How ICHRA Works with Medicare: The Benefits for Employees 65 and Older

Here’s a question we get all the time from employers exploring ICHRAs:

“Will my older employees be forced into Medicare?”

Our answer?

Yes. And in fact, our ICHRA members on Medicare are some of the “biggest winners.”

Let us explain.

ICHRA and Medicare

Instead of an ACA individual health plan, eligible employees enroll in Medicare Parts A and B or Medicare Advantage to access their ICHRA funds.

Medicare offers broader coverage at a fraction of the cost. Our typical Medicare member pays around $150 to $300 a month total for Parts A, B, D, and Medigap coverage.

They also have thousands of Health Wallet dollars.

During Open Enrollment meetings, we often sit with older employees who are in disbelief. What they realize is that they’re not just covered, they can afford nearly their entire year of medical expenses.

Sure, Medicare is alphabet soup: Part A, Part B, Part C (Medicare Advantage), Part D (prescriptions). The alphabet continues with Medigap plans. It’s complex and quirky.

Take the “blood deductible,” for example: the first three pints of blood aren’t covered. It’ll send you down a Google rabbit hole. How much blood is in the human body? How much does blood cost? Where do you buy blood? Like we said, it’s complex.

Can You Buy an ACA Plan Once You're 65?

TLDR: Not really.

Once you’re eligible for Medicare at 65, most insurance carriers won’t allow you to buy a new Marketplace (ACA) plan. Even if they do, it rarely makes financial sense. ACA premiums increase with age, so at 65 you’d be paying the highest rates for less coverage than Medicare provides.

If you’re 64 turning 65, your existing Marketplace plan doesn’t end right away. You can keep it until the end of the plan year, but it likely won’t renew once you become Medicare-eligible.

Why This Matters for the Modern Workforce

People are working longer than ever. Today, it’s common to see professionals in their late 60s or even 70s still thriving in their careers. Just a few decades ago, most people retired by their early 60s.

That shift brings new challenges for health coverage. Many employees with group insurance assume they can delay enrolling in Medicare, only to face penalties later or struggle to qualify for Medigap coverage. Others end up with both Medicare and employer coverage, paying twice for benefits they don’t need.

ICHRA changes that equation. It creates a win-win for both employers and employees. Workers can move seamlessly onto Medicare at age 65, when coverage options and underwriting are most favorable, avoiding costly penalties. Employers continue to offer a meaningful benefit—at a lower cost and with far greater flexibility.

Simply put, it’s a smarter, simpler way to support the modern workforce. ICHRA isn’t just about giving employees access to personalization and flexibility—it’s about supporting people through every stage of their working life. From their first Marketplace plan to their transition into Medicare, ICHRA builds a bridge that connects the entire employee lifecycle.

Medicare Open Enrollment Starts October 15

Medicare Open Enrollment takes place each year from October 15 to December 7. During this time, anyone enrolled in Medicare can review their coverage and make changes for the upcoming year.

That might mean switching between Original Medicare and Medicare Advantage, choosing a new Part D prescription plan, or updating coverage to better match evolving health needs. Any updates go into effect on January 1.

This window is an important opportunity to make sure your doctors, prescriptions, and costs still fit your situation, since plans and premiums often change each year.

How Does the Venteur ICHRA Handle Medicare?

We’re so glad you asked. Check out the full article or schedule a time to talk to our team by emailing support@venteur.com.