Obamacare refers to health insurance purchased through the federally established healthcare Marketplace.
Marketplace plans were created by the Affordable Care Act. These plans are private insurance plans that are designed to match certain needs and budgets.Medicare is a health program offered by the government to older adults and people with certain disabilities.
You cannot have both Obamacare and Medicare.Obamacare is a term used to describe the services provided under the Affordable Care Act’s Marketplace plans. These private insurance plans were designed to offer comprehensive but lower-cost plans for people who don’t receive health benefits through an employer or the government.
Can you get Obamacare if you are on Medicare? If you are eligible for Medicare — a health plan offered by the government to certain people — you must end your Marketplace coverage to join Medicare.
Can I bundle multiple benefits into one plan?
Medicare is health insurance offered by the federal government to help adults over age 65 and people with certain disabilities pay for healthcare. These plans divide the cost of your healthcare between you and the federal government. There are private insurance Medicare plans — called Medicare Advantage plans — that can be purchased, but they have to meet requirements set by the federal government to offer at least as much coverage as Original Medicare plans.
Obamacare plans, on the other hand, are private insurance plans that are designed to meet the healthcare needs of people who might not otherwise have access to healthcare. These plans, also known as Marketplace plans, were developed after the passage of the Affordable Care Act — a law that aimed to make healthcare more accessible and affordable. The federal government helped get these plans developed but does not administer the plans or offer any financial help. When the Marketplace first opened in 2014, there was a penalty charged to anyone without health insurance. This rule was changed in 2019, and there is no longer any penalty for failing to carry health insurance.
To qualify for Medicare, you must be 65 or older, or you must have qualified for disability from the Social Security Administration for 24 months or have end-stage renal disease or ALS (Lou Gehrig’s disease).
How much you pay for Medicare will depend in part on how much you paid during your lifetime in Medicare taxes. If you have paid Medicare taxes through an employer for 10 years or more, you don’t have to pay a monthly premium for Part A of Original Medicare. Part B, however, requires a standard premium.
While it’s true that just about “anyone” is eligible for a Marketplace plan, there are a few specifics.
Eligibility requirements for these plans are:
While all these plans focus on offering healthcare coverage to people with special financial or medical needs, the key differences are in what type of entity offers the plans.
Obamacare doesn’t affect your ability to qualify for Medicare. Obamacare is intended as an affordable option for people who may not qualify for public assistance health programs like Medicare or Medicaid. Most people who qualify for Medicare drop their current plan — be it a Marketplace health plan or other private plan — and sign up for Medicare instead.
If you want dental services and you are enrolled in Parts A and B of Original Medicare, you may be able to switch to a Medicare Advantage plan that includes dental care. You may also just choose to pay out-of-pocket for these services.
You cannot sign up for a Marketplace dental plan while you have Medicare. You can only add dental services through the Marketplace when you sign up for a Marketplace health insurance plan.
Still have questions? GoHealth has the answers you need.
Medicare coverage is individual in nature, so younger spouses don’t qualify for Medicare when the older spouse turns 65. The younger spouse must also wait until age 65.
Obamacare, however, is available to your spouse whether you are on Medicare or not.
Medicare isn’t mandatory. However, you may be enrolled in some parts of Medicare automatically, and opting out can be complicated.
Additionally, if you decide to wait to sign up for certain Medicare services, you could be faced with late enrollment penalties. These penalties are based on the age when you were first eligible for Medicare and when you finally enrolled.
In some cases, you may choose to keep your pre-Medicare coverage (if it’s something other than Obamacare) after you sign up for Medicare. In these cases, one payer will be the primary payer and one will be secondary. You will need to ask your insurance company about specific coverage rules if you want to keep your plan with Medicare.
Ready for a new Medicare Advantage plan?
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.