Senior couple admiring a green field as they discuss Medicare Advantage

Moving from Marketplace to Medicare

Consider the Advantages of Medicare vs ACA

Turning 65 is one of the most important birthdays in a person’s life; it is similar to turning 18 or 21 in the way you now have new access to new options that were not available before.

There are always exceptions to every rule, but 65 is when Medicare becomes available for the most part. Thats when most move from marketplace to medicare.

How you transition your healthcare could mean the difference between having the best coverage you have ever had or traveling a bumpy back road that you could have avoided.

Honestly, it depends on what coverage is in place that dictates the next step into Medicare. Today we are discussing ACA, Marketplace, Obamacare, or however you know it.

ACA is a different transition, and it is vital to make sure that you are moved to Original Medicare so that you are not penalized.

Let’s take a look at what is at stake.

If you love your ACA plan, then you ARE allowed to keep it. However, any government subsidies would be forfeit in lieu of your Social Security Income check. The first year would most likely remain at no visible change.

However, at tax time would have to pay back each month of subsidies that you received, creating the potential to completely wipe out or drastically decrease a refund or make a massive tax bill you WILL owe.

Though subsidies change from year to year, the 2020 subsidies below will give you an idea of the out-of-pocket increase of which you may not be aware.

86% of the people enrolled in ACA Marketplace health plans as of the first quarter of 2020 were receiving premium subsidies. The subsidies covered an average of 85% of their total premiums. The average subsidy amount in 2020 was $490 a month, where the full cost of an ACA plan was $575.

Meaning whatever your subsidy was, is now owed. Noted above is the average subsidy amount of $490.

In 2021, Part B premium, a medicare supplement, drug plan, cancer coverage, and dental, vision, and hearing coverage will run an average of $330 per month.

Medicare supplements have virtually no geographical limitations inside the US and do not require co-pay unless you choose a Plan-N medicare supplement.

So by leaving the plan you felt was the best, you can keep your doctors, pay the same or less for prescriptions, and travel with the knowledge you are covered no matter where you are for less money.

This $160 savings on average each month can take the strain off of you to use a limited income to pay your other expenses while trying not to dive into savings or retirement.

Senior couple running with their dog as they discuss Medicare Advantage.
In 2021, Part B premium, a medicare supplement, drug plan, cancer coverage, and dental, vision, and hearing coverage will run an average of $330 per month.

Medicare Advantage plans offer Health Maintenance and provide regular check-ups

Medicare Advantage plans can be as low as $0 per month, but there are networks, copays, deductibles, and other fees. These options are still considerably less than the $490 average, keeping essentially the same coverage as the ACA coverage provided initially and possibly more.

When you pair the Medicare Advantage Plans with a Hospital Indemnity Plan, you can prepare for the impact of a significant out-of-pocket by having a monthly premium of between $50–$80, usually even less than the ACA subsidy supplied.

A final note to consider is that Marketplace insurance DOES NOT constitute credible coverage. Having ACA coverage WILL NOT delay your Part B, and you WILL pay the Part B premium each month and see no benefit from this premium.

Paying this premium will mean a $1782.00 net loss with no hope of returning the lost income as of 2021.

If you do not take Part B the standard 10% penalty WILL be incurred.

Do not fall into this very avoidable issue. An experienced and honest Medicare Agent should help you transition from good health insurance to the best health insurance you have ever had. You deserve it!