ACA Marketplace Options for Those Ineligible for Part B

Navigating Medicare enrollment can be complex, especially if you face unexpected circumstances. If you’re in a situation like the one described in the post, discovering that you cannot enroll in Part B outside of the enrollment period can be daunting. However, don’t panic. Here we explore ACA marketplace options available to those ineligible for Part B and provide valuable information to help you make informed decisions.

Understanding the Impact of Part A

If you have enrolled in Medicare Part A but not Part B, you are not eligible to purchase ACA marketplace plans. This is because Part A is considered a government-sponsored health plan, and having it disqualifies you from receiving premium tax credits or subsidies available through the marketplace.

Alternative Coverage Options

In such situations, you have three potential coverage options:

Individual Off-Exchange Plans: These ACA-compliant policies are sold outside the marketplace. They do not qualify for premium tax credits, but they may be more affordable than cobra coverage.
COBRA Extension: If your employer offers COBRA coverage, you may be eligible to extend your coverage beyond the standard 18-month period. This can provide temporary coverage while you explore other options.
Private Medicare Supplement Plans: These plans are designed to cover the costs not covered by Medicare Part A and B. However, they can be expensive and may not cover all healthcare expenses.

Consequences of Delaying Part B Enrollment

If you delay enrolling in Part B, you will incur a late enrollment penalty of 10% for each 12-month period you were eligible but did not enroll. This penalty is permanent and will be added to your monthly Part B premiums for the rest of your life.

Seeking Professional Assistance

It’s crucial to seek professional guidance from a licensed agent to help you navigate the complexities of your situation. They can assess your coverage needs, compare options, and assist you in enrolling in the best plan for your specific circumstances.


If you are ineligible for Medicare Part B due to prior enrollment in Part A, there are still options available for health coverage. By exploring individual off-exchange plans, COBRA extension, and private Medicare supplement plans, you can find a solution that meets your specific needs. Don’t delay enrolling in Part B, as it can have financial consequences. Seek professional assistance to make informed decisions and ensure you have the health coverage you need.

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