I am 80 years old and widowed in December. I have no health insurance and due to a decision to take my money out of PERA, I do not qualify for Medicare. What should I do?


Answer

If you are over 65, and do not qualify for Medicare, you can buy Marketplace insurance and get cost assistance.

Since this is true, the easiest next step is to call healthcare.gov. There are many details to consider, so it can help to get someone on the phone to walk you through it. With that said, below are the basics.

If you are over 65 and do not qualify for Medicare you may be eligible for cost assistance based on your household size and income during open enrollment (or if you otherwise loose coverage and qualify for special enrollment).

Since you recently experienced the death of a close family member, you may also qualify for a hardship exemption (although you won't need it if you sign up before Feb 15).

Here is How ObamaCare Works if You are Over 65, But Don't Qualify For Medicare

You’re over 65 but not eligible for Medicare. You are eligible to get coverage on HealthCare.gov (the ObamaCare marketplace). If you meet the qualifications based on income and family size, you are eligible for cost-saving subsidies, too.

You have retiree health benefits. You’re considered covered under Obamacare and won't owe the fee. You can replace that coverage with coverage from HealthCare.gov. However, if your retirement coverage is considered affordable and meets certain minimum standards, or if you are eligible for Medicare but have chosen not to enroll, you won’t qualify for Obamacare’s cost-saving subsidies.

You don’t have any health coverage. If you are over 65 the fee for not having coverage still applies to you. Whether you get a Marketplace plan, get Medicare, or keep a retiree plan from a previous employer you are covered.

IMPORTANT: If you do have access to Medicare, it's actually illegal for someone to sell you a non-Medicare health plan and you won't be able to shop on the Marketplace.

Learn more from LegalConsumer

Rate and Comment on the Answer

Your email address will not be published. Required fields are marked *

1 2 3 4 5

This site uses Akismet to reduce spam. Learn how your comment data is processed.

jayendra patel on

I am 72 year old,working part time job and getting approximate $160000.

I am not eligible for medicaid nor medicare.

Who can i get obamahelthcare insurance?

I need rate and plan., sorry i have 16 quarters only

thanks

ObamaCareFacts.com on

You won’t qualify for Medicare yet, but you can get ObamaCare. You’ll shop during open enrollment and qualify for cost assistance based on household income claimed on your tax return.

Learn more about Medicare rules here: http://www.insubuy.com/medicare-for-new-immigrants-green-card-holders/

Learn more about ObamaCare coverage at HealthCare.Gov

ps. In some states you may have Medicaid options if your income is below 138% of the poverty level.

brian medhurst on

i am 69 years old. i do not have medicare, and oregon does not have medicaid exp., i receive approx. $13000 per year in pensions. and do not earn enough for obamacare tax breaks…help!!!

Gary N. Smith on

I turn 65 on June 14th and am not eligible for Social Security. My Obamacare started in 2014 but ends on June 30th. Have been unable to RE-NEW my benefits so I need an alternative. I live on a trust…receive from an executor approximately $400 a month. It is finite and running out…$9,000 left. Need healthcare. Undocumented health issues prevent me from working.

tripurari prasad singh on

I am 69 years old. I want to medicare insurance. Please help.

Heather on

My mother is 66. She was on medicaid, until she was denied due to age in April.. She didn’t know she had to apply for Medicare at 65. She thought she could wait until 70, to receive full benefits… As soon as she got the denial from Medicaid she applied for Medicare, but was too late. She has part A, which only covers part of hospitalizations. She has non Hodgkin’s lymphoma. Without insurance, she is not getting the care she needs… I’ve been filling out papers after papers, to no avail… The bills are piling, her body is ill, and I am sickened that our country treats out elderly the way they do…

Roderico Matta on

Every time I entered my information, to see plans, costs, or agents a page came uo with words saying I should look for medicare plans, but I am a legal permanent resident without any social security benefits. Where can I get health insurance??

ObamaCareFacts.com on

If you are Medicare age a great place to start your journey is Medicare.Gov, if not then Healthcare.gov is best. It isn’t that these are your only options, it is that this is a good place to start when you are confused. Enrolling in Medicare is a little complex and must be done during open enrollment periods. See here https://obamacarefacts.com/medicare/medicare-enrollment/

Tanya on

My mother is 71 and has mcr, part D, and a supplement that add up to almost 400 a month, her income is 1150. She has a house payment and bill, food etc.. she can’t afford this insurance. Is there any other options.

