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I’m on Medicare. Can I purchase an individual health plan from the exchange instead?

If you are already on Medicare, it is best for you to remain on Medicare. Insurers who sell plans through the exchange are not even allowed to sell plans to persons already receiving Medicare coverage. Even if you worked around this, Medicare coverage is usually cheaper than the individual coverage you would be able to get through the exchange, even if your income is high enough that you must pay increased premiums on things like Medicare Parts B and D.

While prices can vary greatly based on factors like age and location, the average yearly premium for the “benchmark” silver plan available through the exchange was $13,500 in 2018, with a deductible of $4,000. Even if your income exceeds $100,000 annually, it is unlikely that your Medicare premiums – even for Parts A, B, D, and Medigap combined – would come close to this number. On top of this, having coverage through Parts A, B, D, and Medigap will actually give you more comprehensive coverage and lower out-of-pocket expenses than a plan from the exchange would. Finally, one should keep in mind that cost and access to certain hospitals, healthcare providers, and prescription medications may differ between Medicare and a plan from the exchange.

If you were to drop your Medicare coverage in favor of buying a plan elsewhere, you may also face problems if you ever wanted to re-enroll in Medicare. First, you would need to wait until the general enrollment period from January 1st through March 31st each year, and even then, your coverage would not go into effect until July. You would likely also face penalties for every month you went without Part B and/or Part D coverage between the time you dropped your earlier Part B/D coverage and the time you re-enrolled.

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Should I switch from an exchange plan to Medicare when I become eligible?

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