Several people have wondered why Covered California is now asking them if they are enrolled in Medicare. Most of these people are too young to be Medicare eligible and have never had a disability that allowed them to enroll in Part A of Original Medicare. No one I have talked to at Covered California seems to know what triggers the demand letter to prove that a household member is not enrolled in Medicare.
The demand to prove the lack of enrollment in Medicare is usually sent by letter and usually shows up as an alert on the consumer’s Covered California account.
Proving You Are Not Enrolled In Medicare
Covered California is expanding its dragnet to catch people who may not be entitled to the Advance Premium Tax Credit (APTC) subsidy. If you are eligible for Medicare, or have other minimum essential coverage (MEC), you are not eligible for the monthly APTC subsidy.
Covered California is performing more cross references with federal databases to make sure people meet the conditions for the APTC subsidy. For example, if Covered California cannot verify that you filed your federal income taxes for the previous benefit year – which is a condition for receiving future subsidies – Covered California can flip off the subsidy switch on your account.
They check the tax filing condition by checking with the federal data services HUB. Covered California has said it will be performing mid-year checks for people at or near 65 years of age to see if they are eligible or enrolled in Medicare AND receiving the APTC subsidy at the same time. Somehow, Covered California is getting a false positive for some people when it comes to Medicare eligibility
Medicare Attestation Form
It can be perplexing as to how you prove a negative. There is no physical proof that you are not enrolled in Medicare. Fortunately, Covered California has created a form for you to attest that you don’t have Medicare. There are four different situations:
- Enrolled in Part B, but not Part A (Part A is hospital coverage and meets MEC)
- You had Part A but coverage ended (usually this was from an illness or disability)
- You no longer qualify for Medicare disability
- You never had any Medicare
From the options, it is clear how some false positives for Medicare enrollment may be triggered. If you had Medicare in the past, but are no longer enrolled, the federal system may not be accurately reflecting that situation.
The Medicare attestation form is nice, but as of March 2020, there was no category within the Covered California Eligibility Documents Upload system to assign the document to. Most people have been uploading the form into their accounts through the Documents and Correspondence section and then calling Covered California to view it and then check mark it submitted and verified. Once the Medicare attestation form has been verified, the consumer alert notification vanishes from the consumer’s home page.