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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.

Medicare Mandatory at 65?

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Question: I am currently insured with Blue Shield thru Covered California. I will be 65 in December. Must I choose Medicare and give up my current plan? I am retired and receiving social security benefits.

Answer: If you do not sign up for Medicare when it is offered (age 65 birthday month), you will no longer be eligible for a subsidy through Covered California. Unless you have money to burn, sign up for Medicare.


Phil’s answer above was somewhat incomplete. Although you don’t mention which health plan you have, each of the insurers currently offering health plans through CoveredCA offers Medicare Supplement insurance and, depending on where you live, may also offer Medicare Advantage HMO plans as well. The Medicare Advantage plans will be similar to your existing health insurance, and include the required Prescription Drug Plan benefits.

In most areas of California MAPD plans come with little or no additional premium other than your Medicare Part B monthly premium. Most of the MAPD plans will reduce your out of pocket expense to near $0, as will a Medicare Supplement “Plan F”, but with Med Supp, you also need to purchase a stand-alone Prescription Drug Plan, which can range in price from $18.40 to over $132 per month in California.

Work with a licensed insurance agent to get the best information. You will be eligible to enroll in a Medicare Health Plan or Supplement insurance plan beginning in September, with a 12/1/2016 effective date. This is a one-time election and cannot be changed. However, beginning October 15, and through December 7, you can make as many changes to your coverage as you want, with the last one you make taking effect on 1/1/2017

Choosing Medicare and enrolling in to a Medicare “plus plan” usually reduces premium. Moreover, not choosing Medicare and not enrolling in to a Part-D plan when first eligible may lead to late enrollment penalties.

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