I'm turning 65 but have to pay a premium for Part A. Can I sign up for a Marketplace plan instead?

Short answer: Yes. If you are turning 65 and are not entitled to premium-free Part A because you have not worked 40 quarters, you can buy a Marketplace plan, and you can get premium tax credits to lower the cost. Being eligible for free Part A is what ends subsidy eligibility. Having to pay for Part A does not.

The rule, precisely

Premium tax credits are blocked for people who are eligible for or enrolled in premium-free Part A. That describes most people at 65, which is why the usual advice is "Marketplace coverage ends when Medicare starts."

You are in a different category. CMS guidance to Marketplace assisters is explicit: consumers who are eligible to enroll in premium Part A remain eligible for financial assistance through the Marketplace, unless and until they sign up for Medicare and can start using it. There is no age limit on Marketplace coverage. Turning 65 does not push you off a subsidized plan when you were never entitled to free Part A in the first place.

Who can do this

• You must be lawfully present in the United States and living in the state where you apply. Undocumented immigrants and DACA recipients cannot buy Marketplace coverage, subsidized or not.
• For premium tax credits, household income generally has to be at least 100% of the federal poverty level, which is $15,650 for one person for 2026 coverage.
• Subsidies now stop completely above 400% of poverty, which is $62,600 for one person and $128,600 for a family of four. The enhanced subsidies that softened that edge from 2021 through 2025 expired on December 31, 2025, so the cliff is back.

That cliff matters more at your age than at any other, because Marketplace premiums are age-rated and a 64-year-old is charged three times what a 21-year-old is charged. Just under the line, the subsidy caps your premium as a share of income. Just over it, the full age-rated premium is yours.

What each option costs in 2026

	Buy into Medicare	Subsidized Marketplace plan
Part A premium	$565/mo with under 30 quarters, $311 with 30 to 39	Not applicable
Part B premium	$202.90/mo, required if you buy Part A	Not applicable
Monthly subtotal	$767.90, or $513.90 with 30 to 39 quarters	Capped as a share of income up to 400% of poverty
Drug coverage	Separate Part D plan	Included in the plan
Gap coverage	Medigap or Medicare Advantage, extra	Included, with an out-of-pocket maximum
Realistic all-in	roughly $930 to $1,100/mo	Often far less below the subsidy cliff, often far more above it

For most people in this situation with income under 400% of poverty, the Marketplace plan wins, and it is not close. Above the cliff, Medicare usually wins. That single threshold is what the decision turns on.

If you are still working, the math can change again

Quarters keep accruing as long as you keep paying Medicare taxes, at any age. Two consequences worth planning around:

• Reaching 30 quarters cuts the Part A premium from $565 to $311, a savings of $3,048 a year.
• Reaching 40 quarters makes Part A free. At that point you would pay only the Part B premium, and Medicare becomes the obvious choice. It also ends your Marketplace subsidy eligibility, so you would need to switch.

If you are three or four years of work away from 40 quarters, a subsidized Marketplace plan can be an excellent bridge. If you are 20 quarters away at 65, it is a long-term plan, not a bridge.

The trap: Marketplace coverage does not protect you from the Part B penalty

This is the most expensive mistake in this whole decision, and it is the one thing the standard answer usually leaves out.

Employer group coverage from active employment lets you delay Part B penalty-free and gives you a Special Enrollment Period later. Marketplace coverage does neither. It is individual coverage, not employer coverage. If you take a Marketplace plan at 65 and enroll in Part B at 72, you will generally owe a 10% surcharge for each full 12 months you waited, for the rest of your life. Seven years of delay is a permanent 70% surcharge, about $142 a month on top of the standard premium at 2026 rates.

There is a Part A penalty too, at 10% for twice the number of years you delayed, but that one ends. The Part B penalty never does.

That does not make the Marketplace the wrong answer. It means the comparison is not just this year's premium. It is this year's premium against the lifetime cost of delay, and it is worth having someone run both numbers before you decide. Details are in Medicare Late Enrollment Penalties (2026).

Switching later, without getting burned

• You can enroll in Medicare during the General Enrollment Period, January 1 through March 31, with coverage starting the first of the month after you sign up.
• Report the change to the Marketplace right away and end your Marketplace plan as your Medicare coverage begins. Your subsidy ends the month Medicare starts.
• Watch out for retroactive Part A, which can create months of overlap and force you to repay advance premium tax credits at tax time. The Marketplace also runs periodic data matching and will flag anyone enrolled in both.
• Do not carry both for convenience. You would pay two premiums for coverage that largely duplicates itself.

Other options worth checking first

• A spouse's work record. If your spouse has 40 quarters and is 62 or older and you have been married a year, you may get premium-free Part A after all. The same can apply through an ex-spouse (10-year marriage) or a late spouse (married nine months). See Can you purchase Medicare without having enough working quarters?
• Medicare Savings Programs. With limited income and assets, your state may pay the entire Part A and Part B premium through the QMB program, using a conditional Part A application.
• Never worked in the U.S. at all? The immigration status rules, the five-year residence requirement, and the 2025 and 2026 law changes are covered in How can someone over 65 get health insurance if they never worked in the U.S.?

Let us run your numbers

The right answer here comes down to your income relative to one threshold, how many quarters you have, and how many more you are likely to earn. We will compare a Medicare buy-in against a subsidized Marketplace plan side by side and tell you which one costs less, this year and over time.

For educational use only. Figures are 2026 amounts: Part A premiums of $0, $311, and $565; standard Part B premium $202.90; federal poverty level $15,650 for one person, with 400% at $62,600 for one person and $128,600 for a family of four in the continental U.S. These change annually. Eligibility is determined by Medicare, the Social Security Administration, and the Marketplace, not by us. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Assistance Program, to get information on all of your options.