The Affordable Care Act (ACA, also commonly called Obamacare) and Medicare are two very different concepts.
The ACA is a sweeping series of laws that regulate the US health insurance industry. Medicare is a federal health insurance program for people 65 and older, as well as certain younger people with disabilities or medical conditions.
In this guide, we compare and contrast Medicare vs. Obamacare in 2019, so you can better understand these types of health coverage.
There are four typical ways that many Americans receive health insurance today:
In most cases, you will typically want to end your Marketplace plan (Obamacare plan) when you first become eligible for Medicare.
Your Medicare eligibility and your Medicare coverage start date depend on your personal situation, so be sure to check with healthcare.gov to determine your eligibility.
Medicare provides health insurance to nearly 60 million Americans in 2019.1
Medicare is available to people who are at least 65 years old or younger Americans who have a qualifying disability, such as ALS (Lou Gehrig’s Disease) or End-Stage Renal Disease (ESRD).
Medicare Part A and Part B are commonly referred to as Original Medicare. They are provided by the federal government.
There are other types of Medicare health coverage that are offered by private insurance companies.
Obamacare is another name for the Patient Protection and Affordable Care Act of 2010, which was signed into law by President Barack Obama.
Obamacare mandated that everyone maintain health insurance coverage, or else they would face a tax penalty. Many people associate Obamacare with the health insurance plans that are sold on the ACA exchange, or Marketplace.
The ACA health insurance exchange opened for business in January of 2014. This marketplace sold plans that qualified as satisfactory coverage according to the new law.
While the ACA remains in place, the tax penalty for not having insurance (called the individual mandate) was repealed in 2019.
More than 11.4 million Americans were enrolled in a health insurance plan obtained through the Obamacare Marketplace in 2019.2
Here is a look at how Medicare and Obamacare compare and contrast across a number of different categories.
The average Medicare Advantage plan premium in 2018 was $35.55 per month.3
The average Medicare Part D plan premium in 2018 was $52.23 per month.3
The average Medicare Supplement Insurance plan premium in 2018 was $125.93 per month.4
When it comes to choosing between Medicare or Obamacare, there’s no single right answer.
You can check with healthcare.gov to determine your eligibility and to make sure you don’t let your health insurance coverage lapse.
To learn more about Medicare Advantage plans that may be available in your area, a licensed insurance agent can help you compare plan specifics such as costs, coverage networks and benefits.
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1 Kaiser Family Foundation. Total Number of Medicare Beneficiaries. Retrieved May, 2019, from www.kff.org/medicare/state-indicator/total-medicare-beneficiaries.
2 Kaiser Family Foundation. Marketplace Enrollment, 2014-2019. Retrieved May, 2019, from www.kff.org/health-reform/state-indicator/marketplace-enrollment.
3 MedicareAdvantage.com's internal analysis of CMS Medicare Advantage landscape source files, May 2018. Data retrieved from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.
4 TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.
5 Rosato, Donna. What ACA Health Insurance Will Cost in 2019. (Nov. 5, 2018). Consumer Reports. Retrieved from www.consumerreports.org/health-insurance/aca-health-insurance-cost. Note: The average monthly premium in each state is based on the second-lowest-cost Silver plan for a 40-year-old nonsmoker who doesn't receive financial subsidies. Your own premium will vary depending on your age, financial status, and which plan you choose.
MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.
Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
Medicare has neither reviewed nor endorsed this information.