Does Obamacare End at Age 65?

If you are enrolled in a health insurance plan through the Affordable Care Act (ACA), also known as Obamacare, you may wonder what happens to your coverage when you turn 65 and become eligible for Medicare. The answer depends on your situation and preferences, but here are some general guidelines to help you understand your options.

Key Takeaways:

• Most people who are enrolled in an Obamacare plan should switch to Medicare when they turn 65 to avoid penalties and gaps in coverage.
• People who are not entitled to Medicare Part A without paying a premium may be able to stay on their Obamacare plan after age 65, but they should compare the costs and benefits of both options carefully.
• People who have other health insurance coverage that is considered creditable by Medicare may be able to delay enrolling in Medicare without penalty until their coverage ends.
• People who enroll in Medicare should also consider enrolling in Part B, Part D, and/or a Medigap or Medicare Advantage plan to help cover some of the out-of-pocket costs of Original Medicare.

Switching from Obamacare to Medicare

Most people who are 65 or older are entitled to Medicare Part A, which covers hospital services, without having to pay a premium. However, you still need to enroll in Medicare Part A when you turn 65, unless you are automatically enrolled because you receive Social Security benefits or Railroad Retirement Board benefits. You can enroll in Medicare Part A online, by phone, or in person at your local Social Security office.

If you do not enroll in Medicare Part A when you are first eligible, you may face a late enrollment penalty when you do enroll later. The penalty is a higher monthly premium that lasts for twice the number of years that you delayed enrollment. For example, if you enroll two years after you were first eligible, you will pay a higher premium for four years.

Medicare Part A does not cover all of your health care costs. You may also want to enroll in Medicare Part B, which covers doctor visits and other outpatient services, and Medicare Part D, which covers prescription drugs. Both Part B and Part D require monthly premiums that vary depending on your income and plan choices. You may also want to consider a Medicare Supplement Insurance (Medigap) policy or a Medicare Advantage plan to help cover some of the gaps and out-of-pocket costs of Original Medicare (Part A and Part B).

If you are enrolled in an Obamacare plan when you turn 65, you have a special enrollment period to sign up for Medicare Part B and Part D without penalty. This period lasts for seven months, starting three months before your 65th birthday month and ending three months after it. If you miss this period, you may have to pay a late enrollment penalty for Part B and Part D when you do enroll later.

Once you enroll in Medicare, you can no longer keep your Obamacare plan. However, you can choose to delay enrolling in Medicare if you have other health insurance coverage that is considered creditable by Medicare. This means that the coverage is at least as good as Medicare’s. For example, if you have health insurance through your or your spouse’s current employer, and the employer has 20 or more employees, you may be able to keep that coverage and delay enrolling in Medicare without penalty until the employment or the coverage ends.

Staying on Obamacare after Age 65

In some cases, you may not be entitled to Medicare Part A without paying a premium because you have not worked long enough or paid enough taxes to qualify. If this is your situation, you may be able to stay on your Obamacare plan after age 65 and receive premium tax credits and cost-sharing reductions if you meet the income and eligibility requirements.

However, staying on Obamacare may not be the best option for you financially or medically. You may be able to find a more affordable and comprehensive coverage through Medicare by paying the Part A premium and enrolling in Part B, Part D, and/or a Medigap or Medicare Advantage plan. You should compare the costs and benefits of both options before making a decision.

If you choose to stay on Obamacare after age 65, you should be aware that you will lose your special enrollment period to sign up for Medicare Part B and Part D without penalty. You will have to wait until the next general enrollment period, which runs from January 1 to March 31 each year, to enroll in Medicare. Your coverage will start on July 1 of the same year. You will also have to pay a late enrollment penalty for Part B and Part D which will increase your monthly premiums for as long as you have Medicare.

Conclusion

Obamacare does not end at age 65, but it is usually replaced by Medicare for most people who are eligible for it. If you are enrolled in an Obamacare plan when you turn 65, you should review your options and enroll in Medicare during your special enrollment period to avoid penalties and gaps in coverage. If you are not entitled to Medicare Part A without paying a premium, you may be able to stay on your Obamacare plan after age 65, but you should weigh the pros and cons of doing so carefully.