Switching from ACA to Medicare

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills
Post Reply
zbxb006
Posts: 63
Joined: Thu Oct 16, 2014 5:06 pm

Switching from ACA to Medicare

Post by zbxb006 » Sat Oct 06, 2018 2:00 pm

My wife and I currently have ACA health insurance. I will be going on Medicare 11/1 and have already gotten parts A, B, supplement, and D - all starting 11/1. Wife will stay on ACA until Dec 2020. I manage my MAGI to maximize the subsidy and use a silver plan for the cost sharing.

Come 11/1, I will need to drop ACA, and keep wife on it. According to healthcare.gov they caution to make sure to do the dropping by phone and not via the website so that it gets done properly and my wife remains as the new primary contact. When I tried calling to set this up with a little lead time, the questionable response I got was to wait until 11/1 to call and cancel myself. And not to notify my current insurance company ahead of time. Does this sound right?

Also, it's not clear to me what to do about the MAGI numbers. I was shooting for a MAGI of around $24k for the year. I can easily control this via IRA withdrawals. Will that be impacted since I will be on ACA for 10 months, but my wire will be on it for the whole year.

User avatar
dm200
Posts: 18757
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: Switching from ACA to Medicare

Post by dm200 » Sat Oct 06, 2018 2:15 pm

My wife went through the same process - should have been simple - one person and with same provider. Kept getting billed for the ACA coverage for several months after being on medicare. Took a lot of responses and phone calls. BUT finally accomplished without paying twice for the same coverage period.

cherbob85
Posts: 33
Joined: Tue Oct 05, 2010 7:27 pm

Re: Switching from ACA to Medicare

Post by cherbob85 » Sat Oct 06, 2018 5:15 pm

It will be a couple years before I need to go on Medicare and my wife is 2 years younger. I was advised that the year I need to cut over to Medicare that I should make my wife the primary. Then when I drop off no major changes.

As far as MAGI, that is something I need to figure out as well.

Bob D

DrakeSRT
Posts: 90
Joined: Thu Dec 11, 2014 6:43 pm

Re: Switching from ACA to Medicare

Post by DrakeSRT » Sun Oct 07, 2018 10:43 am

Following. 18 months until I'm in the same situation.
What is concerning to me is after I go on Medicare, my Wife will need several more months of ACA coverage. It appears that household income will still be counted for 1 person which will greatly affect her insurance premium.

merdahl
Posts: 12
Joined: Sun Nov 19, 2017 3:10 pm

Re: Switching from ACA to Medicare

Post by merdahl » Sun Oct 07, 2018 12:03 pm

I'm still working for another year. Sounds like when I stop working the wife (younger) should get the ACA insurance in her name (primary). I will be first to transition to medicare so she will just have to drop me at that time. Maybe fewer headaches.

User avatar
dm200
Posts: 18757
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: Switching from ACA to Medicare

Post by dm200 » Sun Oct 07, 2018 12:24 pm

DrakeSRT wrote:
Sun Oct 07, 2018 10:43 am
Following. 18 months until I'm in the same situation.
What is concerning to me is after I go on Medicare, my Wife will need several more months of ACA coverage. It appears that household income will still be counted for 1 person which will greatly affect her insurance premium.
That is my understanding as well. Although, for you, good that is just several more months.

tenkuky
Posts: 567
Joined: Sun Dec 14, 2014 4:28 pm

Re: Switching from ACA to Medicare

Post by tenkuky » Sun Oct 07, 2018 3:43 pm

Interesting thread.
What happens when there is a 2-3 year age gap between spouses?
When the older spouse hits 65 and goes on Medicare after both being on ACA, the MAGI to hit the cliff becomes lower (for single person) so is it likely that one person pays much higher premiums for a few years?
Any guidance on this? Assuming both FIRE and no employer coverage.

