Rules straight from HealthCare.gov. Check your own dates and savings there before you apply.
Health insurance between a job plan and Medicare
If you lose job-based coverage before 65, a Marketplace plan can cover you until Medicare begins. I’ll show you when you can enroll, how savings are figured and how the plan ends.
Jeannie Pond, Licensed Insurance Agent, NPN 8940178, licensed since 2009
Jeannie Pond is registered with CMS to help consumers enroll in Health Insurance Marketplace plans for the 2026 plan year.
No ofrecemos todos los planes disponibles en su área. Actualmente representamos 14 organizaciones que ofrecen 52 productos en su área. Comuníquese con Medicare.gov o llame al 1-800-MEDICARE para obtener información sobre todas sus opciones.
1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, las 24 horas del día, los 7 días de la semana
In short
A Marketplace plan can cover you after job-based coverage ends and before Medicare starts. Losing job coverage lets you apply from sixty days before to sixty days after your separation date, and your application shows any savings, set by income and household size. The plan doesn’t end on its own when Medicare starts. Jeannie Pond is registered with CMS to help consumers enroll in Health Insurance Marketplace plans for the 2026 plan year.
Getting from a job plan to Medicare
Read the drawing from top to bottom, from your last day on a job plan to your first day on Medicare. Four rules matter along the way, and each one links to its HealthCare.gov page.
On a phone, slide the drawing sideways to read every label.
Who can buy a Marketplace plan
To enroll through the Marketplace, you must live in the United States, be a U.S. citizen or national or a lawfully present non-citizen, and not be incarcerated. If you retire before 65 and lose your job-based plan, you can use the Marketplace to buy one. If you already have Medicare, you can’t enroll in a Marketplace health plan.
HealthCare.gov: Are you eligible to use the Marketplace?A Special Enrollment Period when job coverage ends
Outside Open Enrollment, you can enroll in a Marketplace plan only if you qualify for a Special Enrollment Period. Losing job-based coverage can qualify you if you lost it in the past sixty days or expect to lose it in the next sixty. Dropping retiree coverage by choice does not qualify you, and you may have to send documents that confirm your loss of coverage.
HealthCare.gov: Special Enrollment PeriodsSavings set by income and household size
Your Marketplace application shows whether you qualify for premium tax credits and lower out-of-pocket costs, which depend on your income and household size. Savings rest on your income estimate for the year you want coverage, not last year. Your household counts you, your spouse if you’re married, and everyone you claim as a tax dependent.
HealthCare.gov: Saving money on health insuranceEnding the plan when Medicare starts
Marketplace coverage doesn’t end automatically when Medicare starts. You report your Medicare start date on your application, up to three months ahead, and Marketplace coverage ends the day before Medicare starts. Once you have Medicare Part A or Part C, you won’t qualify for Marketplace savings.
For example, if Medicare begins May 1, you can update your application as early as February 1, and Marketplace coverage ends April 30.
HealthCare.gov: Medicare and the Marketplace
Marketplace Open Enrollment for 2027, date by date
If you don’t have a Special Enrollment Period, Open Enrollment is your yearly chance to sign up. Starting with 2027 coverage, CMS set Open Enrollment on the federal platform, HealthCare.gov, at November 1 through December 15.
CMS: 2025 Marketplace Integrity and Affordability final ruleMedicare keeps its own calendar
The Marketplace doesn’t affect your Medicare choices or benefits. The Medicare Open Enrollment Period runs from October 15 to December 7 each year.
Other life changes that open a Special Enrollment Period
Outside Open Enrollment, you can enroll in or change a Marketplace plan only after certain life changes. Losing job-based coverage is one. Here are others that count, and the details vary by change.
A change in your household
- You got married in the past sixty days. Pick a plan by the last day of the month, and coverage can start the first day of the next month.
- You had a baby, adopted a child or placed a child for foster care. Coverage can start the day of the event, even if you enroll up to sixty days afterward.
- You got divorced or legally separated and lost health insurance. Divorce or separation without losing coverage doesn’t qualify.
- Someone on your Marketplace plan died, and you lost your plan because of it.
A move
- To a new home in a new ZIP code or county.
- To the U.S. from a foreign country or a U.S. territory.
- Moving only for medical treatment, or staying somewhere on vacation, doesn’t qualify.
Other changes
- You lost Medicaid or CHIP coverage. If you lost it in the past ninety days, you may qualify.
- You became a U.S. citizen, or you left incarceration.
- You were affected by an unexpected event or natural disaster, such as a hurricane, massive flooding or an earthquake.
When you apply, you attest that what you report is true, including the change that qualifies you, and you may have to send documents to confirm it. If you’re turned down but think you qualify, you can appeal. Medicaid and CHIP don’t wait for a window: you can apply for them at any time.
HealthCare.gov: Getting health coverage outside Open EnrollmentEstimating your income before you apply
Your savings rest on what you expect your household to earn in the year you want coverage, so it pays to get the estimate right. Here’s how to build it.
Start from adjusted gross income
Begin with your household’s adjusted gross income: your total income for the tax year minus certain adjustments, such as deductions for conventional IRA contributions and student loan interest. It appears on IRS Form 1040, line 11. Then update it for the changes you expect in the year ahead.
HealthCare.gov: Saving money on health insuranceCount retirement withdrawals
If you retire early and live on savings, IRA and 401k withdrawals generally count as income. The IRS has guidance on reporting income from retirement savings.
