How to take action if you have both Medicare & Marketplace coverage

If you recently got a notice that you (or another person on your application) may lose Marketplace coverage or savings for your Marketplace plan because of Medicare enrollment, you need to take action.

Why did I get this notice?

We check federal Medicare data to be sure the people on your application have the right coverage. Records show that you (or at least one person on your application) may be enrolled in both a Marketplace plan and Medicare.

If a person is eligible for or enrolled in Medicare Part A (Hospital Insurance), they don’t qualify to get savings for their Marketplace plan. We may terminate (end) your Marketplace coverage if you've allowed us to act on your behalf.

What should I do now?

First, let us know if the people on your application are enrolled in Medicare. Check the “Marketplace & Medicare coverage” section of your Application Details page. This section will also show you a date you need to take action by.

If everyone is enrolled in Medicare: You’ll end their Marketplace coverage. Open this helpful guide for step-by-step instructions on how to do this. It’s a good idea to keep this open so you can follow the steps to correctly update your information.

If no one is enrolled in Medicare: You’ll update your application. Open this helpful guide for step-by-step instructions on how to do this. It’s a good idea to keep this open so you can follow the steps to correctly update your information.

If at least one person has Medicare: You’ll need to end Marketplace coverage for some people and update your application for others. Open this helpful guide for step-by-step instructions on how to do this. It’s a good idea to keep this open so you can follow the steps to correctly update your information.

How do I know I’ve successfully completed the necessary actions?

You’ve successfully completed the necessary actions if you go to the “Marketplace & Medicare coverage” section of your Application Details page and see this message: “Our records show that you’ve resolved this issue. You don’t need to do anything else at this time.”

What if I don’t take any action?

If you don’t take the necessary actions by the date listed in the “Marketplace & Medicare coverage” section of your Application Details page, the Marketplace will end any savings members of your household are getting for their Marketplace coverage. After the savings end, these people will stay enrolled in their Marketplace coverage at full cost, unless you take action. If you gave the Marketplace permission to end your Marketplace coverage and we find you enrolled in Medicare, we’ll end your Marketplace coverage automatically.

Can I keep both my Marketplace and Medicare coverage?

If you’re eligible for or enrolled in Medicare Part A that counts as qualifying health coverage, you can choose to stay enrolled in Marketplace coverage, but you won’t get help paying for your coverage.

If you’re not already enrolled in Medicare Part B, consider enrolling as soon as possible.

If you’re enrolled in premium-free Medicare Part A only, generally you’ll want to enroll in Medicare Part B. You may be able to sign up for Medicare Part B now, without a late enrollment penalty. To make sure you don’t have a gap in coverage, you should end your Marketplace coverage after you’re notified that your Medicare Part B coverage has started.

To enroll, visit your local Social Security office. Bring a copy of this letter with you and mention “equitable relief” when you make the request. If you made a request before and were told you didn’t qualify, you can ask again. To find out more, visit socialsecurity.gov or call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).

If you’re currently paying a late enrollment penalty for Medicare Part B, you can request a penalty reduction.

You may qualify to have your late enrollment penalty reduced or removed.

To request a reduced penalty, visit your local Social Security office. Bring a copy of this letter with you and mention “equitable relief” when you make the request. If you made a request before and were told you didn’t qualify, you can ask again. To find out more, visit socialsecurity.gov or call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).

Where can I get help?

Call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325). Or you can make an appointment with in-person help. Find help near you at LocalHelp.HealthCare.gov.