Transition from Obamacare to Medicare

[Packman]

I have seen some threads on this topic before and there seemed to be some difficulties with the transition, so I am researching in advance for next year.

I will be eligible for Medicare in September, 2021. My DW will not be 65 until 2023. I have spoken to both my current HI company and the Marketplace as both my DW and I are on healthcare.gov plans now (we are on the same plan). I am the primary contact on our current marketplace application. The marketplace people tell me to call them the day before I transfer to Medicare (8/31/21) and they will cancel my policy and switch the application over to my wife's name. However, my current HI company says that when that happens it will be a 'new' application and my wife's ($6,500 annual) deductible will reset to zero for the rest of 2021 even though she will remain on the same plan. Not sure if all of this is true and correct since my current (no-name) HI company usually doesn't know what they are talking about. So, I am wondering if we should/can just start the year of 2021 with two separate applications on the Obamacare Marketplace and two separate HI policies, so it would be very easy to cancel mine and she would not have two deductible's for 2021. Would that work? Is there any penalty, or additional premium to do that? We have had marketplace plans for 5 years, but always had the same plan on just one application.

I would appreciate any advice from those that have gone through this, or know more than I do. It's sad that I cannot trust the people I talk to with my insurer, and even the marketplace - but both have provided wrong information to me in the past on other topics. Thanks.

 

[spncity]

Can you just switch and make her the primary starting in 2021? Then you (the one switching to Medicare) can just drop off the policy and she continues.

That's what we did (although it was a small business group plan and not ACA).

 

[Packman]

As I understand from my insurance company that will still restart the deductible, but that's a possibility that I will check on.

 

[toddm]

We have had separate ACA policies for the last couple of years in anticipation of this very event. Although it’s still a ways off, my wife is a year and a half younger than I am so it will be an issue. We both have high deductible policies and the subsidies are split between us. This seems like the easiest and cleanest approach to me

 

[pb4uski]

Packman.... I think you are on the right track... just get 2 separate policies for 2021.

We've had separate ACA policies for years (no ACA subsidies).

We originally did it because way back when because if we bought one policy for the two of us with a $12k deductible we would have to have $12k of expense between the two of us before any insurance kicked in. But if we had individual policies and one of us had over $6k in claims then the insurer would pay claims in excess of $6k... so it was an easy decision.

They later changed the way the deductible worked to be stacked rather than aggregate so it didn't matter but we just kept the individual policies since we had it set up that way.

We both turn 65 in 2020 and DW's transition to Medicare in March went smoothly and I anticipate that mine will too... in fact, I just signed up for Medicare today.

 

[audreyh1]

DH and I always had separate ACA policies, so his switch to Medicare this year was seamless and didn’t affect me. No ACA subsidies for us.

 

[sengsational]

So, pb4uski, do you attribute the smoothness of March to having two policies?

Like you, I had separated them because of the stacked/aggregate thing, and kept that a few years after the rule change. But the last few years I've bought just one, just for simplicity, and also if one of us hits the family level, the other gets free services (not like that is likely).

Still a bit of time for us, but might tap your experience now, while it's fresh in your head.

 

[Murf2]

If a couple does switch to two individual accounts, do you just split your combined income in half for your estimated income when you apply?

Thanks
Murf

 

[toddm]

If a couple does switch to two individual accounts, do you just split your combined income in half for your estimated income when you apply?

Thanks
Murf

No. Here are the instructions I followed:

For a married filing joint couple the way to do this is that you fill out the application for your household combined income. After you submit the application you will find your subsidy for the household. Before you look for plans there is a place to make GROUPS. Make a group for one of you then make a group for the other person. Each of you gets 1/2 of the total subsidy and you can each choose a plan. This is how you can choose different plans if you want. We usually choose the same plan (individual policies) but each person can use their half of the subsidy on their choice of plan.

 

[Murf2]

Thanks toddm!

Sounds simple enough. Are those instructions from the healthcare.gov site?

If you happened to check, does it cost about the same either way?

Thanks again!
Murf

 

[toddm]

Those were instructions I from another forum post some time ago. I'm sure the healthcare.gov site has additional information if you were to search for groups.

My recollection is that the cost is the same either way. In our case, we actually chose slightly different plans, since my wife's medical needs are greater than mine. But had we chose the same plan, the costs would have been the same as if we had chosen a single plan.

 

[sengsational]

If both plans are the same, the cost is the same...to the penny. And subsidy is also exactly the same.

 

[ShokWaveRider]

We had a joint policy when I reached Medicare Age. DW was only 60. I went to Boomer Benefits and arranged my Medicare + Supplement.

We were using a local insurance rep for Florida Blue to navigate the ACA for us. She just seamlessly set up DW with her own plan. No issues at all.

 

[pb4uski]

So, pb4uski, do you attribute the smoothness of March to having two policies?

Like you, I had separated them because of the stacked/aggregate thing, and kept that a few years after the rule change. But the last few years I've bought just one, just for simplicity, and also if one of us hits the family level, the other gets free services (not like that is likely).

Still a bit of time for us, but might tap your experience now, while it's fresh in your head.

I don't know, but it just seems more straightforward and less things to get tangled up.

The other reason that I hadn't combined them is that we had a devil of a time getting the powers that be to recognize that we qualified for the catastrophic plan under ACA and I didn't want to take any chances that they would screw it up.

As it was there was a minor glitch... both of our ACA plans were on auto-pay so we called to make sure that the auto-pay was turned off for DW's policy... I took time to ask the rep that mine would still be on and she said yes... of course they screwed it up and I noticed it and had to call and re-set up the auto-pay.