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Will seniors in New York benefit from the Affordable Care Act?

Authored By: Empire Justice Center and LawHelpNY
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Seniors with Medicare are already benefitting from two major parts of the Affordable Care Act besides the Health Care Exchange and expanded Medicaid coverage:

Addition of free preventive service to the Medicare benefit package; and Closure of the Medicare Part D "donut hole" for prescriptions

The general rule for seniors with Medicare is that they will NOT qualify to get coverage through the new health care exchange. They will continue to get their Medicare and related benefits (such as Medigap, Medicare Advantage, Medicaid, MSP, and/or Extra Help) the same way they do now.

However, there are a few small exceptions:

  • Medicare recipients who are caretaker relatives can apply for MAGI Medicaid through the exchange.
  • Seniors who don't have enough work quarters to get free Part A coverage can go through the exchange if they are not enrolled in Part A.
  • Uninsured seniors who are too young for Medicare can definitely benefit from the exchange. Some will be newly eligible for Medicaid and others can get private health care coverage with or without subsidies, depending on their income.

PLEASE NOTE: People under 65 qualify for Medicare if they receive Social Security Disability (SSD) or have End Stage Renal Disease.  SSD recipients have a 24 month waiting period for Medicare unless they have ALS (Amyotrophic lateral sclerosis).

Last Review and Update: Nov 22, 2013

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