User avatar
dm200
Posts: 18757
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: Switching from ACA to Medicare

Post by dm200 » Sun Oct 07, 2018 4:54 pm

tenkuky wrote:
Sun Oct 07, 2018 3:43 pm
Interesting thread.
What happens when there is a 2-3 year age gap between spouses?
When the older spouse hits 65 and goes on Medicare after both being on ACA, the MAGI to hit the cliff becomes lower (for single person) so is it likely that one person pays much higher premiums for a few years?
Any guidance on this? Assuming both FIRE and no employer coverage.
Sure - BUT it is likely that the spouse on Medicare will experience lower costs. It will also depend on what Medicare options you choose, as well as choice of providers.

When my wife went to Kaiser Medicare from Kaiser ACA Medicare, her costs went down. In addition to premium reductions, the coverage was much better - lower Physician copays and no charge for blood tests.

jdsmith296
Posts: 1
Joined: Sun Oct 07, 2018 4:43 pm

Re: Switching from ACA to Medicare

Post by jdsmith296 » Sun Oct 07, 2018 5:01 pm

Regarding ACA timing, I went through this earlier this year except my wife was primary and she was going on Medicare effective 5/1. I'm 2 years younger so I stay on ACA. Wait until 11/1 then call healthcare.gov at 800-318-2596. They will walk you through the process. She will need to pick a new ACA plan at that time and will become primary. I found them to be very helpful. Your timing is weird because ACA open enrollment for 2019 starts 11/1. I'm sure healthcare.gov will be swamped with calls so good luck getting through.

User avatar
munemaker
Posts: 3517
Joined: Sat Jan 18, 2014 6:14 pm

Re: Switching from ACA to Medicare

Post by munemaker » Mon Oct 08, 2018 2:32 pm

To the OP -->

I am the contact person on a health insurance policy I bought on the ObamaCare Exchange, and already bought a Medicare Advantage plan that is effective on 11/01/2018. I will have to be removed from the ObamaCare policy and my wife made the contact person.

So how to switch me only from ObamaCare to Medicare and leave her on the ObamaCare policy? Since I am the contact person, it cannot be done online and has to be done over the phone with the exchange. I called the Exchange and they told me to call on 11/01/2018 to stop my ObamaCare and make my wife the contact. The exchange will notify my insurance company. I asked if my insurance company would be billing me beyond the end of October and the answer was the Exchange cannot speak for my insurance company.

So I called my insurance company and they said I have to notify the exchange on 10/31/2018 so they can be notified or I will be charged a premium. I told them the exchange said not to call until 11/01/2018. The insurance company then told me to call the insurance company on 10/31/2018 and they would get the Exchange on the line with us on a 3 way call. Doesn't sound like the left hand knows what the right hand is doing.

People have to be switching from ObamaCare to Medicare on a daily basis, so why is this process so unclear? Hopefully it goes easier than it sounds.

User avatar
munemaker
Posts: 3517
Joined: Sat Jan 18, 2014 6:14 pm

Re: Switching from ACA to Medicare

Post by munemaker » Mon Oct 08, 2018 2:37 pm

dm200 wrote:
Sun Oct 07, 2018 4:54 pm
... it is likely that the spouse on Medicare will experience lower costs.
I would not count on that. My wife and I pay a combined $135/month for ObamaCare (2nd lowest cost Silver Plan).

When I switch to Medicare on 11/01/2018, she will continue to pay $135/month for ObamaCare (I don't think the ObamaCare premium goes down because I am no longer on the policy). In addition, I will be paying the government $134/month for part B and paying the insurance company $20/month for an Advantage plan.

So our monthly premiums (for both of us) will go from $135 to $289.

I hope I am wrong, but that's my understanding.

zbxb006
Posts: 63
Joined: Thu Oct 16, 2014 5:06 pm

Re: Switching from ACA to Medicare

Post by zbxb006 » Mon Oct 08, 2018 9:13 pm

I am expecting the same thing. Net (after tax credit) ACA premium for just one of us will be the exact same as for two of us combined. I have no idea how this is calculated, but playing around with the app at healthcare.gov for days results in the same net cost for one or for a couple.

