I am disabled but not yet eligible for Medicare. Can I purchase a plan from the exchange?
Yes, disabled persons who are not qualified for coverage through Medicare are welcome to purchase plans from the health insurance exchange/marketplace. If your income falls between 100% and 400% of the federal poverty level, you will also qualify for premium tax credits (also called premium subsidies), which can help make your plan more affordable.
However, it is important to note that things will change once you become eligible for Medicare. In most cases, after you have received disability benefits for two full years, you will be automatically enrolled in Medicare Parts A and B. When this happens, you will no longer be eligible to receive subsidies through the exchange. While you can still renew your exchange coverage beyond that point if you wish, you will need to pay full price for it. You will also have trouble switching to a different exchange plan, since insurers are prohibited from selling new exchange coverage to those who are already enrolled in Medicare. If you do keep your old exchange plan in addition to having Medicare, Medicare will be the primary payer for your healthcare expenses.
Depending on your income, you may also qualify for Medicaid or for Extra Help, the latter of which can reduce the premiums and cost sharing for your Medicare Part D benefits. You can learn more about these programs and how they work with Medicare from your State Health Insurance Assistance Program (SHIP) or by visiting the Medicare website at www.Medicare.gov.
If I enroll in Medicare, I’ll owe premiums on my Part A coverage. Can I get a plan through the exchange instead?