MedicareRights.org
Dear Marci,
I have a Medicare Advantage plan, but I’ve heard that I can buy a health
insurance plan with better coverage in the Marketplace. Should I drop my Medicare Advantage plan and buy a health insurance plan in the Marketplace?
– Luiz (Norwalk, CA)
Dear Luiz,
No. If you have Medicare, you should not buy health insurance plans
through the Health Insurance Marketplace.This is true, whether you get your Medicare benefits through Original Medicare, the traditional Medicare program directly administered by the federal government, or through a Medicare Advantage plan, which is Medicare coverage offered through a private insurance company.
Health Insurance Marketplaces, also known as Health Insurance Exchanges,
were created under the Affordable Care Act (sometimes called “Obamacare”) as a way for people who are uninsured or underinsured to compare and purchase health insurance plans. Keep in mind that Marketplaces may have different names, depending on which state you live in. For example, the California Marketplace is called Covered California, while the New York Marketplace is called the New York State of Health.
Again, the important thing to know is that people who have Medicare should
not drop their Medicare coverage and sign up for a Marketplace plan. If you have Medicare, your Medicare benefits will not change as a result of the Market- places. In addition, insurance agents and brokers are not allowed to sell you Marketplace health insurance plans if they know you have Medicare.
Another thing to keep in mind is that the Marketplace is not a way for you to
get Medicare coverage. You cannot get Medicare coverage, such as Original Medicare or Medicare Advantage plans, in the Marketplace. Medigap plans, also known as supplemental insurance plans that helps pay Original Medicare costs, will not be sold through the Marketplace. Similarly, Medicare prescription drug plans, also known as Medicare Part D plans, will not be sold through the Marketplace.
Lastly, keep in mind that there are some consequences that may occur if you
drop your Medicare coverage and somehow mistakenly sign up for a health insurance plan in the Marketplace. If you drop your Medicare coverage, you will most likely have to pay a premium penalty if you enroll in Medicare again in the future. In addition, you will likely have to wait until a specific enrollment period to sign up for Medicare and may therefore, experience gaps in health coverage.
Remember, it’s best to speak to a Social Security Administration agent anytime
you decide to drop your Medicare coverage. You can contact Social Security by calling 800-772-1213 or by going to your local Social Security office. Be sure to record the time and date of your conversation, who you spoke to and the outcome of your conversation.
For information about your Medicare benefits, contact 800-MEDICARE or go
online and visit www.medicare.gov. Click here for more information on Medicare and the Marketplaces.
-Marci
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Tuesday, February 25, 2014
Have Medicare? Keep it. The MarketPlace Exchange Plans are for those who don't. Confused? Just give me a call.
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