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Seattle your transition will be very clean and very simple. The fact your current insurance has been purchased through an exchange will not change any part of the transition as compared to transferring from a healthcare plan through an employer.

I personally worried and fretted about this - that was unnecessary. You can sign up for Medicare Parts A & B at

A few comments beyond your question -

Think carefully and long about getting a Supplemental (aka Medigap) policy. There are two basic choices.

One is an Advantage type plan. These were created in the Bush administration. Currently these plans get a subsidy paid by traditional Medicare recipients. That changes annually, I believe it in the $700 to $900 per year range. The capitation allows Advantage plans be be profitable with either lower premiums or at similar premiums offer additional coverage(s). You may recall during the ObamaCare fights each party accused the the other of taking money form Medicare in the amount of roughly $700 Billion - that money was an elimination of the capitation. The Ryan Health plan did and an original ACA legislation did that. I am not aware of any pending change in the capitation, but as medical costs for the government continue to increase that is low hanging fruit.

The second option is traditional Medicare with a Medigap policy (There is no requirement for the Medigap policy, but 20% of the costs for any major illness or injury is not small. ICU fees start at $10K per day here in Atlanta.)

One way or another under current law you are required to either have Drug coverage or sustain a life long cost increase penalty of 1% per month. So skip 2 years of Part D coverage. Say you sign up your premium, not matter what policy you select will be 124% of the stated rate. The penalty is permanent and intend to force people into coverage at younger ages when they needs are less.

Everyone has opinions - I have tried several choices and I think it is best to have all of one's medical premiums deducted from a social security payment. From time to time I change my Part D policy. The switch is much cleaner via Social Security. If you change banks, you do not have mess with moving the insurance payments - a process I have found always takes more than 1 monthly billing cycle.

You have to watch your Part D plans (If you go that way as opposed to say an Advantage plan most of which satisfy the Drug coverage requirement.) Companies offer broad formularies one year maybe with competitive prices. Then sometime slowly sometimes quickly they ax the formulary, jack up copays or maybe raise premiums. Each year I feel a person needs to examine options at (I screwed up one year by accidentally comparing 2013 premiums for some plans with 2012 premiums for other plans. When you go to in the fall, both prices sets are present.)

The system for comparing PartD plans is excellent. If you sign up for ABC's plan and decide to change to the XYZ plan it is simple. You will be include in the last plan you signed up for. The process of signing up for any plan automatically cancels existing or previously selected plans.

In you choose a traditional Medigap policy the coverages for each of the government described plans is the same. There are very few coverage differences between insurance providers. I know there are significant difference in the quality of customer service. Do your research. You only are guaranteed one bite at this apple - generally speaking. Yes I could switch my insurance company - I am in good health and any company would like me. But we had a friend who had a stroke and no one would take her. Three years after her stroke, her company existed the health insurance business. That event is the one exception which guarantees a second bite at the apple. One should the selection of an insurance company for Medigap coverage as a lifetime commitment, unlike Part D which can be changed annually.
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