Individuals who have Medicare Part A coverage are considered to meet minimum coverage requirements under the Affordable Care Act and are therefore ineligible to receive premium and cost-sharing assistance for Marketplace health insurance plans. Individuals who have Medicare Part B coverage are eligible to receive premium and cost-sharing assistance for Marketplace health insurance plans. The Social Security Administration states that individuals may not have known they were not eligible for premium and cost-sharing assistance for Marketplace health insurance plans if they had Medicare Part A coverage. This may have caused individuals to not enroll in Medicare Part B, drop Part B or enroll late in Part B and be assessed a penalty.
The Social Security Administration allows individuals to request equitable relief from their failure to have Medicare Part B. The Social Security Administration is phasing out this relief but has extended it until June 30, 2020.
To be eligible for equitable relief, individuals must have enrollment in premium-free Medicare Part A and meets one or more of the following: Part A entitlement date between July 2013 and June 2020; notified of retroactive Part A entitlement between October 1, 2013 and June 30, 2020 or special enrollment period ended between October 1, 2013 and June 30, 2020. The beneficiary must also request Part B enrollment or premium surcharge rollback or removal, mention equitable relief or being enrolled in both a Marketplace plan Medicare Part A, and present proof of Marketplace enrollment for any period between January, 2014 and June 30, 2020. (EM-16033 REV 7, October 25, 2019.)