Medicare vs. Covered California


There has been a lot of talk lately and questions regarding Medicare and Covered California. People are always asking me “I have Covered California, can I enroll in Medicare? What happens to my tax credits if I enroll in Medicare? Is Medicare better than Covered California? I am going to address some of the most common question and attempt to keep it simple.

If you have a Covered California plan and you are under 65, you have an option to enroll in Medicare and keep your Covered California plan. Medicare will pay first and Covered California will be secondary. But look at this scenario, you will be paying a monthly premium for Medicare Part B, plus your monthly premium for your Covered California policy.

Sounds like a lot up front and it is! The good news is, you won’t need Medicare Part D (drug Plan) because your Covered California plan will contain your pharmacy benefits. There is something called coordination of benefits, that means if Medicare pays, your Covered California plan will also pay. If you are on dialysis those upfront monthly premium charges for 2 health plans, you are pretty much paying little to nothing for your dialysis treatments. If you enroll in Medicare after you purchase a Covered California policy, you could be at risk to lose your tax credits, which could raise your monthly premium. Remember you cannot purchase a Covered California policy for yourself if you are already enrolled in Medicare.

For our clients who are enrolled in Covered California, I always advise them to count the costs before enrolling in Medicare. You may have better coverage with your health plan than with Medicare. For dialysis treatments Medicare is an 80% coverage plan, you may have better dialysis coverage with your existing Covered California plan. When making your decisions, again count the costs.

Of course, these short paragraphs cannot possible cover every scenario, so please feel free to contact me. Next up, Chronic Kidney Disease, Dialysis and Transplantation when to think about enrolling in a Medicare Advantage Plan.