Medicare & the Marketplace

The Health Insurance Marketplace® is for people who don’t have health insurance. You don’t need to join the Marketplace if you have Medicare.

The Marketplace doesn’t affect your Medicare choices or benefits.

Tips about Marketplace if you already have Medicare

Do I need to do anything with the Marketplace during Medicare's Open Enrollment?

No. Medicare’s Open Enrollment isn’t part of the Marketplace. During the Medicare Open Enrollment Period (October 15–December 7), you can join or switch Medicare health and drug plans or switch to Original Medicare.

Can I get a Marketplace plan in addition to Medicare?

No. It’s against the law for someone who knows you have Medicare to sell you a Marketplace plan. This is true even if you have only Medicare Part A (Hospital Insurance) or only Part B (Medical Insurance) .

If you want coverage to add to Original Medicare (Part A and Part B), you can buy a Medicare Supplement Insurance (Medigap) policy . Instead of Original Medicare, you can also choose to join a Medicare Advantage Plan that may offer some extra benefits.

What if someone tries to sell me a Marketplace plan?

It’s against the law for someone who knows that you have Medicare to sell you a Marketplace plan. Tell the person you have Medicare.

If you got Marketplace coverage in addition to Medicare, you can log into your account at HealthCare.gov or call our Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) to end your Marketplace coverage.

Say no to scams
Don’t share your Medicare number or other personal information with anyone who contacts you by phone, email, or in person, unless you contacted them first and gave them permission to contact you.

If someone calls and asks for your information, for money, or threatens to cancel your health benefits, hang up and call us at 1-800-MEDICARE (1-800-633-4227). TTY: 1-877-486-2048.

Getting Medicare if you already have Marketplace coverage

Even if you have Marketplace coverage (or other individual health coverage that isn't based on current employment), you should sign up for Medicare when you’re first eligible (usually when you turn 65) to avoid a delay in Medicare coverage and the possibility of a Medicare late enrollment penalty.

Some important points to consider if you have Marketplace coverage:

• Your Marketplace plan may not renew your coverage at the end of the year. This means you and your family could have a gap in your coverage starting January 1 of next year.
• You should end your Marketplace coverage in a timely manner when you become eligible for Medicare to avoid an overlap in coverage.
• Once you're eligible to sign up for premium-free Part A, or already have Part A with a premium, you won’t qualify for help from the Marketplace to pay your Marketplace plan premiums or other medical costs. If you keep getting help to pay your Marketplace plan premiums, you may have to pay back some or all of the help you got when you file your federal income taxes.

Can I choose Marketplace coverage instead of Medicare?

Generally, no. You can choose Marketplace coverage instead of Medicare if you have to pay a Part A premium. Before making this decision, check if Marketplace coverage meets your needs and fits your budget. Also consider:

• If you don’t sign up for Medicare when you’re first eligible (usually when you turn 65), you might have to wait to sign up. You might also have to pay monthly late enrollment penalties.
  How much are the penalties?
• If you can’t afford the monthly Medicare premiums, there are programs to help lower the costs. Get details about cost saving programs.
• If you qualify for Part A without having to pay a premium, you won’t be eligible for help paying your Marketplace plan premiums.

If you have End-Stage Renal Disease (ESRD) and haven’t signed up for Medicare, you can get a Marketplace plan. Before making this decision, learn about Medicare coverage for people with ESRD.