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National Council on Aging logo. We believe every person deserves to age well. That’s why we’re on a path to improve the lives of 40 million older adults by 2030.

Medicare and the Marketplace: Frequently Asked Questions (FAQ)

The Health Insurance Marketplaces were created by the Affordable Care Act (ACA, sometimes known as Obamacare or Health Care Reform) where individuals and families can compare and purchase health insurance plans. Small business owners can also use the Marketplace to purchase health insurance plans for their employees called Small Business Health Options Program (SHOP) plans.

Marketplaces provide insurance options to individuals who are uninsured or underinsured (meaning their current coverage is insufficient). This includes people who may not have health insurance through their or a spouse's employer.

In most cases, you do not need to use the Marketplace if you have Medicare or Medicaid. Some states may require that you be screened for other types of insurance before enrolling in a Marketplace plan.

These Frequently Asked Questions were developed for us by the Medicare Rights Center. The FAQ includes answers to the following questions:

  • What is a Qualified Health Plan (QHP)?
  • Can someone with Medicare have a QHP?
  • Who is eligible for tax subsidies to offset the cost of Marketplace plans?
  • Should an individual enroll in Medicare if they have a QHP from the Marketplace?
  • Will Marketplace plans notify someone that they should transition to Medicare when they become eligible?

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