Medicare – Health Insurance Marketplace

By Tucker Thompson, CSA

 Below are a few answers to some of the most asked questions concerning Medicare and Health Insurance, Affordable Health Care, Obama Care, and SHOP Marketplace.

What if I become eligible for Medicare after I join a Marketplace plan?

You can get a Marketplace plan to cover you before your Medicare begins. You can then cancel the Marketplace plan once your Medicare coverage begins. Medicare starts the first day of your birthday month when you turn 65. If your birthday is the first day of any month, Medicare will start the first day of the previous month.

The Initial Enrollment Period for Medicare starts three months before your 65th birthday and ends three months after your 65th birthday. Once your Medicare Part A coverage starts, any tax credits and reduced cost sharing you get through the Marketplace will stop. If you enroll in Medicare after your initial Enrollment Period ends, you may have to pay a late enrollment penalty for the rest of your life.

If I’m getting health coverage from an employer through the SHOP Marketplace, can I delay enrollment in Medicare Part B without a penalty?

Yes. You can delay enrollment if you’re getting health insurance from an employer through the SHOP Marketplace based on you or your spouse’s current employment. You have a Special Enrollment Period to sign up for Medicare Part B without a penalty. You have an eight-month period that begins the month after the employment ends or the coverage ends, whichever happens first.

If you don’t sign up during this Special Enrollment Period you may have a late enrollment penalty for the rest of your life. And, you can only enroll during the General Enrollment Period which occurs each year from January––March with Part B coverage beginning July 1.

If I have Medicare, can I get health coverage from an employer through the SHOP Marketplace?

Yes. Employer coverage through the Shop Marketplace is treated the same as coverage from an employer group health plan. Medicare Secondary Payer rules apply for health coverage from an employer through the SHOP Marketplace.

Tucker Thompson, CSA, has worked in the insurance field for over 24 years in Life Insurance, Long-Term Care, Medicare Supplements, Medicare Advantage Plans, and Prescription Drug Plans.