Does the Affordable Care Act Affect Medicare? What Seniors Need to Know for 2024-2025
With the Affordable Care Act (ACA) continuing to make headlines—especially during election seasons—many Medicare-eligible seniors may wonder how the ACA impacts their current or future Medicare coverage. The good news? Medicare remains largely unaffected by changes to the ACA.
If you’re approaching age 65 or are already enrolled in Medicare, here’s what you need to know during the 2024 Medicare Open Enrollment period, and how to make informed decisions about your health care options.
Key Takeaway: Medicare Is Not the Same as ACA Marketplace Plans
Although the ACA governs the federal health insurance exchange (also known as the “Marketplace”), it does not apply to Medicare. Seniors covered by Medicare are not impacted by ACA enrollment deadlines, premium subsidies, or coverage changes on the Marketplace.
When Is Medicare Open Enrollment?
Medicare Open Enrollment runs from October 15 through December 7, 2024. During this time, you can:
- Switch from Original Medicare (Part A & B) to a Medicare Advantage Plan (Part C)
- Change from a Medicare Advantage Plan back to Original Medicare
- Join, switch, or drop a Medicare Prescription Drug Plan (Part D)
- Switch between Medicare Advantage Plans
This period should not be confused with the ACA’s open enrollment window, which runs from November 1, 2024 to January 15, 2025 and applies only to individuals purchasing coverage through the ACA Marketplace.
How to Choose the Right Medicare Plan for 2024
Enrolling in Medicare can feel overwhelming, but you don’t have to go it alone. Arizona has a robust network of licensed Medicare brokers who offer free, in-person or virtual consultations. Some agents will visit your home, while others host local seminars to help seniors compare Medicare plans side by side.
Are You Turning 65? Here’s When to Enroll in Medicare
Most individuals become eligible for Medicare at age 65. You have a seven-month enrollment window which includes:
- Three months before your 65th birthday month
- The month of your 65th birthday
- Three months after your birthday month
Visit Medicare.gov to check eligibility, apply online, or compare plans in your zip code.
Important Differences Between Employer Plans and Medicare
If you’re transitioning from an employer-provided health plan to Medicare, keep in mind that the coverage and rules may differ. Here are some key questions to ask as you compare Medicare Advantage or Medigap plans:
- Are your current doctors in the plan’s network?
- Will your prescription medications be covered? Are there formulary restrictions?
- What are the monthly premiums, deductibles, and co-pays?
- Is prior authorization required for services you’re used to receiving freely?
- Does the plan offer dental, vision, or hearing benefits?
- Are wellness programs or fitness memberships (e.g., SilverSneakers) included?
Maximize Your Medicare Benefits in 2024
Whether you’re new to Medicare or considering a plan switch, take the time to research your options. Look at star ratings, customer satisfaction reviews, and network directories. Your health and budget deserve a plan that fits your lifestyle, medical needs, and preferred providers.
For more information, visit www.Medicare.gov or call 1-800-MEDICARE.