Changing from the Marketplace to Medicare

If you have a Marketplace plan, you can keep it until your Medicare coverage starts. Find out how to end your Marketplace plan without penalty.

If you choose to keep the marketplace coverage, you’ll no longer be eligible for subsidies and will have to pay full price. And if the marketplace doesn’t adjust your premiums right away, you may have to pay back the extra subsidies when you file your federal income tax return.

Even though you can keep your marketplace coverage after you enroll in Medicare, you’re not able to get a new marketplace policy at that point. In fact, it’s against the law for someone who knows you have Medicare to sell you a marketplace health insurance plan, even if you have only Part A or Part B.

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.

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.

Begin highlighted textIMPORTANT

Don’t end your Marketplace plan until you know for sure when your new coverage starts. Once you end Marketplace coverage, you can’t re-enroll until the next annual Open Enrollment Period (unless you qualify for a Special Enrollment Period).

End highlighted text

Your Medicare coverage start date depends on your situation.

Step-by-step instructions: How & when to cancel your Marketplace plan

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.

What if I’m eligible for Medicare, but my spouse isn’t and wants to stay covered under our current Marketplace plan?

If someone gets Medicare but the rest of the people on the application want to keep their Marketplace coverage, you can end coverage for just some people on the Marketplace plan, like a spouse or dependents.

Get step-by-step instructions on how to end your Marketplace plan based on your situation.

How to cancel your Marketplace plan

You may need to end your Marketplace plan if you get other health coverage, or for another reason.

IMPORTANT:Don’t end your Marketplace plan until you know for sure when your new coverage starts. Once you end Marketplace coverage, you can’t re-enroll until the next annual Open Enrollment Period (unless you qualify for a Special Enrollment Period).

• If you’re ending coverage for everyone on the application, your termination can take effect as soon as the day you cancel, or you can set the Marketplace coverage end date to a day in the future — like if you know your new coverage will start on the first day of the following month.
• If you’re ending coverage for just some people on the application, in most cases their coverage will end immediately. In some cases, coverage will not end immediately, including when the household members who remain enrolled in coverage qualify for a Special Enrollment Period. The best way to make sure coverage ends on the right date is to contact the Marketplace Call Center and request the change.

When and how to end your Marketplace plan depends on your situation. Select the reason you’re ending coverage below for step-by-step instructions.

Ending coverage for just SOME people on your Marketplace plan because you’re eligible for Medicare

You can end coverage for just some people on your Marketplace plan, like a spouse or dependents. You may want to do this if someone gets Medicare, but the rest of the people on the application want to keep their Marketplace coverage.

If you’re ending coverage for just some people on the application, in most cases, their coverage will end immediately. The best way to ensure you receive your desired coverage end date is by requesting the change at the Marketplace Call Center.

To end Marketplace coverage online for some people (excluding the household contact), follow these steps:

1. Log into your Marketplace account.
2. Click “Start a new application or update an existing one.”
3. Click on your name in the top right of the screen, and select “My applications & coverage.”
4. Select your application under “Your existing applications.”
5. Click “Report a life change” on the menu to the left.
6. Click “Report a Life Change” near the bottom.
7. Select “Report a change in my household’s income, size, or other information.”
8. Check the attestation box, then click “Save & Continue.”
9. Continue through the application, updating information as necessary.
10. For the “Who Needs Coverage” question, indicate the household members who want to keep Marketplace coverage.
11. Click “Save & Continue.”
12. Click “Remove” for people you want to remove from the Marketplace plan.
13. Confirm the removals and answer any following questions.
14. Click “Save.” Note: You must complete steps 11, 12, and 13 for each household member you want to remove from Marketplace coverage. After removing these people from the list of people who need Marketplace coverage, if they’re still members of your tax household (like your spouse or tax dependents on your federal income tax return), you need to add them back in as people in your household who don’t need Marketplace coverage. This is because your savings are based on income for everyone in your household — including people who don’t need coverage.
15. Continue clicking through the application, updating information as necessary.
16. When you get to the screen that asks about your household information, answer the questions appropriately and list members of the tax household. This may include listing people you just removed as an applicant, if they’re still a member of the tax household.
    1. Click “Save & Continue.”
    1. Continue clicking through the application, adding or updating information as needed.
17. Click “View Eligibility Results.” After you’ve read them, click “Continue to Enrollment.”
18. Important: Complete all items on the “To-Do List,” including selecting and confirming a plan.
    1. The plan selection will show only people who applied and were found eligible to enroll in a Marketplace plan. Anyone who is or may be eligible for Medicaid or CHIP OR who’s no longer applying for Marketplace coverage won’t appear in the plan selection.
    1. Anyone continuing Marketplace coverage must select and confirm enrollment in a Marketplace plan for the coverage changes to take effect. Anyone eligible for a Special Enrollment Period can select a new plan if they want to.
    1. Once enrollment in a Marketplace plan is confirmed, coverage will end for the people you’ve removed.

In some cases, coverage won’t end immediately, including when the people staying on the Marketplace plan qualify for a Special Enrollment Period. For example, if you update your household income after ending coverage for one or more people and the amount of premium tax credits or other cost savings changes, the remaining enrollees may qualify for a Special Enrollment Period with the following coverage end date options:

• If the person is removed by the 15th of the month: Coverage ends on the last day of the current month.