If you're approaching 65 on an ACA marketplace plan, you're about to make an important switch. Here's what changes and how to avoid the penalties that catch people off guard.
Why you usually move to Medicare
Once you're eligible for Medicare, ACA subsidies generally end, so keeping a marketplace plan often means paying full price for coverage you can replace. For most people, Medicare becomes the better deal — and Part A is premium-free if you have enough work history.
The parts, briefly
- Part A: hospital coverage (usually premium-free).
- Part B: doctors and outpatient (monthly premium).
- Part D: prescription drugs.
- Medigap or Medicare Advantage: two different ways to round out coverage.
The deadline that matters most
Your Initial Enrollment Period is a 7-month window around your 65th birthday (the 3 months before, your birthday month, and the 3 months after). Miss it without other qualifying coverage and you can face lifelong late-enrollment penalties on Part B and Part D. Don't assume it's automatic — in many cases you must sign up.
Coordinate the handoff
- Don't cancel your ACA plan until Medicare is active, to avoid a gap.
- Decide between Medigap and Medicare Advantage based on your doctors, travel, and budget.
- Check that your prescriptions are covered under the Part D or Advantage plan you choose.
If you're bridging the years before 65, see our guide to health insurance before Medicare.
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