Changing From Marketplace Insurance to Medicare

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

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 (IEP) 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. This may create a gap in your coverage. 
Canceling 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.

IMPORTANT: Don’t end your Marketplace plan until you know for sure when your new coverage starts! Once you end your Marketplace coverage, you can’t re-enroll until the next Annual Enrollment Period, unless you qualify for a Special Enrollment Period at any point before then.

Your Medicare coverage start date depends on your situation. For assistance in canceling your Marketplace plan or in obtaining Medicare coverage once you are eligible, please contact Group Plans Inc! Our decades of experience in managing risk and helping the community of Arizona get quality coverage and service are important to us! 

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