Can I stay on my Affordable Care Act marketplace plan instead of Medicare?

Quick Answer

Technically yes, but it usually costs you more and creates gaps. Once you're eligible for Medicare, marketplace plans stop qualifying for premium tax credits, making them expensive to keep.

Detailed Explanation

Once you turn 65 and become eligible for Medicare, the Affordable Care Act marketplace changes the rules on you. At that point, you no longer qualify for the premium tax credits that make marketplace plans affordable for most people. Without those credits, the premiums on a marketplace plan can be significantly higher than what you'd pay for Medicare.Beyond cost, there's a timing issue. If you delay signing up for Medicare Part B and then want to enroll later, you may face a late enrollment penalty that adds to your Part B premium permanently. That penalty grows the longer you wait, so the decision to skip Medicare isn't consequence-free.There are narrow situations where keeping a marketplace plan temporarily makes sense, like if you're still working and waiting to coordinate with employer coverage, but simply preferring your current marketplace plan isn't a strong enough reason to skip Medicare. The math almost never works out in your favor.If you like your current doctors and you're worried about changing coverage, that's worth talking through. Some people find Medicare covers their needs at a lower total cost once premiums, deductibles, and out-of-pocket costs are compared side by side.

How This Applies in Utah

If you're on a Utah marketplace plan through Your Health Idaho or the federal exchange and approaching 65, contact Utah's ADRC (the state's free Medicare counseling program) to review your options before your birthday.

What This Means For You

For you, this means keeping a marketplace plan past 65 usually costs more and risks a lasting penalty, so it's worth comparing actual numbers before deciding to delay Medicare.

Disclaimer

‍How Resting Sycamore Advisors Uses CMS Data

Our Commitment to Reliable Medicare Information

At Resting Sycamore Advisors, we work to provide accurate, current, and trustworthy information about Medicare Advantage, Medicare Part D, and Special Needs Plans.

To do that, we use data published by the Centers for Medicare & Medicaid Services (CMS), which is the official source for Medicare plan and enrollment information.

CMS Data Sources We Rely On

Our Medicare plan pages and comparison tools are powered by CMS datasets, including:

  • Medicare Advantage and Part D Landscape Files for annual plan availability and benefit details
  • Plan Benefits Package (PBP) Files for detailed benefit and coverage information
  • Part C and Part D Performance Data for quality ratings and plan performance measures
  • Monthly Enrollment Data for enrollment counts by contract, plan, state, and county

When possible, we link to the original CMS resources so you can review the source material directly.

How Often We Update Our Data

We follow the CMS release schedule and update our website as new data becomes available.

Annual Plan Year Updates (September)

We load new plan year Landscape and PBP files before the Medicare Annual Enrollment Period (October 15 through December 7). We also monitor CMS.gov for updates or revisions and refresh our content when needed.

Mid-Year Updates

We update enrollment and performance data as CMS publishes revised files, which are typically released monthly or quarterly.

Ongoing Maintenance

We routinely monitor CMS announcements for corrections, reissued files, or other changes and update our pages accordingly.

Each plan page includes a Last Accessed date so visitors can see when the source information was most recently reviewed.

How We Prepare CMS Data for Our Website

CMS data can be difficult to read in raw form. To make it easier to use, we format and organize the data for clarity.

This includes:

  • Standardizing plan identifiers such as contract ID, plan ID, and segment
  • Normalizing terminology so common Medicare terms are presented consistently
  • Organizing plan information by state, county, and ZIP code to match how people shop for coverage

All data values come from CMS. We do not change the underlying values beyond formatting, organization, and presentation.

Version Tracking and Transparency

We keep internal records of the CMS dataset versions used on our site.

Major Version History

  • Current Version: CY2025 Medicare Advantage and Part D Landscape Files (v1.0, published October 2025)
  • Prior Version: None. Resting Sycamore Advisors first began publishing structured Medicare plan information in March 2025

If CMS issues corrected or revised files, we update our website to reflect the latest available version.

Important Limitations

Please keep the following in mind:

  • CMS is the official source of truth. For enrollment and coverage decisions, always confirm details with Medicare.gov or 1-800-MEDICARE.
  • Data timing can vary. Enrollment and performance updates may appear on our website a few weeks after CMS publishes changes.
  • Plan details can change. Plan availability, costs, and benefits may change. Always verify current details directly with the plan provider.

Need Help From Official Medicare Resources?

For personalized Medicare assistance, please use these official resources:

  • Medicare.gov Help Center — https://www.medicare.gov
  • 1-800-MEDICARE (1-800-633-4227) TTY: 1-877-486-2048
  • State Health Insurance Assistance Program (SHIP) — free local counseling for Medicare beneficiariesIf you want, I can also give you a shorter legal-style version for a footer or /disclaimer page summary.