Will My ACA Plan Continue If My Spouse Goes on Medicare?

Losing Coverage Due to Life Changes

Life events, such as getting married, having a baby, or losing a job, can affect your health insurance coverage. Losing coverage is known as a qualifying life event, which allows you to enroll in a new health plan outside the Open Enrollment Period.

Qualified Life Event: Losing Coverage Due to a Spouse’s Medicare Enrollment

When one spouse drops off an Affordable Care Act (ACA) plan and enrolls in Medicare, it can trigger a qualifying life event for the other spouse. This is because the ACA considers losing coverage through a spouse’s plan as a loss of coverage.

Impact on ACA Plan Continuation

If your spouse drops off your ACA plan and enrolls in Medicare, your plan will generally not continue as is until the next Open Enrollment Period. You will need to select a new ACA plan or explore other coverage options within 60 days of your spouse’s Medicare enrollment.

Limited Exception

There is a limited exception to this rule. If you and your spouse are both covered under the same ACA plan, and your spouse becomes eligible for Medicare due to disability, your plan may continue to cover you until the end of the plan year.

Seeking Professional Assistance

Understanding the implications of life events on your health insurance coverage can be complex. It is highly recommended to contact a licensed insurance agent or visit HealthCare.gov for personalized guidance and assistance in selecting the best coverage options for your situation.

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