Medicare (A,B,D and G) costs for me will be much higher (4 times higher) than for ACA. But this is largely a function of maxing the ACA tax credit by manipulating MAGI.

User avatar
dm200
Posts: 18757
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: Switching from ACA to Medicare

Post by dm200 » Tue Oct 09, 2018 10:09 am

zbxb006 wrote:
Mon Oct 08, 2018 9:13 pm
I am expecting the same thing. Net (after tax credit) ACA premium for just one of us will be the exact same as for two of us combined. I have no idea how this is calculated, but playing around with the app at healthcare.gov for days results in the same net cost for one or for a couple.

Medicare (A,B,D and G) costs for me will be much higher (4 times higher) than for ACA. But this is largely a function of maxing the ACA tax credit by manipulating MAGI.
Medicare A is no cost to the participant.

zbxb006
Posts: 63
Joined: Thu Oct 16, 2014 5:06 pm

Re: Switching from ACA to Medicare

Post by zbxb006 » Fri Oct 12, 2018 10:56 pm

After another round of phone calls with the marketplace and my insurance company(blue cross), I think I got a clearer understanding. The insurance co rep this time sounded knowledgeable and confident - a first for them.
Their instructions were to call the marketplace on 11/1 to cancel my ACA and change the primary contact to my wife. Blue Cross would be electronically notified within one day of the changes. They would cancel my ACA insurance and open a new account for my wife. Although Nov will have already been billed to me for both of us and include expected tax credits for both, I am to ignore that until they send an updated Nov bill for just the wife, with her expected tax credit included. Hmmmm.

No need to call the insurance co again, as everything is driven by the marketplace. Except to clear up the resulting mess that's likely to happen according to the insurance company. At least they were honest.

The marketplace could not tell me what the new insurance cost or tax credit for one person would be. But using the 2019 projections at healthcare.gov indicates the premium for one person is the same as for two (interesting), while the tax credit of course is half since it is only for one. Since the calculations use total household income even when one person is on ACA and one is not, I've decided its best just to stick with the same MAGI as I was originally planning.

I'll be glad to get the wife on medicare in two years so I can stop the MAGI manipulation and just get on with normal living. ACA has saved us a ton of money the last few years, and I'm grateful for that, but I think I used up way too many brain cells trying to work the system.

donall
Posts: 800
Joined: Tue Mar 13, 2012 6:45 am

Re: Switching from ACA to Medicare

Post by donall » Sat Oct 13, 2018 12:22 am

ACA uses family size and income to determine the premium and subsidy. If one of the couple starts Medicare, the family size stays the same at 2. The same would happen if the two children are in Medicaid, while parents obtain ACA insurance, where the family would be 4.

FBN2014
Posts: 465
Joined: Sat Mar 08, 2014 3:07 pm

Re: Switching from ACA to Medicare

Post by FBN2014 » Sat Oct 13, 2018 12:06 pm

You have to be very careful when you have an ACA plan and you are going on Medicare. If you talk to SS, ACA exchange rep, or the insurance carrier you will get confusing and conflicting information. If you don't do the sign up for Medicare correctly then it will cost you big time if you are receiving an ACA subsidy. Once you turn 65 then you are automatically enrolled in part A Medicare which is important because you then lose your ACA subsidy. This is very confusing because the law says you have a 7 month window to enroll in Medicare - 3 months before your birthday month to 3 months after your birthday month. But no one is going to notify you that you will lose the subsidy. Now if you are still on the ACA plan after your birthday month then you will get a nasty surprise from the IRS when you file your taxes the following year because now you will owe back all that money that the government paid the insurance company for your premium subsidy. The best thing to do is sign up for Medicare 3 months before you turn 65 so that Part A and B start on the first day of your birthday month. You still will have that 7 month window to get a supplemental plan or Advantage plan with no medical underwriting. So if you arranged your income so that you could get the maximum subsidy since the ACA plan is costing you less than Medicare and you ttherefore waited past your birthday month to sign up, think again because you will be surprised. If anyone made the mistake of signing up for Medicare after your birthday month while you were still on the ACA plan, please share how you fixed it so you didn't end up having to pay back the subsidy that was advanced to the insurance carrier. Remember what Reagan said about the 9 most terrifying words in the English language. "I'm from the government and I'm here to help".
"October is one of the peculiarly dangerous months to speculate in stocks. The others are July, January, September, April, November, May March, June, December, August and February." - M. Twain

