Obamacare and Seniors
If you’re over the age of 65, your health insurance options under the Affordable Care Act depend on whether or not you’re covered by Medicare or another insurance plan. To find out what, if anything, you need to do, find the situation below that applies to you.
You have Medicare. If you’re already enrolled in Medicare, you’re considered covered under the ACA, and you don’t have to do anything. In fact, it’s illegal for someone who knows you have Medicare to try to sell you a plan through a health care marketplace.
The Affordable Care Act enhances your existing Medicare coverage in a couple of important ways:
- You get more preventive care benefits, such as cancer screenings and an annual wellness visit.
- If you fall into the prescription drug “donut hole,” there are new discounts to help you save money until the hole closes completely in 2020.
For more information on Medicare coverage, go to Medicare.gov. To learn about Medicare Advantage plans -- which include traditional Medicare benefits, prescription drug coverage, and more -- see Medicare Advantage By Zip Code.
You’re over 65 but not eligible for Medicare. You are welcome to purchase a health plan from NY State of Health, the health insurance marketplace for New York. If you meet the qualifications based on income and family size, you are eligible for cost-saving subsidies, too.
You have retiree health benefits. If you have a health plan from a previous employer, you’re considered covered under the Affordable Care Act. You don’t have to do anything -- and you don’t have to worry about the penalty faced by the uninsured. That said, you are welcome to shop for a new, individual health plan at NY State of Health. 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. Older adults who aren’t enrolled in Medicare and have no other health coverage may owe a tax penalty. If you are currently uninsured, you can enroll in a plan at NY State of Health. Keep in mind, however, that if you are eligible for Medicare but choose to enroll in a marketplace plan instead, you will not qualify for the cost-saving subsidies offered by the Affordable Care Act.
For more information about the tax penalty, including how it works and who has to pay, see Do I Have to Get Obamacare in New York?
To learn about the costs of marketplace health insurance plans, see How Much Does Obamacare Cost in New York?
For more information on the cost-saving subsidies that may be available for marketplace plans, see Ways to Save Money on Obamacare in New York.