As you approach your 65th birthday, you have decisions to make about your health care and health insurance coverage. If you currently have coverage through the health insurance marketplace and want to enroll in Medicare, here’s what you need to know about how to sign up for Medicare at age 65.

What’s the difference between Medicare and the health insurance marketplace?

Medicare is health insurance for people age 65 and over provided by the federal government. People under age 65 may also qualify for Medicare if they are disabled or have end-stage renal disease. The marketplace is simply a service that helps people shop for and purchase insurance coverage online, in person, and over the phone, and qualify for tax credits and other programs that lower the cost of coverage.

If you have a marketplace plan and you’re eligible for Medicare at age 65, you may want to cancel your marketplace plan when you enroll in Medicare so you are not paying two premiums unnecessarily.

How do I sign up for Medicare at age 65?

If you are getting Social Security or Railroad Retirement benefits for at least four months prior to your 65th birthday, you’ll be automatically enrolled in Medicare.

If you aren’t getting Social Security, you’ll have to apply for Medicare, either online at the Social Security Administration website, or in person at your local Social Security office. You can also apply over the phone by calling the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778) 7:00 AM to 7:00 PM in all time zones. Your Initial Enrollment Period for Medicare is the seven-month period that begins three months before the month in which you turn 65, includes your birthday month, and extends for three months after your birthday month.

You can keep your marketplace health insurance plan once you’ve applied for Medicare at age 65, but if you enroll in Part A, you won’t be eligible for any tax credits or premium subsidies you may have received before. You’ll pay full price for your marketplace plan.

How do I cancel my health insurance marketplace plan?

The process for ending your marketplace health insurance depends on whether or not you are the only person in your household on the plan, or if other members of your family are also on the marketplace plan when you enroll in Medicare.

If you are the only one covered by the marketplace plan, simply terminate your whole application. Your coverage should end about two weeks after you complete the cancellation process. You can also choose a future termination date so your marketplace plan ends on the day your Medicare coverage begins.

If you are canceling coverage for just one person on a plan that covers other members of the household, coverage usually ends immediately, so you’ll need to time your termination request with the effective date of your Medicare coverage.

In most cases, you can make changes to your health insurance marketplace plan online through or the state health insurance exchange where you bought your plan.