zbxb006
Posts: 63
Joined: Thu Oct 16, 2014 5:06 pm

Re: Switching from ACA to Medicare

Post by zbxb006 » Sat Oct 13, 2018 3:10 pm

Yes, I ran into that while researching whether I could just wait two months and start my medicare on 1/1, 2 months past my turning 65. Just to avoid making the switch 11/1 and dealing with the confusion and potential screw ups. The caution I received was that ACA would not allow insurance coverage after turning 65, and if they somehow did there was the potential for having to pay back the excess tax credit.

So although medicare gives you the 3 months before or after 65 option, ACA does not.

User avatar
dm200
Posts: 18757
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: Switching from ACA to Medicare

Post by dm200 » Sat Oct 13, 2018 3:16 pm

zbxb006 wrote:
Sat Oct 13, 2018 3:10 pm
Yes, I ran into that while researching whether I could just wait two months and start my medicare on 1/1, 2 months past my turning 65. Just to avoid making the switch 11/1 and dealing with the confusion and potential screw ups. The caution I received was that ACA would not allow insurance coverage after turning 65, and if they somehow did there was the potential for having to pay back the excess tax credit.

So although medicare gives you the 3 months before or after 65 option, ACA does not.
From my wife's experience, just keep track of the calls made, and other correspondence. Be both patient and persistent.

blevine
Posts: 2051
Joined: Sat Feb 27, 2010 3:57 pm
Location: New York

Re: Switching from ACA to Medicare

Post by blevine » Sat Oct 13, 2018 4:33 pm

Well I knew someday marrying a slightly older woman would come in handy.
Only six weeks older, but I guess when I buy an ACA policy upon retirement, I will put it in my name,
she can drop off when she hits 65, with me remaining as primary for a few more weeks :-)

Hopefully by then this will be streamlined, I am still in my 50s and near not at retirement !
Last edited by blevine on Sat Oct 13, 2018 11:57 pm, edited 1 time in total.

blevine
Posts: 2051
Joined: Sat Feb 27, 2010 3:57 pm
Location: New York

Re: Switching from ACA to Medicare

Post by blevine » Sun Oct 14, 2018 12:02 am

Well I still have employer coverage, and they just switched providers, and some of our docs no longer in network. I dont understand why, switching from one major carrier to another. How are docs not taking major carriers ?

FBN2014
Posts: 465
Joined: Sat Mar 08, 2014 3:07 pm

Re: Switching from ACA to Medicare

Post by FBN2014 » Sun Oct 14, 2018 12:08 pm

dm200 wrote:
Sun Oct 14, 2018 10:58 am
FBN2014 wrote:
Sat Oct 13, 2018 11:50 pm
blevine wrote:
Sat Oct 13, 2018 4:33 pm
Well I knew someday marrying a slightly older woman would come in handy.
Only six years older, but I guess when I buy an ACA policy upon retirement, I will put it in my name,
she can drop off when she hits 65, with me remaining as primary for a few more weeks :-)
Hopefully by then this will be streamlined, I am still in my 50s and near not at retirement !
Hopefully by the time you retire the ACA will have been repealed. In the 4 years that we have been on it we have had 4 different insurance company plans and had to switch doctors several times. Only the idiots in Congress could create this nightmare.
How did ACA force you to be on 4 different plans?
Because the insurance company only offered the plan for one year and then they withdraw from the exchange marketplace. Providers that are in network are also limited. Not every doctor or hospital wants to deal with Obamacare so they opt out.
"October is one of the peculiarly dangerous months to speculate in stocks. The others are July, January, September, April, November, May March, June, December, August and February." - M. Twain

