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Turning 65 is a significant milestone in terms of healthcare in the United States because it is the age at which most individuals become eligible for Medicare. If you currently have an individual plan with Covered California and are approaching age 65, here’s what you generally need to know and do:

  1. Understand Medicare Eligibility: As you approach age 65, you will become eligible for Medicare. Medicare is a federal health insurance program for people aged 65 and older and some younger individuals with disabilities.
  2. Review Medicare Options: There are different parts of Medicare, including Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage). You’ll want to understand what these parts cover and decide which parts you’ll need.
  3. Enroll in Medicare: You can sign up for Medicare during the Initial Enrollment Period (IEP), which begins three months before the month you turn 65 and continues three months after the month you turn 65. If you’re receiving Social Security benefits, you may be automatically enrolled in Parts A and B.
  4. Decide About Keeping Covered California: If you enroll in Medicare, you will typically no longer qualify for premium assistance through Covered California. You’ll need to decide whether to keep, modify, or cancel your Covered California plan. This will depend on your specific healthcare needs, Medicare enrollment, and financial situation.
  5. Consult with Covered California: Contact Covered California or a health insurance broker who can assist you with the transition. They can explain your options and help you make the best choice for your situation.
  6. Notify Covered California if Dropping Coverage: If you decide to cancel your Covered California plan, you’ll need to notify Covered California to ensure you are no longer billed for the coverage.
  7. Coordinate with Your Healthcare Providers: If you choose to move to Medicare, make sure your current healthcare providers accept Medicare, or find new providers that do. You may also wish to discuss your options with your doctor to ensure that your healthcare needs will be met under your new plan.
  8. Consider Additional Coverage: Depending on your health needs, you may also want to consider purchasing supplemental coverage known as Medigap or enrolling in a Medicare Advantage plan to cover additional healthcare costs that traditional Medicare does not cover.
  9. Watch for Mail and Notifications: Pay attention to the information that you receive from both Covered California and Medicare as you approach age 65. These communications will contain important details about your options and next steps.

In conclusion, turning 65 and becoming eligible for Medicare while on a Covered California plan requires careful consideration and timely action. Understanding your Medicare options, coordinating with Covered California, and seeking professional guidance if needed will help you navigate this transition smoothly.


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