July 31, 2015

Turning 65 soon? How to transition from the Marketplace to Medicare coverage

If you have a health plan through the Health Insurance Marketplace and will soon have Medicare eligibility, it’s not too soon to start planning for your coverage to switch.

If you have a Marketplace plan now, you can keep it until your Medicare coverage starts. Then, you can cancel the Marketplace plan without penalty.

When to apply for Medicare

Once Medicare eligibility begins, you’ll have a 7 month Initial Enrollment Period to sign up. For most people, this is 3 months before, the month of, and 3 months after their 65th birthday.

It’s important to sign up for Medicare when you’re first eligible because once your Medicare Part A coverage starts, you’ll have to pay full price for a Marketplace plan. This means you’ll no longer be eligible to use any premium tax credit or help with costs you might have been getting with your Marketplace plan. Also, if you enroll in Medicare after your Initial Enrollment Period, you may have to pay a late enrollment penalty. It’s important to coordinate the date your Marketplace coverage ends with the effective date of your Medicare enrollment, to make sure you don’t have a break in coverage. If you have limited income or resources, you may qualify for help paying costs.

How to cancel your Marketplace coverage

If you’re the only person on your Marketplace application, you can cancel the whole application.

If you and your spouse (or other household members) are enrolled on the same Marketplace plan, but you’re the only one eligible for Medicare, you’ll cancel Marketplace coverage for just yourself. This way any others on the Marketplace application can keep Marketplace coverage. Find out how here.

Learn more about transitioning from the Marketplace to Medicare coverage.