Obamacare: what happens when you turn 65

I am 64 and my spouse is 58. If my spouse and I are on Obamacare what happens when one of us turns 65 at the end of April 2015? Does that individual automatically drop off of Obamacare and does the household tax credit go from two people to one person for a given income? Could I double insure with Obamacare and Medicare and ride it out until the end of 2015. Or if I did would I have to pay back a portion of the tax credit? Any comments are appreciated. Thanks!

Richard in Florida

Dear Richard,

When you turn 65 and qualify for Medicare, you stop qualifying for a subsidy for your exchange health insurance.  You would not be able to double insure yourself and continue to get the subsidy.  It would be a waste of your money to carry two plans, in any case.   It’s also possible that your exchange insurer would drop you as soon as they discovered that you have Medicare.  They would find out as soon as you had a claim.

The enrollment changes are not quite automatic.  You need to enroll in Medicare, Medicare Part B, and Medicare Part D or an Advantage Plan that wraps all of the parts together.  You should receive a letter from Medicare with instructions.

The subsidy does change, exactly as you describe.  You would now get a subsidy for your spouse’s one-person plan.  Your household income is your household income no matter how many people need insurance; you don’t get to subtract your part of the income.

Your best bet is to get going on your Medicare enrollment, and notify your current insurer.  That way, you can have a smooth transition.  If you have assets that you want to preserve, you could also consider buying a supplemental policy, also called “Medi-gap”.  You might want to find an insurance broker to help you or you can go to the Florida Office of Insurance Regulation’s Medicare Supplemental web page.

Good luck!

Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.