User avatar
dm200
Posts: 18757
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: Switching from ACA to Medicare

Post by dm200 » Sun Oct 14, 2018 2:36 pm

blevine wrote:
Sun Oct 14, 2018 12:02 am
Well I still have employer coverage, and they just switched providers, and some of our docs no longer in network. I dont understand why, switching from one major carrier to another. How are docs not taking major carriers ?
Maybe just have not caught up with "paperwork"? A few years ago, our primary care physicians accepted one insurance company as a PPO -- but not as HMO. Within a few months, fortunately for us, they accepted the HMO in which we were enrolled.

User avatar
munemaker
Posts: 3517
Joined: Sat Jan 18, 2014 6:14 pm

Re: Switching from ACA to Medicare

Post by munemaker » Sun Oct 14, 2018 9:48 pm

FBN2014 wrote:
Sun Oct 14, 2018 12:08 pm
Not every doctor or hospital wants to deal with Obamacare so they opt out.
None of that nonsense in our area (Western PA), thank goodness. At least, none that I am aware of.

I do see that here with Medicaid though.

User avatar
celia
Posts: 8479
Joined: Sun Mar 09, 2008 6:32 am
Location: SoCal

Re: Switching from ACA to Medicare

Post by celia » Mon Oct 15, 2018 3:09 am

tenkuky wrote:
Sun Oct 07, 2018 3:43 pm
Interesting thread.
What happens when there is a 2-3 year age gap between spouses?
When the older spouse hits 65 and goes on Medicare after both being on ACA, the MAGI to hit the cliff becomes lower (for single person) so is it likely that one person pays much higher premiums for a few years?
Any guidance on this? Assuming both FIRE and no employer coverage.
While you early retirees kept your income low to take advantage of govt ACA subsidies, I hope you've thought ahead to age 70.5 RMDs and what they will do to your tax bracket while also taking SS at the same time. For those with a lot of money in their TIRAs, the low income years are the best time to do Roth conversions to help avoid bumping up to higher tax brackets after age 71.
A dollar in Roth is worth more than a dollar in a taxable account. A dollar in taxable is worth more than a dollar in a tax-deferred account.

User avatar
munemaker
Posts: 3517
Joined: Sat Jan 18, 2014 6:14 pm

Re: Switching from ACA to Medicare

Post by munemaker » Mon Oct 15, 2018 5:18 am

celia wrote:
Mon Oct 15, 2018 3:09 am

While you early retirees kept your income low to take advantage of govt ACA subsidies, I hope you've thought ahead to age 70.5 RMDs and what they will do to your tax bracket while also taking SS at the same time. For those with a lot of money in their TIRAs, the low income years are the best time to do Roth conversions to help avoid bumping up to higher tax brackets after age 71.
I am one who has done this and you raise a good point. Yes, I have thought about RMDs at age 70.5 and have it all mapped out using RPM. The prospect of getting very low cost, good quality health insurance is/was too good to pass up. Some people get upset about this, thinking people like me are taking advantage of the system. However, as you point out, there often is a cost to ObamaCare subsidies for millionaires in the form of higher future taxes. I will be doing fairly large ROTH conversions from age 66 through age 70, but additional taxes (such as IRMAA) have to be considered. Everything (health insurance, tax laws/rates, etc.) is dynamic so you make the best decisions you can at the time and live with them.

