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Covered California Q&A

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.


When One Household Member Becomes Medicare Eligible?

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Question: I will become Medicare eligible 7/1/2015 and elect a Medicare Supplement or Adv plan. My wife has another year before Medicare Eligibilty. When/how should I notify CovCA and /or Blue Shield that I am going off but wife needs to stay on plan. I have heard of others who had both spouses cancelled and huge headache to get straightened out. Do not need that hastle! Thanks.

Answer: You will need to cancel your Covered California coverage by June 15, 2015. You can remove yourself from coverage, leaving your spouse's coverage unchanged, through your Covered California online account. If you are not comfortable with the online method, your agent can handle it for you or you can call Covered California at 800-300-1506.

7 Comments

My wife is primary on our Covered CA plan. She is moving to Medicare and I have been told that my plan is being cancelled. Covered CA is hoping to get me reinstated in 45 days. This is the second time that Obamacare has dumped me off of my insurance. I was one of the self employed people who had their plan cancelled and was forced into a substandard plan. The amazing thing to me, judging by the dates on the previous posts, this has been going on for more than 18 months. All you people who want the government to run health care need to get a clue. I called my Assembly woman to see what can be done……

In my experience, remaining spouse will have a brand new policy as a new one has to be created. I suggest switching as soon as possible so you limit the loss of deductible & out of pocket max.

If Primary will become Medicare eligible June 1st when do you suggest contacting CovCA to change the to be remaining spouse to Primary? Is it best to do at same time- eg., contact about 5/15 to make the younger spouse the Primary and also advise that older soon to be Medicare eligible spouse to be disenrolled at end of May as he will be on Medicare June 1st? Or better to request that younger be Primary now and then call in disenrollment of older spouse about May 15th? Other timeline on doing this suggested? It is terrible that what use to be such a simple matter would possibly be so complicated!

Murph, I have learned the hard way to list the youngest as the primary as the secondary is easily removed and the primary is difficult (read nearly impossible). IF the Medicare-Eligible member is the primary; call Covered CA and find someone who will work with you to get spouse switched then Insurance Co will honor the deductible/Out of Pocket Max already spent by spouce.

As quote typically the husband is Primary on insurance and in most cases the first to qualify for Medicare- HOW does one make sure this possible glitch is avoided- getting Primary off CovCA when Medicare eligible but KEEPING spouse on CovCA until she becomes Medicare eligible? It seems like it would be fairly simple but not in today’s health insurance situation!

Vanessa, how do you fix the case where the “primary” spouse is cancelling and preserve the coverage for the remaining spouse?

The glitch in cancelling one spouse from Covered CA to move to Medicare is usually because the ‘cancelling spouse’ is the primary. Double check that the spouse keeping the policy is currently the primary applicant on Covered CA account.

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