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How do I get health insurance if I retire before 65?

The short answer

If you retire before 65 you need your own coverage until Medicare starts. Your main choices are COBRA, a spouse's plan, retiree coverage from your employer or a marketplace plan. You have 60 days after job coverage ends to pick a marketplace plan. For 2027, marketplace savings stop completely if your income is above 400% of the poverty level.

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What are my options if I retire before 65?

If you retire before 65 you can choose from the five kinds of coverage below. Compare them before your job coverage ends, because the sign up deadlines are short.

OptionHow it worksWhat to watch for
COBRAKeeps your employer plan, usually for up to 18 months, or up to 29 months with a disability extension.You can pay up to 102% of the full premium, with no employer share. During a disability extension it can be up to 150%.
Spouse's employer planLosing your job coverage lets you join a spouse's plan outside its usual enrollment period.The deadline is set by the plan and is often shorter than 60 days. Ask the benefits office right away.
Retiree coverage from your employerSome employers keep retirees on a plan until Medicare.Ask what it costs, how long it lasts and whether it works with Medicare later.
Marketplace planYou have 60 days after losing job coverage to enroll, and you can apply up to 60 days before it ends.Savings depend on your income. Above 400% of the poverty level there are none.
MedicaidYou can enroll any month if your income is low enough where you live.Rules depend on your state, so check your state Medicaid agency.

How much does a marketplace plan cost for a retiree?

It depends on your income, not on how much you have saved. The benchmark plan is the second lowest cost silver plan in your area. For 2027 coverage, the IRS expects you to pay 2.15% of your income for it at the lowest incomes, rising to 10.22% between 300% and 400% of the poverty level. The premium tax credit covers the rest of the benchmark plan's price. Above 400% there is no credit.

Share of income you are expected to pay for the benchmark plan, 2027One person, with income shown as a share of the 2026 poverty guideline ($15,960), which applies to 2027 coverage. A bar is the percentage of your income.
  • 100% of poverty ($15,960)2.15%
  • 150% of poverty ($23,940)4.30%
  • 200% of poverty ($31,920)6.78%
  • 250% of poverty ($39,900)8.66%
  • 300% of poverty ($47,880)10.22%
  • 400% of poverty ($63,840)10.22%

Source: IRS Revenue Procedure 2026-26, section on 2027 applicable percentages; HHS 2026 poverty guidelines

Between the points shown, the percentage rises smoothly. For a household of two, 100% of poverty is $21,640, and each additional person adds $5,680.

How does the 400% income limit affect early retirees?

If your household income is even $1 above 400% of the poverty level, you get no premium tax credit at all. For one person that is $63,840, and for two people it is $86,560. Before 2026, enhanced credits removed this limit, and for 2027 the original rule is back. In retirement, your pension, IRA withdrawals and investment income decide which side of the line you are on.

Example for one person. The $900 monthly price is an assumption, not a quote.
Income $63,000Income $64,000
Share of poverty levelAbout 395%About 401%
Premium tax creditAbout $363 a monthNone
You pay for a $900 planAbout $537 a month$900 a month
Yearly costAbout $6,439$10,800

In this example, $1,000 more income costs about $4,361 a year in lost savings. If you can choose when to take income, ask a tax professional how to stay under the line. Our 2027 marketplace savings guide covers the general rules for everyone.

Which income counts toward the limit?

The marketplace uses modified adjusted gross income (MAGI). For most people it is close to the adjusted gross income on their tax return. MAGI also adds untaxed foreign income, nontaxable Social Security benefits and tax-exempt interest.

  • Usually counts: wages and self-employment income, pension payments, interest and dividends, capital gains, and withdrawals from traditional IRAs and 401(k) plans.
  • Selling savings you already paid tax on counts only for the gain, not the amount you originally put in.
  • Contributions to a health savings account and to a traditional IRA can lower the figure for some people. A tax professional can tell you what applies to you.
  • Estimate your income for the year you want coverage, and update the application when it changes. Savings you receive above what you qualify for are repaid when you file your taxes.

How do I avoid a gap in coverage?

To avoid a gap, work backward from your last day of job coverage:

  • Up to 60 days before your job coverage ends, you can apply for a marketplace plan. Ask your employer for the exact end date.
  • After it ends you have 60 days to enroll in a marketplace plan.
  • You have at least 60 days to elect COBRA, counted from when coverage ends or from the date of your election notice, whichever is later.
  • Do not cancel COBRA before the marketplace plan starts, unless you have a qualifying reason to switch.

What happens when I turn 65?

Marketplace coverage does not end by itself when Medicare starts. Once you are eligible for premium-free Part A, you cannot get premium tax credits, and you pay full price for a marketplace plan if you keep it. Update your marketplace application to end the plan, up to three months before Medicare begins.

Your Medicare window opens three months before you turn 65. COBRA does not extend it.

If you have an HSA, stop contributing before Medicare starts. Our guides on the Medicare timeline and on HSA limits explain the dates.

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Common questions

Can I get a premium tax credit if I retire at 62?

Yes, if your household income is within the range for savings and you do not have other qualifying coverage such as Medicare, Medicaid or an affordable employer plan. For 2027 the credit ends above 400% of the poverty level.

How long does COBRA last if I retire?

Usually up to 18 months, and up to 29 months if you qualify for a disability extension. The cost can be up to 102% of the full plan price, because your former employer no longer pays a share. During a disability extension the plan can charge up to 150% for the disabled person.

What is the cheapest way to get health insurance before 65?

It depends on your income and your health needs. A marketplace plan with a premium tax credit is often cheapest at moderate incomes, and Medicaid is free or low cost if you qualify. Compare total yearly cost, not only the monthly premium.

Do I need to enroll in Medicare at 65 if I retired early?

Yes, in most cases. Marketplace coverage does not count as Medicare, and waiting past your seven month window can bring a late enrollment penalty. You also lose premium tax credits once you are eligible for premium-free Part A.

Does retiring change my open enrollment dates?

Retiring and losing job coverage gives you a 60 day special enrollment period for a marketplace plan, even outside open enrollment. Open enrollment for 2027 coverage runs from November 1, 2026 to January 15, 2027 in most states.

Sources

Rules change. Confirm dates and eligibility with your marketplace, your state Medicaid agency or Medicare before you enroll.

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