Covered California Subsidies for someone over 65
if ineligible for Free Medicare Part A Hospitalization 

You cannot buy additional coverage through #Covered California
if you have premium-free Medicare Part A Hospital

Medicare complies with Health Care Reform, so you do NOT need to get a an Individual policy or a subsidized one from Covered CA.  It fact, it's illegal for anyone to sell you a policy!  ^{Kaiser Health News * Covered CA Medicare Fact Sheet * Medicare.Gov Medicare & Market Place #11694  * CMS.Gov FAQ Medicare & Marketplace * HealthCare.Gov when - how to change from Covered CA to Medicare  * Social Security §1882  * Health Care.Gov}

NOTE: This information also applies to people younger than 65 whose benefits begin the first month they receive disability benefits because they have Amyotrophic Lateral Sclerosis (ALS), better known as Lou Gehrig’s Disease, and to people younger than 65 who have Medicare because of a disability and are receiving SSDI Social Security Disability Insurance.

There are a lot of ands, if or buts in this complex issue.  Please refer to the source material below.  There are some exceptions, but they are very complex.  Don't even think of getting a 1/2 correct answer over the phone. If you have to pay for Part A Hospital, then are options, like subsided Covered CA Plans. Email us [email protected]  

Video about Covered CA – if no Premium Free Part A – jump to 2:30  Medicare & the Marketplace (Covered CA

Medicare vs Covered CA - Publication 11694

Links & Resources 

• Medicare Publication # 11694 Medicare & Covered CA
• Covered CA Medicare Fact Sheet 
• InsureMeKevin.com

Sec. 1882. [42 U.S.C. 1395ss]

(3)(A)

(i) It is unlawful for a person to sell or issue to an individual entitled [no premium] to benefits under part A or enrolled under part B of this title (including an individual electing a Medicare+Choice plan [MAPD] under section 1851)—

(I) a health insurance policy with knowledge that the policy duplicates health benefits to which the individual is otherwise entitled under this title or title XIX,

(II) in the case of an individual not electing a Medicare+Choice plan, [aka MAPD Medicare Advantage] a medicare supplemental policy with knowledge that the individual is entitled to benefits under another medicare supplemental policy or in the case of an individual electing a Medicare+Choice plan, a medicare supplemental policy with knowledge that the policy duplicates health benefits to which the individual is otherwise entitled under the Medicare+Choice plan or under another medicare supplemental policy, or

(III) a health insurance policy (other than a medicare supplemental policy) with knowledge that the policy duplicates health benefits to which the individual is otherwise entitled, other than benefits to which the individual is entitled under a requirement of State or Federal law.

(ii) Whoever violates clause (i) shall be fined under title 18, United States Code, or imprisoned not more than 5 years, or both, and, in addition to or in lieu of such a criminal penalty, is subject to a civil money penalty of not to exceed $25,000 (or $15,000 in the case of a person other than the issuer of the policy) for each such prohibited act. ^{Sec. 1882. [42 U.S.C. 1395ss]} 

Our webpages that touch on this Issue:

• Part B – Doctors – How to sign up – Benefit
• Part B Late Enrollment Penalt
• End Stage Renal – Kidney Failure
• Age 65 – Tax Credits?
• Part A Hospital rules for zero premium
• Employer Plans vs Medicare - over or under 20 employees?