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If you have a health plan through the Health Insurance Marketplace and will soon have Medicare eligibility, it’s not too soon to start planning for your coverage to switch.

If you have a Marketplace plan now, you can keep it until your Medicare coverage starts. Then, you can cancel the Marketplace plan without penalty.

When to apply for Medicare

Once Medicare eligibility begins, you’ll have a 7 month Initial Enrollment Period to sign up. For most people, this is 3 months before, the month of, and 3 months after their 65th birthday.

It’s important to sign up for Medicare when you’re first eligible because once your Medicare Part A coverage starts, you’ll have to pay full price for a Marketplace plan. This means you’ll no longer be eligible to use any premium tax credit or help with costs you might have been getting with your Marketplace plan. Also, if you enroll in Medicare after your Initial Enrollment Period, you may have to pay a late enrollment penalty. It’s important to coordinate the date your Marketplace coverage ends with the effective date of your Medicare enrollment, to make sure you don’t have a break in coverage.

How to cancel your Marketplace coverage

If you’re the only person on your Marketplace application, you can cancel the whole application.

If you and your spouse (or other household members) are enrolled on the same Marketplace plan, but you’re the only one eligible for Medicare, you’ll cancel Marketplace coverage for just yourself. This way any others on the Marketplace application can keep Marketplace coverage. Find out how here.

Learn more about transitioning from the Marketplace to Medicare coverage.



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Medicare and Medicaid celebrate 50 years on July 30th!

In 1965, President Lyndon B. Johnson signed Medicaid and Medicare into law. Medicare and Medicaid began as basic insurance programs for Americans without health insurance. Over the years they have continued to evolve, becoming the standard bearers for quality and innovation providing even more Americans with quality and affordable care.

The Affordable Care Act has strengthened both programs.

  • Under the health care law, Medicare benefits have expanded. Things like free preventive benefits, certain cancer screenings, and an annual wellness visit are now covered. You can also save money if you’re in the prescription drug “donut hole” with discounts on brand-name prescription drugs.

  • The health care law also provides states with additional federal funding to expand their Medicaid programs. In states that choose to expand Medicaid, free or low-cost health coverage is available to all people with household incomes below a certain level.

Medicare and the Marketplace

Medicare provides health coverage for people 65 and older, certain younger people with disabilities, and people with End-Stage Renal Disease.

Here are a few things to know about Medicare and the Marketplace:

  • Medicare isn’t part of the Health Insurance Marketplace, so if you have Medicare coverage you don’t need to do anything. If you have Medicare, you’re considered covered.

  • If you’re under 65 and don’t have health coverage, you can enroll in a Marketplace plan. Once your Medicare coverage starts, you can end the Marketplace plan without penalty.

Get more information on Medicare and the Marketplace.

Medicaid and the Marketplace

When you fill out a Marketplace application, you’ll also learn if you qualify for Medicaid or the Children’s Health Insurance Program (CHIP).

  • Medicaid and CHIP provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Both programs are run jointly by federal and state governments.
  • You may qualify for these programs based on your household size, income, and other factors, like age and disability. You can enroll and apply any time of year.

  • Some states have expanded their Medicaid programs to cover all people with household incomes below a certain level. See if your state has expanded coverage and what this means for you.

  • Note: Even if your state hasn't expanded Medicaid, you should apply for coverage to see if you qualify.

Learn how to apply for Medicaid coverage.

Medicare and Medicaid make America healthier

Medicare and Medicaid save lives, help people live longer, and provide the peace of mind that comes with affordable health care.

If Medicare or Medicaid have improved your life or the life of someone you care about, share your story through Medicare.gov, Twitter, or the Medicare Facebook page.



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You’ve got questions; we’ve got answers. Read these 5 questions to learn more about dental coverage in the Health Insurance Marketplace. Dental coverage in the Health Insurance Marketplace

  1. Can I get dental coverage through the Marketplace? In the Marketplace, dental coverage is included in some health plans. You can also get a stand-alone plan and pay a separate premium.