FBN2014
Posts: 465
Joined: Sat Mar 08, 2014 3:07 pm

Re: Switching from ACA to Medicare

Post by FBN2014 » Mon Oct 15, 2018 8:41 am

munemaker wrote:
Mon Oct 15, 2018 5:18 am
celia wrote:
Mon Oct 15, 2018 3:09 am

While you early retirees kept your income low to take advantage of govt ACA subsidies, I hope you've thought ahead to age 70.5 RMDs and what they will do to your tax bracket while also taking SS at the same time. For those with a lot of money in their TIRAs, the low income years are the best time to do Roth conversions to help avoid bumping up to higher tax brackets after age 71.
I am one who has done this and you raise a good point. Yes, I have thought about RMDs at age 70.5 and have it all mapped out using RPM. The prospect of getting very low cost, good quality health insurance is/was too good to pass up. Some people get upset about this, thinking people like me are taking advantage of the system. However, as you point out, there often is a cost to ObamaCare subsidies for millionaires in the form of higher future taxes. I will be doing fairly large ROTH conversions from age 66 through age 70, but additional taxes (such as IRMAA) have to be considered. Everything (health insurance, tax laws/rates, etc.) is dynamic so you make the best decisions you can at the time and live with them.
What is RPM?
"October is one of the peculiarly dangerous months to speculate in stocks. The others are July, January, September, April, November, May March, June, December, August and February." - M. Twain

User avatar
munemaker
Posts: 3517
Joined: Sat Jan 18, 2014 6:14 pm

Re: Switching from ACA to Medicare

Post by munemaker » Mon Oct 15, 2018 6:18 pm

FBN2014 wrote:
Mon Oct 15, 2018 8:41 am
munemaker wrote:
Mon Oct 15, 2018 5:18 am
celia wrote:
Mon Oct 15, 2018 3:09 am

While you early retirees kept your income low to take advantage of govt ACA subsidies, I hope you've thought ahead to age 70.5 RMDs and what they will do to your tax bracket while also taking SS at the same time. For those with a lot of money in their TIRAs, the low income years are the best time to do Roth conversions to help avoid bumping up to higher tax brackets after age 71.
I am one who has done this and you raise a good point. Yes, I have thought about RMDs at age 70.5 and have it all mapped out using RPM. The prospect of getting very low cost, good quality health insurance is/was too good to pass up. Some people get upset about this, thinking people like me are taking advantage of the system. However, as you point out, there often is a cost to ObamaCare subsidies for millionaires in the form of higher future taxes. I will be doing fairly large ROTH conversions from age 66 through age 70, but additional taxes (such as IRMAA) have to be considered. Everything (health insurance, tax laws/rates, etc.) is dynamic so you make the best decisions you can at the time and live with them.
What is RPM?
RPM = Retiree Portfolio Model
The Retiree Portfolio Model is a downloadable Excel spreadsheet created by a retiree for retirees. It models the most common financial aspects of a retiree and their spouse's lives, including pensions, Social Security benefits, living expenses, IRA Required Minimum Distributions, purchase of an annuity, sale of a house, and many other items including Federal and state income taxes. All of this data is used to create a model of their accounts over a period of 1 to 40 years.

A feature of this model allows the user to compare their normal portfolio results with one that includes alternative choices, such as doing Roth IRA conversions, choosing alternative Social Security starting ages and benefits, or buying a Single Premium Immediate Annuity. The model was developed by forum member BigFoot48.
Reference: https://www.bogleheads.org/wiki/Retiree_Portfolio_Model

RPM is really good. I highly recommend it for people who are recently retired or will be retiring soon. I have spent quite a few hours planning Roth conversions, RMDs, SS claiming age, taxes, etc.

jalbert
Posts: 3814
Joined: Fri Apr 10, 2015 12:29 am

Re: Switching from ACA to Medicare

Post by jalbert » Mon Oct 15, 2018 6:41 pm

Probably not helpful to the OP at this stage, but there often is no disadvantage to splitting up the enrollments for a couple in ACA-exchange-based plans other than paying two bills. It enables having different plans for each person as well. Then when one qualifies for Medicare, the other spouse is unaffected.

