Turning 65 Soon? Transitioning From Marketplace to Medicare

January 2, 2019

Editor’s note: This post was originally published on 11/4/16 and has been updated for accuracy and comprehension.


If your healthcare coverage is currently supplied by the marketplace, when you turn 65, you need to know the options available to you.

Even if your 65th birthday is a ways away, it’s never too soon to plan for the future.

The good news is, you don’t have to do anything now. You can keep your marketplace coverage until you’re eligible for Medicare.

However, you’ll want to investigate your options as soon as possible for one big reason.

The danger

If you do nothing, you may pay higher costs later on when you enroll in Medicare. That’s because you’ll incur a penalty for late enrollment.

The penalty is generally 10% of your Part A premium and you’ll have to pay it for twice the amount of years you were eligible and didn’t enroll.

For example, if you waited a year to enroll in Medicare, you could pay a 10% penalty for two years.

The facts

Here’s what you need to know to make a successful transition from Marketplace coverage to Medicare.

  • Once your Medicare eligibility begins and you enroll in a plan, you can end your Marketplace coverage without incurring a penalty.
  • If you keep your Marketplace coverage, you won’t get tax credits or other savings. This means you’ll likely pay more for the Marketplace policy.

Navigating your options

As you’re planning for the transition, you’ll have two options:

Applying for Medicare

Get the facts about your enrollement period, avoid fees, filling in coverage gaps and canceling Marketplace coverage.

Here’s what you need to consider.

1. Know your enrollment period

You need to know your Medicare eligibility period, which is three months before your 65th birthday, the month of your birthday, and three months after that date.

This gives you a full seven months to enroll in Medicare.

2. Avoid late fees

Don’t miss this enrollment period, as you’ll have to pay a late enrollment penalty.

3. Fill in the gaps

You’ll need to coordinate coverage so that your Medicare plan will take effect immediately after the Marketplace coverage ends. You don’t want to have a gap in healthcare coverage, which could leave you financially exposed and negatively impact your health, too.

4. Know how to cancel

It’s fairly easy to cancel your Marketplace policy. If you’re the only person on the policy, go ahead and cancel it. Keep in mind that it could take approximately 15 days for the cancellation to become effective.

However, if you have other family members on the plan and they aren’t yet eligible for Medicare, you should cancel coverage only for yourself.

Seek guidance you can trust

It’s important to get expert advice when navigating the transition from Marketplace to Medicare to avoid incurring penalties and gaps in coverage, as well as securing the best plan you can get.

Talk to the Medicare experts at InsureOne Benefits today by calling 1-800-722-7331 to get the help you need to successfully navigate the transition.

As you near age 65, are you prepared to make the transition from Marketplace to Medicare?

Medicare has neither reviewed nor endorsed this information.