Question: I’m 68 years old. Should I be shopping for health insurance on the online exchanges?
Answer: No. Seniors 65 and older, and disabled individuals, already meet their insurance requirements through Medicare. In fact, selling marketplace coverage to people who have Medicare is illegal.
Beginning October 1, 2013, uninsured Americans can sign up for health care insurance online through an exchange. The exchanges will allow individuals and consumers to comparison shop for health insurance, if they are eligible.
The new exchanges are online marketplaces where individuals and small employers will be able to shop for insurance coverage.
Seniors and disabled individuals enrolled in Medicare Part A — which covers hospitalization and limited nursing home care and is free for most beneficiaries – do not need to buy a marketplace plan, because they are already meeting the insurance requirements. Indeed, selling marketplace coverage to people who have Medicare is illegal.
The Marketplace does not offer Medicare supplement (Medigap) insurance or Part D drug plans. For information on these programs, visit Medicare.gov. Medicare beneficiaries can enroll in the program’s traditional drug coverage on Medicare.gov during the Medicare open season, which begins Oct. 15.
Here are some answers to common questions about the exchanges:
What is an exchange?
It’s an online marketplace where individuals and small employers will be able to shop for insurance coverage. Enrollment begins Oct. 1 for policies that will go into effect on Jan. 1. The exchanges will also help people find out if they are eligible for federal subsidies to help cover the cost of coverage or if they are eligible for Medicaid, the federal-state health insurance program for the poor. Read more
Seniors can spend days in the hospital under observation care instead of as an admitted patient, which means they have to pay more money out of pocket for drugs and other expenses and they lose coverage for post-hospital nursing care.
Question: My mother was in the hospital for several days and then we had to put her in a nursing home. It turns out that she was never considered an admitted patient while in the hospital. She was considered outpatient under observation care. Because of that, the nursing home is saying we have to pay out of pocket for her nursing home care. How can I fix this?
Answer: You can challenge the observation status. The Center for Medicare Advocacy recommends patients file two kinds of appeals. For more information, read Seniors Increasingly Entering Hospitals As Observation Patients. Read more
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