Transitioning From The Marketplace To Medicare

Transitioning your healthcare coverage from the Marketplace to Medicare can be confusing. However, there is no reason that it needs to be. Armed with the information in this quick guide you will be fully prepared to confidently navigate the process of moving from Marketplace to Medicare coverage with ease. 

Let’s look at the entire process from the start of the transition period. For the purposes of this guide, we will assume that your healthcare coverage is currently supplied through the Marketplace, and you will be reaching your 65th birthday within the next year. 

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Medicare Initial Enrollment Period

As you near your 65th birthday and become eligible for Medicare coverage you will have an initial enrollment period in which to sign up for Medicare healthcare coverage. In the vast majority of cases, the initial enrollment period will start 90 days, or 3 months, prior to the date of your 65th birthday. The initial enrollment period generally closes 90 days, or 3 months, after the date of your 65th birthday.

While it is not a requirement, in most instances it will be in your best interest to begin the process of signing up for Medicare healthcare coverage as soon as you become eligible to do so. There are several reasons why it may be advantageous to enroll for Medicare healthcare coverage during the initial enrollment period.

  • Once you become eligible, and your Medicare Part A healthcare coverage begins, you will no longer be eligible to receive the annual tax credit intended to offset your Marketplace healthcare coverage premium.
  • Once you become eligible, and your Medicare Part A healthcare coverage begins, you may no longer qualify for any savings programs, or other cost reduction benefits currently in place to reduce the expense of the premiums paid for your Marketplace healthcare coverage.
  • If you fail to enroll for Medicare coverage within the initial enrollment period you may incur a late enrollment fee for Medicare Part B coverage which will increase the cost of your Medicare Part B premiums for the life of your Medicare Part B coverage.
  • If you fail to enroll for Medicare Part B coverage within the initial enrollment period you may be required to wait to enroll during the next Medicare general enrollment period. The Medicare Part B general enrollment period begins on January 1st and extends through March 31st of each calendar year. 
  • If you fail to enroll for Medicare Part A coverage within the initial enrollment period, and you will be paying a premium for Medicare Part A healthcare coverage, you may be required to wait to enroll during the next Medicare general enrollment period. The Medicare Part A general enrollment period begins on January 1st and extends through March 31st of each calendar year.
  • If enrolling for either Medicare Part A or Medicare Part B healthcare coverage during the Medicare Part A or Part B general enrollment period, healthcare coverage may not begin until July 1st of the calendar year in which the enrollment was completed. This may create a gap in healthcare coverage if Marketplace healthcare coverage is no longer in place. 
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Avoiding A Gap In Healthcare Coverage During The Transition Period

For many, maintaining continuous healthcare coverage throughout the process of transitioning from Marketplace healthcare coverage to Medicare healthcare coverage is an important concern. With proper planning, knowledge, and careful attention to key deadlines, and enrollment periods you will be able to ensure that you do not experience any gaps in your healthcare coverage. 

  • If you are currently enrolled in a healthcare coverage plan obtained through the Marketplace, you may continue this coverage during the time that you are completing the sign-up and enrollment process for Medicare healthcare coverage. 
  • Ensure that you know the actual date that your Medicare healthcare coverage will go into effect. To avoid any possible gap in healthcare coverage you may want to consider continuing your Marketplace healthcare coverage until the date that your Medicare healthcare coverage becomes fully active.
  • Once the enrollment process for Medicare healthcare coverage has been completed, you may no longer be eligible for the annual tax credit, and any additional cost savings, rebate, or payment assistance programs intended to offset the cost of your Marketplace healthcare coverage. Be aware that you may need to pay a higher cost to maintain your Marketplace healthcare coverage during the period of time when your enrollment for Medicare coverage has been completed, and the official start date when your Medicare healthcare coverage is fully active.
  • Pay close attention to the dates of the healthcare coverage enrollment period, as well as the official effective date when your Medicare healthcare coverage will be fully active. To ensure that there is no gap in healthcare coverage, do not cancel your Marketplace healthcare coverage until your Medicare healthcare coverage begins. Once you have canceled your Marketplace you may not be eligible to re-enroll for Marketplace healthcare coverage until the next Marketplace open enrollment period.
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Visit Coverage2Care To Learn More About Transitioning from Marketplace To Medicare Healthcare Coverage

Visit Coverage2Care to learn more about the best way to transition from Marketplace healthcare coverage to Medicare healthcare coverage without incurring costly penalties and fees, or suffering any gaps in your healthcare benefits.

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