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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Exchange available for over 65 but not Medicare eligible?

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Question: If I am over 65 and not yet eligible for Medicare, as a recent immigrant, am I eligible to purchase individual coverage through the exchange? If not, what are my options? Will there be guaranteed issue coverage outside the exchange?

Answer: If you are a legal resident, you will be eligible for Covered California coverage even over age 65.

4 Comments

Have you solved your problem ? I am asking because my mother is over 65 and without medicare too (permanent resident since sept 2011) and as such was able to enroll in an “Anthem - Bronze 60 PPO” plan on Covered CA. However this was Oct 2nd and as of Nov 16th we didn’t receive any package, bill or confirmation from Anthem, so it makes me wonder if we are not in a situation similar to yours where the government approved her but the insurer won’t issue a policy … Is there an appeal process for this situation ? Thank you in advance.

So, the largest insurance carrier in Wisconsin has their product called “WPS ARISE” for the Exchange.

I just talked to them their “system” does not allow for anyone above 65.

I was simply told that “a legal resident above 65 is not covered”. “If they are not covered by medicare or medicaid, its not our problem….”

M Akbar, MD

Yes. This is an affect of the Affordable Care Act and is effective nationally. If you are a legal resident and not eligible for any public insurance coverage, you will be eligible for Exchange coverage even over age 65.

Can we expect the same in States which have deferred to the federal exchange. Is this eligibility provision provided by the State of California of is it part of the federal guidelines. I am in Wisconsin which has deferred to the federal marketplace. I am trying to figure out if someone over 65, not medicare eligible as a recent immigrant legal permanent resident, will be eligible to purchase through the federal exchange?

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