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Transitioning From Marketplace To Medicare Coverage

Transitioning from Marketplace to Medicare Coverage

If you currently have a Marketplace plan and are turning 65 this year, you become eligible to switch from Marketplace to Medicare coverage. You’ll have an Initial Enrollment Period to sign up for Medicare. For most people, this enrollment starts 3 months before their 65th birthday and ends 3 months after their 65th birthday.

In order to avoid a gap in coverage, double check when Medicare coverage starts before ending Marketplace coverage. Once Marketplace coverage has ended, you will not be able to re-enroll until the next Open Enrollment Period (unless you qualify for a Special Enrollment Period).

For a smooth transition, it be best to cancel your Marketplace coverage after your Medicare enrollment has been confirmed – to avoid paying full price for your Marketplace plan. 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. Meaning, you would have to pay full price for the Marketplace plan.

In most cases it is to your advantage to sign up for Medicare when you’re first eligible because 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. Additionally, you can only enroll in Medicare Part B during the General Enrollment Period, which runs from January 1 through March 31 each year. Coverage doesn’t start until July of that year. This may create a gap in your coverage.

Below are some key items to keep in mind when cancelling your Marketplace plan when you become eligible for Medicare:

  • If every member on the plan is ending coverage, cancel the Marketplace coverage for the entire household.
  • If only the household contact (usually the person who created the Marketplace account) is ending coverage, contact the Marketplace Call Center to change the household contact or remove them from the plan.
  • If some members of the household will be ending coverage, remove them individually through their Marketplace account.

Changing From Marketplace to Medicare?

For more information, contact us at (352) 405 – 6433.

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