Can ObamaCare Be Used as a Secondary Insurance?
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I carry very good medical/dental insurance through my employer. My ex wife has shared custody with my daughter. My son, who is over 18 is also covered under my insurance. My ex wife’s new husband signed both my daughter and my son up to obamacare as a “secondary” insurance. Is this legal? As a tax payer it concerns me that obamacare can be used as a secondary insurance, when insurance is already being provided.
Ralph Thompson
I have a 74 year old friend who has original Medicare but no supplemental insurance coverage. He’s facing some treatments for cancer and is asking if he can use Obamacare as a secondary insurance to help with the 20% that Medicare won’t pay? (He doen’t have the internet and can’t speak to anyone on the phone due to poor hearing. I’m checking out these possibilitied on his behalf).
ObamaCareFacts.com
The answer to the question is that people on Medicare would use supplemental Medicare insurance including Medicare Advantage and Medigap in most cases. There are some edge cases where a person has one part of Medicare or is eligible for Medicare but can get a marketplace plan, but they are very specific cases. You can see a list of all the info here https://www.healthcare.gov/medicare/medicare-and-the-marketplace/. But most likely you’ll want to look into Medicare enrollment periods for them and pick up a supplemental Medicare plan like a Part C plan which does cover extra costs. https://medicarepolicyhelper.com/medicare-guide/medicare-enrollment-periods/
Dawn Simmons
My son, a 21 y.o. with a first time job, will be starting to receive insurance benefits through his employer. He’s been on my ACA policy all along. If I drop him, my plan, to remain affordable, must be lowered to bronze from silver, and my deductable is through the roof. No more copays, but everything is OOP until the deductable is met. Not a great plan for a healthy individual! Can I keep the current policy with him remaining on, and name that as a secondary for him only? How would that affect my receiving the tax credits?
Thanks for helping with these challenges!
Erin
You can purchase secondary insurance or supplemental insurance to compliment your sons coverage through your Marketplace family plan. Depending on what state you live in your son may qualify for Medicaid (no OOP costs). While the ACA does allow parents to cover their adult children on a family plan until 26, it doesn’t require it. Sometimes, the best option for families is for their adult children to use the marketplace or Medicaid as individuals depending on their income. So you may want to look into these options fro your son.
Linda Thomas
I am 60 years old and a retired federal employee. I currently have blue cross blue shield as my primary insurance. My question is can I get a ACA supplemental insurance until I qualify for Medicare. I am a Type !! Diabetic
Thanks
Paul Nix
Beginning 2017, my son was unemployed, and had a subsidized ACA plan. Five months ago he got a job with a large company. After three months, he became eligible for his company-sponsored plan.
He has continued to pay the low (subsided) ACA premium each of the last two months.
Question:
When he sees a doctor, is it correct for him to tell the doctor’s office to use his Company Plan as his primary insurer, and the ACA Plan as his secondary insurance? Secondly, does the doctor’s office have the authority to tell him what he should do?
ObamaCareFacts.com
In general the insurers are supposed to work out which plan is the primary and which is the secondary, not the doctor. I don’t however know if there is a rule against what the doctor did or not (it doesn’t seem right, but I don’t 100% know).
With that said, your son shouldn’t be using a subsidized marketplace plan and employer plan. That is going to cause problems down the road (at tax time when he goes to file for the tax credits he used while he had an employer plan).
He should call the marketplace immediately and drop the marketplace plan to avoid owing back additional cost assistance.
John
“You can get ObamaCare as a secondary insurance, but you can’t get tax credits on it. Generally holding more than one comprehensive insurance plan makes no sense. If your dependents have coverage through your employer, they can’t get cost assistance through the Marketplace. So technically they shouldn’t be getting tax credits, that said the person filing for the children is responsible for ensuring they are covered. The correct thing to do would be for you to provide them coverage through work, or for them to be on the Marketplace plan without cost assistance. Also, this doesn’t override divorce agreements it just goes hand-in-hand with it.”
Pardon me but is this true is every state? Where in the law is this subject addressed – chapter and verse?
ObamaCareFacts.com
So, divorce and tax credits has proven to be tricky. You can get an exemption for a non-custodial parent to claim credits, so that should be accounted for. As for “where does it say”, form 8962 has some directions, the non-custodial form is Form 8332, and the rest is essentially logic.
In the final rules based on the law it essentially says “if you have employer coverage, you can’t get marketplace tax credits” and that “the parent who files is the one who claims the credits”. Putting it all together gives you the gist.
Because this is complicated I would 100% suggest seeking help from a tax and/or legal professional. Hope the above helped with some clarification though.
Terry
I have just went on disability and I am on medicare. I Will need undergo a surgery and it will not pay it all
ObamaCareFacts.com
There is no direct answer to that, but you can call healthcare.gov (or in your case, best bet is Medicare.gov) if you want details. Essentially you can’t get private coverage in the individual market if you have Medicare, but you can use Medicare special enrollment to switch to a more robust plan.
Terry
How much does it cost to get Obama care as a secondary insurance plan.
Dave Reeve
Follow up to my original question. my ex got tax credits that I am now on the hook for since it is my year to claim my daughter as a dependent. Now what? Everyone (healthcare.gov, IRS, etc) seems to be downplaying this. Isn’t there legal ramifications for her getting these tax credits? I would think that she would have had to lie on her application to get these tax credits
ObamaCareFacts.com
I am just as confused as you as to the mechanics of this. Thank you for the update, hopefully this will help others. Anyone who has insight please chime in.
Teresa
I agreed with you until you said that if the mother claims the children there is no need to provide insurance. As you have not been provided a copy of the divorce nor custody papers. You have no knowledge of what has been mandated through the courts.
ObamaCareFacts.com
Yeah you are right, I updated the answer. In this instance the kids had coverage through the employer so they shouldn’t be getting cost assistance. But I added in a blip about divorce agreements as well.
Judith Reed
i am on medicare – can affordable health care be used as a supplemental insurance?
ObamaCareFacts.com
No, you can only get Medicare and supplemental Medicare if you are eligible for Medicare.
Paul
Not sure you answered his question:
He said he already has Medicare.
Your answer: “No, you can only get Medicare and supplemental Medicare if you are eligible for Medicare.”
Of course you can only get Medicare if your eligible for Medicare!
(I have Medicare, plus a “Medicare Supplement” through Blue Cross.)
Restating his question:
Can one use an ACA plan as one’s Medicare Supplemental plan (which will pretty much pay what Medicare doesn’t pay.)
What do you know to be the factual answer?
Thanks,
Paul
ObamaCareFacts.com
No, you cannot hold a private individual and family plan and Medicare at the same time.
If you have Medicare Original, then you can ONLY get Medicare plans like Part D, Part F, Part C etc.
I’ll reword the page so it is more clear.