ACA Public Exchanges May Expel Medicare Enrollees Faster

Here are some 2019 Medicare data matching program details that could be of interest to producers who are trying to help consumers understand data matching program notices, or resolve coverage cancellation problems.

In some cases, an ACA exchange will cancel a suspected double dipper’s exchange plan coverage along with the subsidy money.

The exchange may cancel a suspected double dipper’s exchange plan coverage automatically if the suspected double dipper gave the exchange permission to do so, by saying “yes” to a question in the exchange application.

An affected consumer will have 30 days from the date the notice is sent to respond to the notice.

If a consumer has given an exchange permission to cancel double dipper exchange plan coverage automatically, then the exchange can cancel the suspected double dipper’s ACA subsidies, and health coverage, after the 30-day response window has ended.

Consumers may give an exchange permission to end their exchange plan health coverage, as well as their ACA subsidy support, automatically, if the exchange discovers that the consumers are Medicare-exchange plan double dippers. The question authorizing automatic coverage terminations is in the exchange program application.

Exchanges may send Medicare periodic data matching notices throughout the year.

Consumers who believe that they are still eligible to keep their coverage in place can file appeals. A consumer must send the appeal to the U.S. Department of Health and Human Services’ Marketplace Appeals Center. “Consumers will receive instructions on how to appeal the exchange’s determination in the final [periodic data matching] notice outlining the action that the exchange will be taking,” officials say in the data matching program guide.