Medicare and the Marketplace

Changing from the Marketplace to Medicare

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

If you like, you can keep your Marketplace plan too. But once your Medicare Part A coverage starts, you’ll no longer be eligible for any premium tax credits or other cost savings you may be getting for your Marketplace plan. So you’d have to pay full price for the Marketplace plan.

Learn about other ways to supplement your Medicare coverage.

When you become eligible for Medicare

Let’s assume you have a Marketplace plan and are turning 65 sometime this year.

Once you’re eligible for Medicare, you’ll have an Initial Enrollment Period to sign up for Medicare. For most people, the Initial Enrollment Period starts 3 months before their 65th birthday and ends 3 months after their 65th birthday.

In most cases it’s to your advantage to sign up for Medicare when you’re first eligible because:

  • Once your Medicare Part A coverage starts, you won’t be eligible for a premium tax credit or other savings for a Marketplace plan. If you kept your Marketplace plan, you’d have to pay full price.
  • If you enroll in Medicare after your Initial Enrollment Period ends, you may have to pay a Part B late enrollment penalty for as long as you have Medicare. In addition, you can enroll in Medicare Part B (and Part A if you have to pay a premium for it) only during the Medicare general enrollment period (from January 1 to March 31 each year). Coverage doesn’t start until July of that year. This may create a gap in your coverage.

Learn more about when Medicare coverage starts and your Initial Enrollment Period.

Cancelling your Marketplace plan when you become eligible for Medicare

In most cases, if you have a Marketplace plan when you become eligible for Medicare, you’ll want to end your Marketplace coverage. To end your plan online, follow the instructions that best describe your situation:

Be sure not to end your Marketplace plan before your Medicare coverage begins. Otherwise, you may have a gap in coverage.

When Marketplace coverage ends

In most cases, when you end Marketplace coverage for only some people on your application, coverage ends immediately.

But in some cases, coverage won’t end immediately. For example, if you update your household income after ending coverage for one or more people and the amount of premium tax credit or other savings changes, the remaining enrollees may qualify for a Special Enrollment Period. In this case, here is when coverage would end:

  • If the person is removed on or before the 15th of the month: Coverage ends on the last day of the current month.
  • If the person is removed after the 15th of the month: Coverage ends on the last day of the next following month.

Questions about changing from a Marketplace plan to Medicare?

More answers: Changing from the Marketplace to Medicare

Can I get help paying for Medicare?

If you need help with your Part A and B costs, you can apply for a Medicare Savings Program.

You may also qualify for Extra Help to pay for your Medicare prescription drug coverage if you meet certain income and resource limits.