If one spouse has schedule C self-employment income, then it may make sense to have only one enrollment for both spouses for the tax deduction, at least until the year one spouse qualifies for Medicare, maybe even that year as well.
Risk is not a guarantor of return.

zbxb006
Posts: 63
Joined: Thu Oct 16, 2014 5:06 pm

Re: Switching from ACA to Medicare

Post by zbxb006 » Thu Nov 08, 2018 4:50 pm

OP here for an update. Surprisingly, the conversion seems to have gone well. I called the Marketplace on 11/1 to cancel my ACA plan, but keep my wife on ACA. Canceling my plan was quick and easy. In order to keep my wife on ACA, we had to do a new application for her over the phone. The questions and process were quite extensive and took about 45 minutes. In the end, they were able to confirm the plan ID, the premium tax credit and the net monthly premium. Since we were in the 2019 sign-up window, they offered to select her 2019 plan also, but I declined since I hadn't reviewed the 2019 options yet.

They said it might take the insurance company (blue cross/shield AZ in this case) two weeks to make the switch, but to make sure to pay the Nov period ASAP to insure coverage. Couldn't do that though since I needed the new member ID and wouldn't get that until after the insurance company did their thing.

Meanwhile I had received the Nov bill for the old coverage for both of us, including the expected premium tax credit. So far I have ignored that and it seems to be OK. Their online system now shows the coverage as having ended 10/31 under the old member ID.

Today we received the wife's Nov billing with the new member ID and I e-payed it.

Advice for anyone in a similar situation to make this process easier and less stressful - the younger spouse should be the primary on ACA, then the older one can just be cancelled off ACA when joining Medicare without the extra complexity. Wish I would have come across that tidbit while researching the ACA stuff three years ago.

User avatar
munemaker
Posts: 3517
Joined: Sat Jan 18, 2014 6:14 pm

Re: Switching from ACA to Medicare

Post by munemaker » Thu Nov 08, 2018 5:35 pm

munemaker wrote:
Mon Oct 08, 2018 2:32 pm
To the OP -->

I am the contact person on a health insurance policy I bought on the ObamaCare Exchange, and already bought a Medicare Advantage plan that is effective on 11/01/2018. I will have to be removed from the ObamaCare policy and my wife made the contact person.

So how to switch me only from ObamaCare to Medicare and leave her on the ObamaCare policy? Since I am the contact person, it cannot be done online and has to be done over the phone with the exchange. I called the Exchange and they told me to call on 11/01/2018 to stop my ObamaCare and make my wife the contact. The exchange will notify my insurance company. I asked if my insurance company would be billing me beyond the end of October and the answer was the Exchange cannot speak for my insurance company.

So I called my insurance company and they said I have to notify the exchange on 10/31/2018 so they can be notified or I will be charged a premium. I told them the exchange said not to call until 11/01/2018. The insurance company then told me to call the insurance company on 10/31/2018 and they would get the Exchange on the line with us on a 3 way call. Doesn't sound like the left hand knows what the right hand is doing.

People have to be switching from ObamaCare to Medicare on a daily basis, so why is this process so unclear? Hopefully it goes easier than it sounds.
Here's an update on our situation:

The conversion went well. I called the Marketplace at 10:00 pm on 10/31 to cancel my ACA plan, but keep my wife on ACA. The ACA person said I should call back on 11/01, but he would do it now if I insisted. I told him the insurance company said I should do it on 10/31, so let's do it. Canceling my plan was easy. In order to keep my wife on ACA, we had to do an entire new application; I did it online but asked the ACA person to stay on the phone, which was good because there were a few confusing parts. I updated our income to reflect the latest information. At the end of the application, it showed the insurance was cancelled as of 10/30, so the ACA person was correct that I should have called on 11/01 rather than 10/31 (I was actually uninsured for 1 day). The ACA person was able to confirm the plan ID, the premium tax credit and the net monthly premium while I was on the phone. Since we were in the 2019 sign-up window, they offered to sign her up for 2019 also, but we declined since I had not estimated our 2019 income.

They said it might take the insurance company (UPMC in this case) two weeks to make the switch. Prior to calling, I had received the Nov bill for the old coverage for both of us, including the expected premium tax credit. The insurance company told me to ignore it which I did.

My wife had a doctor's appointment a few days after this and she obviously did hod not received the new insurance card. She called the insurance company and they took her November payment over the phone, and gave her the ID number to give to the doctor's office; this worked out fine.

