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Health Insurance Marketplace


The Health Insurance Marketplace is a Federal Insurance Exchange where individuals, families, and small businesses can: learn about their health coverage options; compare health insurance policies based on costs, benefits, and other important features; choose a plan; and enroll in coverage.  The Marketplace also provides information on programs that help people with low to moderate income and resources pay for coverage.  This includes ways to save on the monthly premiums and out-of-pocket costs of coverage available through the Marketplace, and information about other programs, including Badger Care Plus and the Children's Health Insurance Program (CHIP).  The Marketplace encourages competition among private health plans, and is accessible through websites, call centers, and in-person assistance. In some states the Marketplace is run by the state.  In Wisconsin it is run by the Federal Government.  To be eligible to enroll in health coverage through the Marketplace, you must live in the United States, be a U.S. citizen or national (or be lawfully present) and cannot be incarcerated.  To learn more about The Marketplace, find out if you are eligible for coverage and what it may cost go to http://www.healthercare.gov/get-coverage/.



Marketplace and Medicare:
If you have a Marketplace plan you can keep it until your Medicare coverage starts.  Then you can end your Marketplace plan without penalty.  If you like, you can keep your Marketplace plan too, but once your Medicare coverage starts you will no longer be eligible for any premium tax credits or other cost savings you may be getting with your Marketplace plan.  Generally, you need to return to the exchange to terminate any premium tax credits or other cost savings, and pay full price for the Marketplace plan.  Let's assume you have a Marketplace plan and are eligible for Medicare due to disability or because you are reaching age 65 sometime this year. In most cases it's to your advantage to sign up for Medicare when you're first eligible.  You'll have to pay full price for the Marketplace plan.  Conversely, if you do not enroll in Medicare during your initial enrollment period, you may not be able to join again for some time and may have to pay a late enrollment penalty.  Also, delayed enrollment to Medicare may create a gap in your health care coverage.  For prescription drug coverage, you can buy a Medicare Part D drug plan.  You can join other Medicare options, like Medicare Advantage Plans or add a Medigap policy.  Be sure to end your Marketplace plan just before your Medicare coverage begins.  Otherwise, you may have a gap in coverage.  In some cases, Marketplacecoveage may not end immediately for the person being removed from the plan.  Example: Person is removed on or before the 15th of the month:  coverage ends on the last day of the current month.  Person is removed after the 15th of the month: coverage ends on the last day of the next following month.


 

 

 

Last Modified:   7/27/2016 9:21:05 AM   
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Board on Aging & Long Term Care
1402 Pankratz Street, Suite 111
Madison, Wisconsin  53704-4001
FAX:  608 246 7001
BOALTC@Wisconsin.Gov