  2. How do I add dental coverage to my Marketplace plan? You can buy a dental plan through the federal Marketplace only when you enroll in a health plan at the same time. If you’re already enrolled in a Marketplace plan, you can’t add on dental coverage. You have to wait until the next Open Enrollment Period to change health plans to one that includes dental coverage or add a stand-alone dental plan. If you qualify for a Special Enrollment Period, you can get dental coverage when you change health plans.

  3. How can I see what dental plans and benefits are available? After you complete your Marketplace application and get your results, you can view health plans that include dental coverage. If you decide you want a stand-alone dental plan, you can choose one after you select your health plan.

  4. Do I have to get dental coverage for my child? No. Dental coverage for children is an essential health benefit. This means if you’re getting health coverage for someone 18 or under, dental coverage must be available for them either as part of a health plan or as a stand-alone plan. But while dental coverage for children must be available, you don’t have to buy it.

  5. Can I cancel my Marketplace dental coverage at any time and still keep my health coverage? It depends on what type of dental coverage you have. If you have a separate, stand-alone dental plan, you can cancel your dental coverage any time during the year by not making payments on the dental plan premium. As long as you continue to pay your health plan premium, you’ll stay enrolled in your health plan.

If you have a health plan that includes dental benefits, you can change to another health plan without dental benefits only during Open Enrollment, unless you qualify for a Special Enrollment Period.

Get more information on dental coverage in the Marketplace.



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If you’re a small business owner, you know how important it is to offer high-quality, affordable health and dental coverage that meets the needs of your business and your employees. The Small Business Health Options Program (SHOP) Marketplace can help you do that by offering flexibility, choice, and the convenience of online application and account management.

The SHOP Marketplace is currently open to employers with 50 or fewer full-time equivalent employees (FTEs), including non-profit organizations. In 2016, the SHOP Marketplace will be available to larger businesses with 100 or fewer FTEs. You can enroll in the SHOP Marketplace at any point throughout the year, and there’s no restricted enrollment period when you can start offering your enrollees SHOP Marketplace coverage.

Here are 5 benefits of the SHOP Marketplace:

  • Everything’s online. Visit http://ift.tt/1fvEb7V to apply for the SHOP Marketplace, choose a plan or plans, complete your coverage offer, manage employee participation, and pay your premiums. Your enrollees can apply online too.

  • Flexible coverage options. You control the coverage you offer and how much you pay toward employee premiums. You choose whether to offer dependent coverage and dental insurance. You choose how long your employees’ Open Enrollment Period is, and the waiting period before new employees can enroll.

  • There’s help to apply and enroll. Licensed agents and brokers registered to work with the SHOP Marketplace can help you apply and enroll for coverage. You can also continue to use your current agent or broker as long as they complete the SHOP Marketplace registration requirements. Working with a SHOP-registered agent or broker doesn’t cost you or your employees a dime. When you apply, you can search for agents and brokers registered to sell SHOP Marketplace plans by name and ZIP code.

  • Employee choice. In all states, you can offer one health and one dental plan to your employees. In some states, you can choose a coverage category, like Bronze or Silver, and let your employees select the plan that meets their needs within the category that you choose.

  • You may be eligible for a tax credit. The SHOP Tax Credit Estimator can help determine if your business may qualify for the Small Business Health Care Tax Credit worth up to 50% of your premium costs. The tax credit is available only for plans bought through the SHOP Marketplace.

See if you qualify to offer SHOP Marketplace coverage to your employees, and learn how to enroll.



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Life change? You may be able to get health coverage for 2015

Thinking about moving, getting married, having a baby, or changing jobs? When you make big decisions in life, you may be eligible to buy or change Health Insurance Marketplace coverage outside the yearly Open Enrollment Period.

If you’ve had a qualifying major life event, you have 60 days from the life event to enroll in coverage. You can apply or change plans online or by phone. Before you apply, use this checklist (PDF) to gather everything you need before you call or log in.

See if you qualify for a Special Enrollment Period.



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