Subsidies in the Healthcare Marketplace and Medicare Eligibility

The Affordable Care Act (ACA) created the Healthcare Marketplace, whereby, some 9 million Americans have been successfully enrolled. At Muneris Benefits, we’ve helped hundreds of folks in Virginia and West Virginia secure valuable coverage. We want to remind our clients that once you become eligible for Medicare Part A (either by age or due to a disability); you will lose any premium tax credits (subsidies) upon becoming eligible for Medicare. The Federal Marketplace rules prohibit individuals with Medicare coverage from receiving tax credits.

Some folks in the Marketplace not only receive premium tax subsidies, but also are eligible for cost reductions – a lowering of deductibles and out-of-pocket expenses based upon income. Upon becoming eligible for Medicare Part A, the covered beneficiary will also lose any cost reductions. Federal rules will force you to pay back any subsidies when you file your 2015 taxes, and the insurance carriers must change your plan and eliminate any cost reductions.

A loss of premium tax subsidies and cost reductions would affect everyone covered. Our recommendation would be to call our office before you turn 65, or become eligible for Medicare due to  a disability. We will help you report the changes to the marketplace, help you update income, household changes, address and health coverage eligibility to the Federal Marketplace as soon as possible.

While the Healthcare Marketplace has become a great option for many, the rules are complicated, and the ACA enforcement of the rules is becoming a reality.

For more information regarding the Healthcare Marketplace, and if you are eligible for coverage, do not hesitate to give us a call.

Burman S. Clark

Burman S. Clark

Burman S. Clark, RHU, CSA is the President of Muneris Benefits and a licensed insurance broker and consultant. His independent practice and focuses on employee benefits, individual life, disability, medical, and senior products. Burman has traveled extensively and provided guidance to large employer associations with regards to the Affordable Care Act.