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Medicare and the Marketplace

Changing from Marketplace to Medicare

If you will soon get or already have
Part A (Hospital Insurance) or Medicare Advantage (Part C), you should end your Marketplace coverage.
You can't get savings on your Marketplace plan
or
once you're eligible for Medicare Part A, or once your Medicare Part A or Medicare Advantage (Part C) coverage starts. You'll have to pay full price for your Marketplace plan. 

Sign up for Medicare when you're first eligible

Your first chance to sign up for Medicare (called your "Initial Enrollment Period") is usually when you turn 65. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after you turn 65. 
You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease).
Find out how and when to sign up for Medicare.

End your Marketplace coverage

Marketplace coverage doesn’t end automatically when Medicare starts. Update your Marketplace application to end Marketplace coverage for those starting Medicare. You can report a Medicare start date on your application up to 3 months before Medicare starts. After you submit your application update, make sure you confirm the plan for others in your household who need to keep their Marketplace coverage. 

Example of when to update your Marketplace application

If your Medicare begins on May 1, you can update your Marketplace application as early as February 1. In your application, report that your Medicare starts on May 1. Your Marketplace coverage ends on April 30 (the day before Medicare coverage starts). 
Marketplace coverage doesn't lower your out-of-pocket costs in Medicare. Medicare offers:

Can I keep my Marketplace plan if I have Medicare?

Yes, but you’ll pay full price for it. And, your insurance company might end your Marketplace coverage. It’s against the law for someone who knows you have Medicare to sell you a Marketplace plan.
If you have to pay a premium for Medicare Part A, you can choose whether you want to have coverage through Medicare or the Marketplace. Compare your costs and coverage, and consider the Medicare late enrollment penalties when making your decision.

Keeping both Marketplace and Medicare

Occasionally, we re-check our records to make sure people getting savings on their Marketplace plan still qualify for it. If you don’t end your Marketplace coverage when you get Medicare and continue to get the premium tax credit, you may get a letter from us.
This letter tells you that you need to take action within 30 days, or we’ll make changes to your coverage based on what you told us in your Marketplace application. When you applied for Marketplace coverage, you selected whether you wanted us to end Marketplace coverage or stop savings for those who get Medicare. 
If we stop savings for anyone with Medicare, they’ll still have Marketplace coverage, but they’ll pay full price for it.
Others on your application will keep their Marketplace coverage. We also re-check the amount of savings anyone else on your application gets.
Get steps to end coverage
 
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