I agree with OP's advice which is copied here:
Advice for anyone in a similar situation to make this process easier and less stressful - the younger spouse should be the primary on ACA, then the older one can just be cancelled off ACA when joining Medicare without the extra complexity. Wish I would have come across that tidbit while researching the ACA stuff three years ago.

zbxb006
Posts: 63
Joined: Thu Oct 16, 2014 5:06 pm

Re: Switching from ACA to Medicare

Post by zbxb006 » Fri Nov 09, 2018 8:38 pm

One more little bit of confusing info I found out today... I tried to enroll the wife in a 2019 plan. Since she now has a separate health plan via the marketplace and is supposedly the primary contact, I thought that in order to use healthcare.gov she would need her own account. Wrong. Couldn't set her up.

Turns out that I am still the primary on healthcare.gov even though I no longer have an ACA plan. The wife is still listed under my account. So I used my account to enroll her in a 2019 plan, specifying coverage for her but not for me. I guess it makes sense when you understand that healthcare.gov works on a household concept and not an individual. When I talked to the marketplace earlier they were clear about the wife needing a completely separate medical plan where she was the primary, but they didn't mention healthcare.gov implications and at the time I didn't think to ask.

OnTrack
Posts: 348
Joined: Wed Jan 20, 2016 11:16 pm

Re: Switching from ACA to Medicare

Post by OnTrack » Wed Nov 14, 2018 6:35 pm

jalbert wrote:
Mon Oct 15, 2018 6:41 pm
Probably not helpful to the OP at this stage, but there often is no disadvantage to splitting up the enrollments for a couple in ACA-exchange-based plans other than paying two bills. It enables having different plans for each person as well. Then when one qualifies for Medicare, the other spouse is unaffected.

If one spouse has schedule C self-employment income, then it may make sense to have only one enrollment for both spouses for the tax deduction, at least until the year one spouse qualifies for Medicare, maybe even that year as well.
There could be a disadvantage in the way deductibles work. Per: https://www.verywellhealth.com/how-your ... ks-1738660
"Each time an individual within the family pays toward his or her individual deductible, that amount is also credited toward the family deductible. ... If the family deductible is met, health plan benefits kick-in for every member of the family whether or not they've met their own individual deductibles."

Thus, if one person has high expenses which meet the group deductible then the other person does not need to meet his or her individual deductible on a group plan. I think with two individual plans, the other person would need to meet his or her individual deductible.

I agree though, it would greatly simplify the problem of one person dropping off the plan mid-year.

User avatar
FrugalInvestor
Posts: 4901
Joined: Fri Nov 07, 2008 12:20 am

Re: Switching from ACA to Medicare

Post by FrugalInvestor » Wed Nov 14, 2018 6:51 pm

zbxb006 wrote:
Fri Nov 09, 2018 8:38 pm
One more little bit of confusing info I found out today... I tried to enroll the wife in a 2019 plan. Since she now has a separate health plan via the marketplace and is supposedly the primary contact, I thought that in order to use healthcare.gov she would need her own account. Wrong. Couldn't set her up.

Turns out that I am still the primary on healthcare.gov even though I no longer have an ACA plan. The wife is still listed under my account. So I used my account to enroll her in a 2019 plan, specifying coverage for her but not for me. I guess it makes sense when you understand that healthcare.gov works on a household concept and not an individual........
Yes, that's how it works alright. I've been using a broker for the past 3+ years and he helped with my transition to Medicare while my wife remained on an ACA policy. I continued to receive the ACA policy email communications and when we spoke with him about changing that he nicely said to "forget it," it won't happen. I now just forward those emails to my wife.

Not only is ACA based on household income but that's all verified through the IRS. I suspect the fact that my SS number is primary on our married-filing-jointly tax return also ties her to my ACA household.
IGNORE the noise! | Our life is frittered away by detail... simplify, simplify. - Henry David Thoreau

Post Reply