Transitioning from Covered California to Medicare requires a certain amount of research and planning.
You will also need to take proper action and keep track of important dates.

Transition from Covered California to Medicare

Generally speaking, if you are are eligible for Medicare, you are not eligible to receive financial help through Covered California.
You need to report your Medicare eligibility to Covered California within 30 days.
Also, you need to cancel your Covered California plan when you become eligible for Medicare.

If you keep your Covered California plan when you are eligible for Medicare, you may face the following consequences:

  • You may have to pay back all or some of your premium tax credits to the Internal Revenue Service (IRS).
  • You might experience a delay in your Medicare coverage start date. If you don’t sign up for Medicare Part B (medical insurance) during your initial enrollment period, you will have to wait for the general open enrollment period (Jan.1 to March 31), and then your coverage wouldn’t begin until July of that year.
  • You may have to pay lifetime penalties for late enrollment in Medicare and your premiums may increase by 10 percent or more.

There is an exception for people eligible for premium Part A.

If you must pay for Medicare Part A, you may purchase a Covered California health plan.  You might also qualify for financial help, depending on your income.

However, you may still face a permanent late enrollment penalty for Part B.

Covered California and Medicare for Disabilities

People with disabilities approved by the Social Security Administration will be automatically enrolled in Medicare within two years of receiving Social Security Disability Insurance (SSDI) income.

You can purchase health coverage through Covered California during your two-year waiting period. Depending on your income and family size, you may qualify for financial help to lower the cost of your Covered California plan, or get low-cost or no-cost Medi-Cal.

After your two-year waiting period, you will need to cancel your health plan through Covered California at least 14 days before you want your coverage to end.

Covered California and Medicare Part A

If you have active Medicare Part A, or you qualify for premium-free Medicare Part A, you can’t enroll in new coverage through Covered California.

This is because Medicare Part A is considered minimum essential coverage under the Affordable Care Act.

But depending on your income and assets, you may be eligible for additional coverage through Medi-Cal.

How to Apply for Medicare

Unless you currently receive Social Security benefits, Medicare enrollment is not automatic, and you must actively enroll. The timing of your Medicare enrollment is very important. The initial enrollment period starts three months before the month you turn 65 and it ends three months after the month you turn 65. You should sign up for some Medicare parts before the month you turn 65 to avoid a health coverage gap.

If you miss your initial enrollment period, you may have to wait until the general open-enrollment period in January to sign up, with coverage not starting until July of that year. This could result in a delay of the start date of your Medicare coverage. This could also mean that you’d have to pay a higher Medicare premium for the rest of your life.

Due to the recent coronavirus pandemic, many seniors are applying online.  Also if you are a permanent resident, you may be required to submit identification documents.

Apply for Medicare Online

Looking for a Covered California agent?

Skyline Benefit is a certified Covered California broker with expertise in Medicare and Covered California.

Our Covered California agents can go over your medical needs and budget, and help you determine the best health insurance option for you.

You can contact us at (714) 888-5116

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