Turning 65 and Have a Marketplace Plan? Here's What You Need to Know

Turning 65 and Have a Marketplace Plan? Here's What You Need to Know

Table of Contents

1. Introduction
2. Aging into Medicare
3. The Benefits of Medicare
4. Medicare Supplement and Prescription Drug Plan
5. Medicare Part C: Medicare AdVantage Plan
6. Potential Risks of Staying on Marketplace Plans
7. Open Enrollment Period
8. Applying for Medicare
9. General Enrollment Period
10. The Gap in Coverage
11. The Importance of Getting Medicare
12. Conclusion

Aging Into Medicare: The Importance of Getting the Right Insurance Coverage

Turning 65 years old comes with the eligibility for Medicare, a government-sponsored health insurance program. For most individuals in this age group, Medicare offers a more affordable alternative to purchasing an ACA plan through the marketplace or directly from insurance carriers. However, some still choose to keep their marketplace plans, often due to the significant subsidies and cost-sharing benefits they receive. While this may seem like a good idea initially, there are potential risks involved that could leave individuals without proper coverage.

One of the primary risks is that marketplace insurance carriers may switch from being the primary to the secondary insurance once they learn of an individual's eligibility for Medicare. As a result, they may refuse to pay until Medicare pays first, leaving individuals with significant gaps in coverage if they haven't signed up for Medicare. Additionally, during the open enrollment period, individuals who are eligible for Medicare will no longer be eligible for ACA plans or private health insurance, making it crucial to make the right choice before it's too late.

Applying for Medicare outside of the initial enrollment period can also pose challenges. If individuals miss their initial enrollment period, which includes three months before their 65th birthday, the month of their 65th birthday, and three months after, they'll have to wait for the general enrollment period, which occurs from January 1st through March 31st. This delay can result in a significant gap in coverage, leaving individuals uninsured for up to six months.

Having a gap in medical insurance can be incredibly risky. During this period, no one will help cover medical expenses, and it can be challenging to obtain supplemental insurance policies for accidents or critical illnesses. To avoid this predicament, experts strongly encourage individuals eligible for Medicare to take advantage of the program. By getting Medicare Parts A and B, along with a Medicare supplement and a prescription drug plan, individuals can ensure comprehensive coverage and avoid potential gaps in the future.

In conclusion, aging into Medicare presents a critical decision-making period for individuals who currently have marketplace plans. Choosing to keep these plans may seem appealing due to subsidies and low out-of-pocket costs, but it can lead to coverage complications and limited options in the long run. It is important to understand the risks involved, the significance of the open enrollment period, and the potential gap in coverage. By making informed choices and enrolling in Medicare, individuals can secure the necessary insurance coverage as they enter this new phase of their lives. Don't hesitate to reach out to insurance experts for guidance and support in navigating this transition.