Here's the short answer. Once you are eligible for Medicare Part A, or once your Part A or Medicare Advantage coverage starts, you can't get savings on your Marketplace plan premiums or out-of-pocket costs. Marketplace coverage doesn't end on its own when Medicare starts. You have to update your Marketplace application to end it. You can report your Medicare start date up to 3 months before it starts. Plan on signing up for Medicare in your sign-up window and ending the Marketplace plan the day before Medicare begins.
New to all this? See Turning 65: Start Here for the full sign-up walkthrough.
Why timing matters
Two problems can happen if you mix up the dates.
- Paying back tax credits. If you use the premium tax credit and don't end your Marketplace coverage, you'll have to pay back the credit you used when you file your federal taxes.
- Full price. You can keep a Marketplace plan with Medicare, but you pay full price, and the insurance company might end your coverage. It is also against the law for someone who knows you have Medicare to sell you a Marketplace plan.
The other risk runs the opposite way: ending Marketplace coverage before Medicare starts leaves a gap. So the order matters.
Step by step
- Learn your sign-up window. Your Initial Enrollment Period is usually when you turn 65. It lasts 7 months, from 3 months before you turn 65 to 3 months after. If you miss it, you may have to wait to sign up and may pay late penalties that grow the longer you wait.
- Sign up for Medicare. If you already get Social Security benefits before you are eligible for Medicare, you'll get Medicare automatically when you are eligible. Otherwise you sign up yourself. See Enrollment & Deadlines.
- Confirm your Medicare start date. Your approval notice or my Social Security account shows it.
- Update your Marketplace application. Report the Medicare start date. For example, if Medicare begins May 1, you can update your application as early as February 1. Your Marketplace coverage ends April 30, the day before Medicare starts.
- Confirm the plan for others on your application. After you submit the update, confirm the plan for anyone in your household who is keeping Marketplace coverage. Their savings may be re-checked.
- Add the pieces Medicare lacks. The Marketplace doesn't offer Medigap or Medicare drug plans. Look at Medigap, Part D, or Medicare Advantage.
If you forget to end your Marketplace plan
The Marketplace sometimes re-checks its records. If you still get the premium tax credit after Medicare starts, you may get a letter. It says you must act within 30 days, or the Marketplace will change your coverage based on what you chose in your application. If it stops your savings, you keep the plan but pay full price. Don't wait for that letter.
Special cases
- You turn 65 mid-year. You can have a Marketplace plan until Medicare begins.
- You'd pay a Part A premium. If you pay a premium for Part A, you can choose whether to have Medicare or the Marketplace. Compare costs and coverage, and think about late enrollment penalties.
- Your coverage is through a job. Job coverage through the SHOP Marketplace is treated like any job-based plan. You may be able to delay Part B without a penalty. See Working Past 65.
- You lose other coverage. See Retiring or Losing Coverage.
- Dental. If your state uses the federal Marketplace, you generally can't buy a stand-alone dental plan with Medicare.
Medicare also has programs that lower premiums and costs. See Getting Help Paying.
Common questions
Does my Marketplace plan end when I turn 65?
No. It doesn't end automatically when Medicare starts. You update your Marketplace application to end it.
When do my savings stop?
Once you're eligible for Medicare Part A, or once your Part A or Medicare Advantage coverage starts.
Can I have both a Marketplace plan and Medicare?
You can keep a Marketplace plan, but you'll pay full price, and the insurer might end it. Generally, no one may sell you a new Marketplace plan once they know you have Medicare.
Does Medicare have its own Open Enrollment?
Yes. Medicare's yearly Open Enrollment Period is October 15 to December 7. It is separate from the Marketplace. See Marketplace Open Enrollment 2027 and Medicare Open Enrollment 2027.
Official sources
- HealthCare.gov: Changing from Marketplace to Medicare
- HealthCare.gov: Medicare and the Marketplace
- Learn more about the Marketplace on this site.