MSA 101 – Lesson 4: Who Can Join an MSA

Who Can Join an MSA Plan?

Compared to other Medicare Advantage plans, Medicare requires slightly different eligibility requirements to join an MSA.

Medicare-eligible and enrolled in both Medicare Parts A and B.
Live in the MSA’s availability/service area.
Reside in the U.S. for 183 or more days during the calendar year.
Not have other insurance that covers all or a portion of the MSA plan deductible; some examples could be TRICARE, VA or FEHBP.
Not currently receiving Medicare hospice benefits.
Not currently eligible for Medicaid (not dual-eligible).

Group MSA eligibility includes the general eligibility requirements covered on the other tab, plus:

Must be an eligible beneficiary of the group (eligible for the group’s employment-based health coverage). Depending on the group, eligible beneficiaries could be retirees, active employees (only if the group has 19 or fewer total employees), spouses and/or dependents.
The group must be employment-related, like an employer, a union. Associations and PEOs are eligible if membership in said group is based on some sort of employment by/with the group.