I have been diagnosed with ESRD and will need a transplant.
I haven’t yet applied for Medicare.
Can I get a Covered CA – QHP- Qualified Health Plan – ObamaCare instead?
Medicare and You 2020 #10050
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According to federal guidance, people with ESRD who have not applied for Medicare are eligible for premium tax credits if their income is between 100% and 400% of the federal poverty limit (FPL). This group can buy a Qualified Health Plan (QHP) Covered CA, instead of enrolling in Medicare. This federal guidance does not address the issue of someone with ESRD whose income is above 400% of the FPL and is ineligible for a premium tax credit and whether they can buy a QHP instead of Medicare. It also does not address the issue of whether a person in this situation whose income is between 100% and 250% of the FPL is eligible for any cost-sharing subsidy.
If you are considering a QHP instead of Medicare you should carefully compare all the costs and benefits associated with both a QHP and Medicare before making your decision. Please read the answer to #5 and 6. You should also know that if you do not enroll in Medicare Part A before you have a transplant, you will not be eligible for Medicare’s immunosuppressive medication benefit under Part B, even if you decide to enroll in Medicare later. In addition, you might be charged a late enrollment penalty and have a delay before benefits begin if you apply for Medicare in the future. For more help with this difficult decision, contact your local HICAP for assistance or ask your question in the FAQs / Ask Us a Question below. You don’t have to put in your name. Copied from ca health advocates.org/
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