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Covered California adds Verification Step to their Application for Medicare

By Wendy Barnett

E-Verification of Medicare begins in August, 2016

Covered California Medicare VerificationThe Covered CA application, known as CalHEERS, will now electronically verify an applicant’s Medicare eligibility and enrollment. Previously, when the question on the application asked if you are currently enrolled in Medicare or receiving Medicare benefits, it would allow you to self-attest your answer.  Now, your answer will be verified with the Federal Data Hub when you submit your Covered CA application or your eligibility is re-determined. 

Why is this verification needed?

Covered CA needs to determine if you qualify for a tax credit and are eligible to enroll on Covered CA.  To do this, the application verifies various qualifiers such as income, previous health insurance enrollment, citizenship or lawful presence status, and now Medicare eligibility. Generally, if you qualify for Medicare, you won’t qualify for a tax credit through Covered CA (Some exceptions apply – contact Covered CA at 800-300-1506 for help with exceptions). In order to avoid erroneous enrollments, Covered CA will now electronically verify your eligibility or enrollment for Medicare. In this way, people who do not qualify for Covered CA will not be allowed to enroll.

How will E-verification affect you?

  • If you say “Yes” you are eligible and/or receive Medicare benefits, you will be required to provide a document that proves your Medicare eligibility or enrollment if your information cannot be verified electronically  One of three documents can be provided:

1. Social Security Administration letter

2. Medicare letter

3. Medicare card

  • If you say “No” you are not eligible and/or do not receive Medicare benefits then Medicare E-verification won’t affect you. If you are 65 years of age or older, you will be considered Medicare eligible and will not be able to enroll through Covered CA with a subsidy. Instead, your eligibility will say you are eligible for Medicare.

More information about Medicare

Medicare is a social insurance program that provides government health insurance to U.S. residents who meet certain qualifiers. Generally, you must be 65 or older or have a disability or End-Stage Renal Disease to enroll.

For questions on Medicare enrollment:

  • Health Insurance Counseling & Advocacy Program (HICAP) provides free local individual counseling on Medicare questions and more

To change an address, Medicare Part A or Part B, or to replace a lost Medicare card:

  • Call Social Security Administration(SSA) at 800-772-1213