ObamaCare Plans VS. Medicare

Learn why most seniors should stay with Medicare

by Ray Wilson+ on Oct 03, 2013 | 1 Comment

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Many seniors are wondering if they should switch from Medicare to an ObamaCare plan. You may be able to, but you might not want to. We’ll explain.

ObamaCare Plans

First, let’s discuss what the ObamaCare plans are. Technically the law is the called the Affordable Care Act, ObamaCare is just the nickname. So don’t fall for that question: “Do you like ObamaCare or the Affordable Care Act?” They are the exact same thing. The plans offered are called the ACA Bronze plan, Silver plan, Gold plan, and Platinum plan. These plans offer two types of subsidies:

Premium Subsidies -to help with monthly policy cost
Cost-sharing Subsidies -to help with deductibles, coinsurance, and copays.

Should Seniors Choose an Exchange Plan Over Medicare

Experts say no. These Exchanges are not meant for seniors with Medicare. Main reason is the majority of people who qualify for Medicare, will not qualify for subsidies on the Exchange. However there are two ways for Medicare eligible people to receive ObamaCare subsidies for the new plans:

• Qualify for Medicare because of end-stage renal failure
• Those who do not qualify for premium-free Medicare Part A.

According to the Connecticut Times, Andrea Callow, a policy attorney at the Center for Medicare Advocacy addressed the groups not listed above by saying, “People with Medicare can never get tax credits, and in general, a qualified health plan through the exchange is really not going to be as good for them as, say, a standard Medigap policy.”

Medigap Options for Seniors

Medigap offers various levels of coverage from basic to comprehensive. CBS News Money Watch and the Center for Medicare Advocacy endorse these policies, as Medigap plans help protect seniors from major financial costs due to medical issues. Medigap plans may cover things like Original Medicare’s deductibles, coinsurance, and excess charges. Medigap may also include the “silver sneaker” program, which gives discounted or free gym memberships to seniors with a Medigap policy.

If You Are Not Eligible for Medicare, But Over 65

You must be a legal resident for 5 or more years to qualify for Medicare. If you happen to fall within the group that hasn’t held residency long enough, you can get an Exchange plan with possible subsidies. Remember you must be a legal resident to purchase a qualified health plan from the Exchange.

For further questions about your Medicare, Medigap, or the new ACA plans call 800-930-7956 or contact Senior65.

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Reader Comments and Questions

By Deborah Michaels on February 07, 2016

I will be 65 this year but am not eligible for Social Security or free part A Medicare because I don't have enough work credits. My husband won't be eligible for Social Security for another 4 yrs. Right now we have Health insurance through our state exchange and receive subsidies toward our monthly premium. My question is will I be able to remain on my currant plan for the next 4 years because I'd have to pay a premium for Part A Medicare and continue to receive subsidies as our income allows. Any help would be appreciated Thank You

If you are over 65, but do not qualify for Medicare, you should still be able to enroll through the individual marketplace or the Exchange. If you go through the Exchange you may qualify for subsidies. Hope this helps!
-Eric from https://www.senior65.com/

PLEASE NOTE: We cannot comment on specific Medicare claims. Contact Medicare directly if you are trying to see if your issue is covered.

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