing it online. Or maybe the rep was supposed to do something different and that's what caused the whole problem...

 

[Rianne]

Yikes! Say I call and they don't cancel my ACA in time. I'm still on ACA for another month. Costs me $8.95 but I imagine that would mess up everything for the hospital? Is it illegal to have ACA and Medicare at once due to their mistake?

 

[xlf11]

Yikes! Say I call and they don't cancel my ACA in time. I'm still on ACA for another month. Costs me $8.95 but I imagine that would mess up everything for the hospital? Is it illegal to have ACA and Medicare at once due to their mistake?

You could be on ACA and Medicare at the same time, but you won't be eligible for ACA tax credit once you are on Medicare, mistake or not.

 

[pirsquared]

Yikes! Say I call and they don't cancel my ACA in time. I'm still on ACA for another month. Costs me $8.95 but I imagine that would mess up everything for the hospital? Is it illegal to have ACA and Medicare at once due to their mistake?

You could be on ACA and Medicare at the same time, but you won't be eligible for ACA tax credit once you are on Medicare, mistake or not.

Right, it's allowed to have both but no subsidy/premium tax credit allowed when you are Medicare eligible. So the main problem is cost. Also, our ACA insurance thinks Medicare is primary and Medicare thinks the ACA insurance is primary. Fun times :/

Anyway, the Marketplace escalation process did work as designed, but it was slow and thus it is taking time to correct all the ripple effects of the original error. I am still not 100% sure when/how I was supposed to make this change to avoid this issue. At least I have more than 10 years before I have to switch myself over. However, DD starts a job with benefits this fall so we have to get through that transition this year as well. 2023 is going to be a much, much simpler year for our family.

 

[xlf11]

I would strongly recommend to use an agent for ACA and ACA/Medicare transition from my own experience. For example, I would not get a local ACA insurance company for our region (new and no star on Healthcare.org), if not recommended by the agent. Our two transitions were all done by him with phone/online combination and he seems to know which one works the best and when...

 

[pirsquared]

I would strongly recommend to use an agent for ACA and ACA/Medicare transition from my own experience. For example, I would not get a local ACA insurance company for our region (new and no star on Healthcare.org), if not recommended by the agent. Our two transitions were all done by him with phone/online combination and he seems to know which one works the best and when...

Yes, this is good advice. I will plan to do this when I switch to Medicare in 14 years.

However, it still seems like this should be a simple transition. There must be huge numbers of people making this transition every day. It should not be this complicated.

I think we are mostly through the transition now. The Marketplace has the correct info, our insurance has the correct info, and now it is updating with Medicare. The Medicare rep (from the Benefits Coordination Resolution Center) was able to change it, but she said it will take 72 hours to update in their system. After that, we can have the doctor's office send the claim back through. I will probably call Medicare back and confirm it has updated before having the doctor send it back through so we avoid additional hassle.

 

[Carpediem]

I would strongly recommend to use an agent for ACA and ACA/Medicare transition from my own experience. For example, I would not get a local ACA insurance company for our region (new and no star on Healthcare.org), if not recommended by the agent. Our two transitions were all done by him with phone/online combination and he seems to know which one works the best and when...

What's the best way to find an agent to help with this? And does the agent charge the client for their service?

 

[xlf11]

What's the best way to find an agent to help with this? And does the agent charge the client for their service?

We found one on the Healthcare.org website recommended list with our zipcode, who happened to be both ACA and Medicare qualified (probably most are as both government programs have lots of similarities). So we have used him for both our ACA and Medicare for about 4-5 years. Agents are paid by insurance companies, so it's free whether you use them or do your self. They certainly know much better than us even after we were on ACA and Medicare for a few years...