Council on Aging Answers 2015 - 94

COUNCIL ON AGING - ORANGE COUNTY

INSURANCE

Changing from a Covered
California Plan to Medicare
If you have a Qualified Health Plan (QHP) purchased through the Covered California (Covered
CA), you can keep it until your Medicare coverage
starts. At that time, you can cancel it without penalty.
If you like, you can keep your Covered CA QHP
too. But, if you've been getting tax credits or lower
out-of-pocket costs on a plan you bought through
Covered CA, these savings will end once your
Medicare Part A coverage starts. You'll have to pay
full price for the Covered CA QHP.
Note: According to federal guidance, people who
would have to pay a premium for Medicare Part A
may keep their QHP and are eligible for premium
tax credits if their income is between 100% and
400% of the federal poverty limit. If you consider
keeping a QHP instead of paying for Medicare, you
need to carefully compare both the benefits and the
costs of any health insurance plan you are considering to those of Medicare.
Medicare Eligibility
Once you're eligible for Medicare, you'll have an
initial enrollment period to sign up for Medicare.
For most people, the initial enrollment period starts
3 months before their 65th birthday and continues
until 3 months after their 65th birthday.
In most cases, you should enroll in Medicare
when you're first eligible because:
n Once your Medicare Part A coverage starts,
you won't be able to keep any premium tax
credits or lower out of pocket costs for a Covered CA QHP plan based on your income.
You'll have to pay full price for the Covered
CA QHP plan which will likely be more expensive than Medicare coverage.
n If you enroll in Medicare after your initial
enrollment period ends, you may have to pay
a late enrollment penalty for as long as you
94

Answers Guide 2015

have Medicare. In addition, you can enroll
in Medicare Part B (and Part A if you have to
pay a premium for it) only during the Medicare general enrollment period (from January
1 to March 31 each year). Coverage doesn't
start until July of that year. This may cause a
gap in your coverage.
Cancelling your Covered CA QHP
Once your Medicare coverage starts, you can
cancel your Covered CA QHP health plan without
penalty. You can do this by contacting the Covered
CA call center at 800-300-1506 or visit www.coveredca.com.
If you have Medicare coverage, you're considered
covered under the healthcare law. You won't have
to pay the fee that some people without insurance
must pay.
Do not cancel your Covered CA plan before your
Medicare coverage begins. Otherwise, you may
have a gap in coverage.
For questions about Medicare, contact the Council on Aging - Orange County HICAP (Health
Insurance Counseling and Advocacy Program) at
800-434-0222.
HICAP is a no-cost service to help you understand and maximize your Medicare benefits. Funded in part by the California Department of Aging,
HICAP is the most dependable source of unbiased,
accurate and up-to-date Medicare-related information.
Article excerpted from CMS Frequently Asked
Questions Regarding Medicare and the Marketplace
August 1, 2014
http://www.cms.gov/Medicare/Eligibility-andEnrollment/Medicare-and-the-Marketplace/Downloads/Medicare-Marketplace_Master_FAQ_8-1-14.
pdf

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http://www.coveredca.com http://www.coveredca.com http://www.cms.gov/Medicare/Eligibility-and-Enrollment/Medicare-and-the-Marketplace/Downloads/Medicare-Marketplace_Master_FAQ_8-1-14.pdf http://www.cms.gov/Medicare/Eligibility-and-Enrollment/Medicare-and-the-Marketplace/Downloads/Medicare-Marketplace_Master_FAQ_8-1-14.pdf http://www.cms.gov/Medicare/Eligibility-and-Enrollment/Medicare-and-the-Marketplace/Downloads/Medicare-Marketplace_Master_FAQ_8-1-14.pdf

Council on Aging Answers 2015

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