ObamaCareFacts.com on

IT is very risky to not use Medicare. You can owe a bigger premium if you don’t continue it from your initial enrollment period on. Without giving you my feelings on that, I would generally say there isn’t a better option for a Medicaid eligible person… However, you can always go with just A & B (Original Medicare) then use drug savings card like this one: http://easydrugcard.com/.

Again, once off Part D you could have real problems moving forward, but A & B and a life insurance plan (for long-term care costs) can be an alternative, as can just using a savings account to have back-up money for future costs.

No perfect solution here, but hope this helps.

Nina Rathore on

Hi, my mother is a US Citizen but has lived overseas for past 10+ years. She is planning to move to US and live with me as she has no income here in US. During her prior visits we would purchase her Travelers Insurance but now most insurance are way too high for her. She has not earned enough credits to be eligible for Medicare although I am aware that she can purchase Medicare A&B at registered premiums. Does Obamacare offer any subsidized health care options for my elderly mother. We live in New York.

Erin on

New York has expanded Medicaid and your mother would qualify for Medicaid because she has no income. In addition, you may also be able to be included in your tax family as a qualifying relative and claimed as your dependent. This would allow you to apply for health insurance together and for you to claim an additional dependent exemption and filing as head of household (assuming you couldn’t already), which could potentially lower your tax burden.

mary on

Delete medicare so evrryone can purchase a healthcare plan

mar on

Yes we need keep for old people and because that can’t get any morObamacare. it is hard to get any from the government if you are just had 66/80

Frank Maye on

What is the law ie statute etc that says that if I don’t qualify for medicare that I can get private primary healthcare insurance ?

Frank Maye on

I am 65 and don’t qualify for medicare parts a or b. What is the section or statute or title or page of ACA which says I am entitled to get private insurance thru obamacare
Frank

Mavis Barnett on

I have a member that immigrated from England and has a resident green-card. They qualified for a plan on the marketplace. They received their ID cards and information but the information is referencing U65 and they are over 65? Why does it say U65? Thanks

Alma on

My mother is 66 years old and is a legal permanent resident in California. She is currently on Medical. She does not have enough work credits to qualify for social security which means she will not qualify for Medicare either. She does not want to purchase medicare because she does not have any income other than a small monthly SSI check and the monthly premiums for Medicare are too high. Will she be able to continue with Medical? or does she have Obamacare options that would be cheaper than buying Medicare? She is pretty healthy for her age, she has no chronic illnesses and does not take any medication on a regular basis, therefore if she is unable to find affordable health coverage here she would prefer to visit the doctor in Tijuana Mexico and pay 100% out of pocket which would be way cheaper than buying medicare or any other unaffordable health insurance. Will she have any problems if she does that?

ObamaCareFacts.com on

Yes, she will have problems. Namely, she can get charged higher rates for life if she doesn’t enroll. Medicare is a complex thing to navigate, and it can be expensive, but getting locked in is pretty darn useful. It is a personal choice, beyond that I’d need to offer a full theory of healthcare to give you insight into the pros and cons of forgoing Medicare and going to the doctor in Tijuana.

Angelique Eddins on

Complicated, confusing, and unhelpful

ObamaCareFacts.com on

Sorry you feel that way, we updated the article to make it clearer. Although to be fair, it was actually already offering the correct answer.

T on

An elder relative who is 65 years of age, permanent legal resident, he is qualified not qualified for medicare as he does not have enough work credits. He could not get the medicaid as it automatically kept putting him on medicare. What would be the best next step of actions for him?

Erin on

Call your states Marketplace or the Medicaid program in your state directly for help.

Dunfa on

Just reached 65 in Oregon. Got kicked out of medicaid. Not eligible for Medicare. Income is not enough to get tax credit from Obama care. Is this a loop hole? Now need to pay 700 per month for insurance premiums.

Cora on

My mom is 77 y/o first time in US, never work before, she has ESRD what kind of insurance she can have to get proper treatment of her kidney problem.

Thanks

Anonymous on

A friend was on SSI for most of life, but family helped turn inheritance into small income, just above medicaid, but this person will never be qualified for social security or medicare hospitalization plan bcz never worked ten years. Can they enroll in ACA marketplace plan instead? Much cheaper than being forced to pay for medicare at 65.

ObamaCareFacts.com on

If you qualify for Medicare then you can’t get marketplace insurance. One can however apply for assistance via Medicare. https://www.medicare.gov/your-medicare-costs/get-help-paying-costs