The Health Insurance Marketplace is a Federal Insurance Exchange where individuals and families can find information about health coverage options, compare health plans (based on costs, benefits, and other important features), choose a plan, and enroll in a plan. To be eligible to enroll in health coverage through the Marketplace, an individual must live in the United States, be a U.S. Citizen or national (or be lawfully present), and not be incarcerated.
To learn more about the Health Insurance Marketplace, eligibility for coverage, plan options, and enrollment time frames, go to the website HealthCare.Gov (External Link) or contact
Covering Wisconsin (External Link) to speak with a navigator.
Medicare and the Marketplace
An individual enrolled in a Marketplace plan can keep that plan until Medicare coverage begins. At that time, a person can end Marketplace coverage. If an individual remains with their Marketplace plan after Medicare begins, that person may no longer be eligible for any premium tax credits or other cost benefits they receive with their Marketplace plan. Marketplace coverage is not designed to supplement Medicare.
The Marketplace will not automatically disenroll an individual who begins coverage under Medicare. Individuals with Marketplace plans who become eligible for Medicare may need to contact the Marketplace plan and request disenrollment from their plan just before Medicare coverage begins. In most cases, it’s to a person’s advantage to sign up for Medicare when first eligible to avoid a potential late enrollment penalty or prevent a coverage gap. However, there are instances when an individual can choose a Marketplace plan instead of Medicare, such as someone who has to pay a premium for Medicare Pt A or a person who has a medical condition (such as End-Stage Renal Disease [ESRD]) that has not yet enrolled in Medicare.
Resources
Medicare and the Health Insurance Marketplace (External PDF)
A document from the Centers for Medicare and Medicaid Services (CMS) summarizing how Medicare works with Marketplace coverage.