HealthCare.gov: Health coverage for retireesEligible for retiree coverage, but not enrolled
Being enrolled in retiree coverage rules out income-based savings on a Marketplace plan. If you’re only eligible for retiree coverage and not enrolled in it, you may still qualify for premium tax credits and lower out-of-pocket costs. If you’re 65 or older but not eligible for Medicare, you may also get lower costs on premiums and out-of-pocket costs, based on household size and income.
HealthCare.gov: Health coverage for retireesOne application checks Medicaid too
The Marketplace application also tells you whether you qualify for coverage through your state’s Medicaid program. Not all states have expanded their Medicaid programs, so the answer depends on where you live.
HealthCare.gov: Affordable Care Act (ACA) glossaryPreview now, check again from November 1
Before November 1, you can get an idea of your 2027 savings on HealthCare.gov using 2026 amounts, then come back on November 1 for a more accurate estimate. Exact plan prices and savings appear when you fill out the application.
HealthCare.gov: Saving money on health insurance
A household on both sides of 65
When one of you starts Medicare and the other doesn’t, update your Marketplace application to end coverage for the person starting Medicare, then confirm the plan for everyone else in the household who needs to keep it.
The one starting Medicare
Report the Medicare start date on the household’s Marketplace application, up to three months before it starts, and Marketplace coverage ends the day before. From then on, it’s against the law for someone who knows you have Medicare to sell you a Marketplace plan.
The one keeping the Marketplace plan
After you submit the update, confirm the plan for the others in your household who need to keep their Marketplace coverage. Savings are still figured on the whole household: you, your spouse if you are married, and everyone you claim as a tax dependent, including those who don’t need coverage.
Medicare coverage works differently. The Marketplace doesn’t offer Medicare Supplement Insurance or Medicare drug plans, and Medicare Advantage Plans bundle Part A, Part B and usually Part D. For the steps before 65, in order, see turning 65 in Florida, step by step.
My CMS Marketplace registration
Jeannie Pond is registered with CMS to help consumers enroll in Health Insurance Marketplace plans for the 2026 plan year.
Jeannie Pond ayuda a las personas menores de 65 años a inscribirse en planes del Mercado de Seguros Médicos.
Jeannie Pond, Licensed Insurance Agent, NPN 8940178. Florida W272782; Arizona 8940178; California 4524185; Georgia 2669678; Indiana 4017600 (health only); Michigan 8940178; New Jersey 3004406991; North Carolina 8940178; Tennessee 960426; Texas 1617709; Virginia 1447142 (health only); Washington 1346341.
Agents and brokers can help you enroll through the Marketplace or handle the whole process for you. HealthCare.gov notes that they may be paid a commission by health insurance plans when they help enroll you in a plan.
Before you call, look up each of my license numbers on the state’s insurance license search. And one HealthCare.gov warning worth repeating: never share your information with anyone offering cash, gifts or other perks.
You’ll find other kinds of coverage, from Medicare plans to life insurance, explained on the services page.
No ofrecemos todos los planes disponibles en su área. Actualmente representamos 14 organizaciones que ofrecen 52 productos en su área. Comuníquese con Medicare.gov o llame al 1-800-MEDICARE para obtener información sobre todas sus opciones.
1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, las 24 horas del día, los 7 días de la semana
Common questions about Marketplace coverage
Who is eligible for Marketplace health insurance?
To enroll through the Marketplace, you must live in the United States, be a U.S. citizen or national or a lawfully present non-citizen, and not be incarcerated. If you have Medicare coverage, you can’t enroll in a Marketplace health or dental plan. (Source: HealthCare.gov, Are you eligible to use the Marketplace?, October 2026.)
Is it cheaper to get health insurance through the Marketplace?
It depends on your household. Your Marketplace application shows whether you qualify for premium tax credits and lower out-of-pocket costs based on your income and household size, and you get exact plan prices and savings when you fill it out. If you’re enrolled in retiree coverage, you can’t get those income-based savings on a Marketplace plan. (Sources: HealthCare.gov, Saving money on health insurance and Health coverage for retirees, 2026.)
Who qualifies for Marketplace savings, and at what income do they stop?
The Affordable Care Act’s premium tax credit lowers costs for households with incomes between 100% and 400% of the federal poverty level, a measure updated each year. Savings rest on your income estimate for the year you want coverage, and once you have Medicare Part A or Part C you won’t qualify for them. HealthCare.gov posts the income levels for the coming year, and your application shows your exact savings. (Source: HealthCare.gov glossary, Affordable Care Act, October 2026.)
When is Marketplace open enrollment?
Starting with 2027 coverage, Open Enrollment on the federal platform, HealthCare.gov, runs November 1 through December 15, and coverage starts January 1. CMS set those dates in its 2025 Marketplace rule. Outside them you need a Special Enrollment Period, such as the one that comes with losing job-based coverage.
Talk to me about coverage before Medicare
Tell me your name and how to reach you, or pick up the phone and call.Medicare help in Lakeland and nearby cities
Jeannie Pond, Licensed Insurance Agent, NPN 8940178. Florida W272782; Arizona 8940178; California 4524185; Georgia 2669678; Indiana 4017600 (health only); Michigan 8940178; New Jersey 3004406991; North Carolina 8940178; Tennessee 960426; Texas 1617709; Virginia 1447142 (health only); Washington 1346341.
Vista Consultants LLC dba Vista Insurance Services holds Florida insurance agency license L135539 (agency NPN 22164003), issued March 19, 2026, with Jeannie Pond as agent in charge.
No ofrecemos todos los planes disponibles en su área. Actualmente representamos 14 organizaciones que ofrecen 52 productos en su área. Comuníquese con Medicare.gov o llame al 1-800-MEDICARE para obtener información sobre todas sus opciones.
1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, las 24 horas del día, los 7 días de la semana