There is a lot of erroneous information about health care reform. Please, read below, so you will not be confused. If you have questions, call me or Medicare, 1-800-MEDICARE.
Medicare & the Health Insurance Marketplace
The Health Insurance Marketplace, a key part of the Affordable Care Act, will take effect in 2014. It’s a new way for individuals, families, and employees of small businesses to get health coverage.
If I have Medicare, do I need to do anything?
No. Medicare isn’t part of the Marketplace, so you don’t need to do anything. If you have Medicare, you’re considered covered.
The Marketplace won’t affect your Medicare choices, and your benefits won’t change. No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan (like an HMO or PPO), you’ll still have the same benefits and security you have now. You won’t have to make any changes.
Note: The Marketplace doesn’t offer Medicare Supplement Insurance (Medigap) policies or Part D drug plans.
Can I get a Marketplace plan in addition to Medicare?
No. It’s against the law for someone who knows that you have Medicare to sell you a Marketplace plan. This is true even if you have only Medicare Part A or only Part B.
If you want coverage designed to supplement Medicare, you can visit Medicare.gov to learn more about Medigap policies. You can also visit Medicare.gov to learn more about other Medicare options, like Medicare Advantage Plans.
Can I choose Marketplace coverage instead of Medicare?
Generally, no. As noted above, it’s against the law for someone who knows you have Medicare to sell you a Marketplace plan.
But, you can choose Marketplace coverage if you’re eligible for Medicare but haven’t enrolled in it (because you would have to pay a premium, or because you’re not collecting Social Security benefits).
Before making this choice, there are 2 important points to consider:
1. 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 have Medicare.
2. Generally, you can enroll in Medicare only during the Medicare general enrollment period (from January 1 — March 31). Your coverage won’t begin until July of that year.
What if I become eligible for Medicare after I join a Marketplace plan?
You can get a Marketplace plan to cover you before your Medicare begins. You can then cancel the Marketplace plan once your Medicare coverage starts.
Once you’re eligible for Medicare, you’ll have an initial enrollment period to sign up. For most people, the initial enrollment period for Medicare starts 3 months before their 65th birthday and ends 3 months after their 65th birthday.
In most cases it’s to your advantage to sign up when you’re first eligible because:
• Once you’re eligible for Medicare, you won’t be able to get lower costs for a Marketplace plan based on your income.
• 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 have Medicare.
Will Medicare Advantage plans still be available after the Marketplace starts?
Yes. The Medicare Advantage program isn’t changing as a result of the health care law.
Where can I get more information?
• To learn more about Medicare enrollment, coverage, and plan choices, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
• If you have family and friends who don’t have health insurance, or if they want to explore new health plan options, tell them to visit HealthCare.gov.
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