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Moving from the Marketplace

The Health Insurance Marketplaces were created under the Affordable Care Act to extend affordable health care coverage to people who otherwise would not have it. Each state has its own Marketplace. The Marketplaces opened for enrollment in October 2013, for coverage beginning in 2014.

Learn more about the Marketplaces.

If you are about to become eligible for Medicare, there are several things you should know:

  • Medicare coverage (including private Medicare Advantage, Part D drug, and Medigap/supplemental insurance plans) is not offered through the Marketplace. You must enroll in Medicare through Social Security. Learn how to enroll.
  • Once you become eligible for and enroll in Medicare, you cannot get the subsidies that help to pay for your Marketplace premium and costs, so you will need to consider whether you should drop your Marketplace plan. You will need to contact the Marketplace plan to disenroll. You should sign up for Medicare on time, or else you may face a gap in coverage and a penalty later on.
  • If you get coverage through the expanded Medicaid program in 2014 (under the new adult Medicaid category in states that expand the Medicaid criteria for certain adults) you will lose eligibility to the new, expanded Medicaid program when you become eligible for Medicare. However, you will get screened for full Medicaid and Medicare Savings Programs (MSPs).

Find where to get personal help to make the transition from the Marketplace to Medicare.

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