It’s a good idea to plan ahead to smoothly transition from your Marketplace plan to Medicare.
Published by: Medicare Rights Center
For those that don’t know, the Health Insurance Marketplaces were created by the Affordable Care Act (ACA) so that people with no insurance or not enough insurance could purchase health insurance. Qualified Health Plans (QHPs) are one type of health insurance policy that you can buy through the Marketplace.
If you have a QHP, in most cases you should enroll in Medicare and disenroll from your QHP. There are, however, two exceptions:
You qualify for Medicare because you have End-Stage Renal Disease (ESRD).
You do not qualify for premium-free Medicare Part A.
If you qualify for premium-free Part A, you should not continue using the Marketplace to get health and drug coverage. You should enroll in Medicare when you are first eligible and disenroll from your QHP in a timely manner to avoid paying extra premiums. To disenroll from your QHP coverage, notify a state or federal Marketplace representative of your intent to disenroll from your plan at least 14 days before your Medicare coverage begins.
If you are enrolled in a plan through the federal Marketplace, contact the Marketplace Call Center at 800-318-2596 or visit www.healthcare.gov.
If you are enrolled in a plan through your state’s Marketplace, contact the state marketplace to learn how and when to disenroll from your plan.
Ask for disenrollment steps from a Marketplace representative if you are enrolled in a family plan.
Speak with your employer if you are enrolled in a Small Business Health Options Program (SHOP) through the Marketplace.
Make sure to work with the Marketplace representative to ensure that your Marketplace plan ends the day that your Medicare begins so that you do not have a gap in coverage.
Be aware that if you delay Medicare enrollment, you will likely experience gaps in coverage and have a late enrollment penalty. It is usually not cost-effective to have both Medicare and a Marketplace plan.
I hope this helps in your transition to Medicare!