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The agency that runs Medicare is phasing out a rescue effort aimed at consumers who signed up for Affordable Care Act (ACA) public exchange plans when they should have signed up for Medicare Part B physician and outpatient services coverage.
The Centers for Medicaid and Services (CMS) says it will cut off eligibility for the fix for ACA exchange plan users with Medicare Part B problems June 30, 2020.
The fix can help Medicare plan clients who were using ACA exchange plans in place of Medicare Part B coverage, then sign up for Medicare Part B coverage late.
When those clients sign up for Medicare Part B coverage, CMS will waive the Medicare Part B late enrollment penalty.
Medicare Basics
The Medicare Part A hospitalization plan pays enrollees' hospital bills.
Most people who have lived and paid taxes in the United States for many years have paid enough into the system that they qualify to enroll in Medicare Part A coverage without paying any additional premiums.
The Medicare Part B program, which covers physicians' bills, outpatient services and some other health care costs, is a voluntary insurance program. Most consumers have to pay a monthly premium to get Part B coverage.
The standard Medicare Part B premium for 2019 is $135.50 per month, or $1,626 per year.
Consumers who age into Medicare Part A hospitalization coverage, then sign up of for Medicare Part B coverage late, may have to pay a Medicare Part B late enrollment penalty. For consumers who don't qualify for exceptions, the late enrollment penalty adds 10% of the standard premium amount to a consumer's annual Medicare Part B bill.
If, for example, Jane Doe put off signing up for Medicare Part B coverage for two years, had no special exemptions, and fit in the income guidelines for paying the standard premium, she would pay 20% more than the standard 2019 premium for 2019 Medicare Part B coverage, or $1,951.20 per year.
The Double Dipper Problem
Starting in 2014, the ACA public exchange system gave people a way to use federal premium tax credit subsidies to buy standardized health plans, from commercial health insurers, through a web-based health insurance supermarket.
Congress and regulators in Washington have created many rules designed to keep people from combining ACA exchange plan coverage with other types of coverage. One reason was to save ACA premium tax credit money, and another was to keep ACA exchange plan coverage from crowding out other types of coverage.
People with Medicare Part A coverage, including people who get Medicare coverage through Medicare Advantage plans, can buy coverage through an ACA exchange program, such as HealthCare.gov or Covered California, but they can't use an ACA premium tax credit to pay for the coverage.
Some people with Medicare Part A coverage have used ACA premium tax credits to pay their ACA exchange plan bills.
