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If I enroll in Medicare, I’ll owe premiums on my Part A coverage. Can I get a plan through the exchange instead?

Generally speaking, those who are qualified for Medicare should enroll in it rather than looking for plans from the exchange/marketplace. People in this situation may even have difficulties buying plans through the exchange because of some of the rules that insurers there must follow regarding Medicare coverage and eligibility. However, you may purchase a plan through the exchange if you are not entitled to receive premium-free coverage through Medicare Part A. Additionally, if your income falls between 100% and 400% of the federal poverty level, you will be eligible to receive premium tax credits (also known as premium subsidies) that can help make your exchange plan more affordable.

Most people will not owe any premiums for their Medicare Part A coverage. In order to fall into this group, you need to have worked for at least 10 years under Medicare-covered employment. If you are close to meeting this requirement, you may consider returning or continuing to work until you have earned your full 10 years. This can be done even after you have already signed up for Medicare Parts A and B, so one option would be for you to enroll in Medicare now and simply pay the premiums for your Part A coverage until you have earned sufficient work history. Alternatively, you could purchase a plan through the exchange using your premium subsidy and keep that coverage until you have met the requirements to receive Part A premium-free, at which point you can switch.

While it may require you to come out of retirement, working towards meeting the threshold for free Part A premiums will likely be the most economical option for anyone who is already close to meeting the requirement. Getting a plan through the exchange is certainly a viable option, but it can also be an expensive one. Most people who purchase a plan through the exchange will opt for something at the silver level. The cost of any given plan will vary based on things like age and location, but a plan like this will typically cost thousands of dollars more per year than getting coverage through Medicare would – even if you opted to get Medicare Supplement Insurance (Medigap) and Medicare Part D (prescription drug coverage) on top of having Parts A and B.

Last but certainly not least, it is worth pointing out that even if you have not met the full 10-year requirement for premium-free Part A coverage, any valid work history that you have accrued will help to bring the cost of your Part A premiums down. So, if you only have only worked 8 of the 10 years required, you will still have to pay premiums on Medicare Part A, but they will be smaller than what you would have had to pay otherwise. Because of this, it may be cheaper to opt for coverage through Parts A and B over a plan from the exchange even if you do not intend to continue working towards meeting the free premium threshold.

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If I enroll in Medicare, I’ll owe premiums on my Part A coverage. Can I get a plan through the exchange instead?

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