When does Medicare start?

Age 65 for most people. Younger people can qualify through Social Security Disability Insurance after a 24-month waiting period or with certain diagnoses like ESRD and ALS, but the standard eligibility age is 65.

How long does COBRA last?

For an employment-related qualifying event, COBRA generally lasts up to 18 months, with exceptions that can extend coverage. It generally continues the same group benefits, subject to plan and provider changes. The employer contribution usually ends, so you may pay the full premium plus an administrative fee.

Can a wealthy early retiree get an ACA subsidy?

Possibly. Marketplace eligibility considers projected coverage-year household income and other requirements, not assets alone. The Marketplace makes the determination. Report changes and consult a qualified tax adviser before making tax decisions.

What happens to my coverage at 65?

Many people first become eligible around age 65, but enrollment timing depends on Social Security status and current employer coverage. Review the official Initial Enrollment Period and Special Enrollment Period rules before ending other coverage.

Does COBRA let me delay Medicare Part B?

COBRA does not extend the Medicare Part B Special Enrollment Period tied to current employment. If employment has ended or you are approaching 65, confirm Medicare enrollment and coverage start dates separately.

An older couple walking together beside a lake in autumn.

Early Retirement Coverage

How Do You Get Health Insurance If You Retire Before 65?

If you retire before becoming eligible for Medicare and do not have employer retiree coverage, compare COBRA, individual ACA coverage, a spouse's employer plan, and any retiree plan available to you. Health sharing is not insurance and does not provide equivalent protections.

Key takeaways

• Many people first become eligible for Medicare around age 65, but enrollment timing can depend on work coverage and Social Security status.
• COBRA generally continues the same group benefits, subject to plan and provider changes, but the employer contribution usually ends and coverage is time-limited.
• Marketplace eligibility considers projected coverage-year household income and other rules. Assets alone do not determine eligibility.
• Report household and income changes to the Marketplace and consult a tax adviser when needed.

What are your coverage options between retirement and Medicare?

COBRA

Generally continues the same group benefits and deductible progress, subject to plan and provider changes. For an employment-related event, coverage generally lasts up to 18 months, with exceptions. The employer contribution usually ends, so you may pay the full premium plus an administrative fee.

ACA plan on or off exchange

The widest plan choice for pre-65 coverage. You may qualify for a premium tax credit depending on your projected MAGI. Off-exchange sometimes gives you access to plans and networks the marketplace does not show.

Health sharing

Health sharing is not insurance and does not provide equivalent contractual protections or guaranteed payment. Review exclusions, sharing limits, and risk carefully.

Spouse's employer plan

May be available when other coverage ends. Confirm the employer plan enrollment deadline, premium, network, prescriptions, and effective date with the plan administrator.

Retiree or part-time employer coverage

Availability and eligibility are employer-specific. Ask the plan administrator about premiums, network, prescriptions, Medicare coordination, and effective dates.

How should household income factor into the review?

Marketplace premium tax credit eligibility depends on projected coverage-year household income, household size, access to other qualifying coverage, and other rules. Do not confuse account balances with taxable household income.

Use the Marketplace application for an eligibility determination, report changes promptly, and coordinate any tax decisions with a qualified tax adviser.

This is general information, not tax advice. Confirm tax decisions with a qualified tax adviser.

How much does bridge coverage cost?

There is no responsible universal estimate. Compare the actual COBRA premium, Marketplace net premium after an eligibility determination, spouse or retiree plan contribution, deductibles, copays, out-of-pocket limits, provider access, prescriptions, and expected annual cost.

COBRA timing matters

Losing job-based coverage can create a Marketplace Special Enrollment Period, generally for 60 days before or after the loss. If you elect COBRA while that original window is still open, you may still be able to choose Marketplace coverage before the window closes. You may also switch during annual Marketplace Open Enrollment.

When COBRA reaches its maximum coverage period, that exhaustion can create another Marketplace enrollment opportunity. HealthCare.gov also identifies the end of a former employer's COBRA contribution or a government COBRA subsidy as a circumstance that can allow a Marketplace switch outside Open Enrollment. Voluntarily ending COBRA early generally does not create a new Special Enrollment Period by itself. Confirm your eligibility and deadline before ending coverage.

Compare the full COBRA premium after the employer contribution ends with confirmed alternatives. Do not cancel COBRA until replacement enrollment is accepted and the new effective date is confirmed.

Read the official HealthCare.gov COBRA guidance and loss-of-job-coverage rules.

COBRA does not extend Medicare enrollment timing

COBRA is not coverage based on current employment for Medicare Part B Special Enrollment Period purposes. If you are approaching 65 or employment has ended, verify Medicare enrollment and start dates separately. Delaying Part B because COBRA continues can cause a coverage gap or late-enrollment penalty.

Medicare.gov: When can I sign up for Medicare?

How to choose coverage between early retirement and Medicare

Assess how many years to bridge. Count the years until you turn 65. This drives whether COBRA can carry you through or you need a longer-term plan.
Compare available coverage. Review COBRA, ACA, spouse employer, and retiree coverage where available, including networks, drugs, deductibles, and effective dates.
Review household income. Estimate coverage-year household income, report changes, and consult a qualified tax adviser when needed.
Enroll during an available window. Losing job-based coverage can create a Marketplace Special Enrollment Period. Voluntarily ending COBRA early generally does not create a new period by itself, so confirm eligibility and replacement effective dates first.
Plan the Medicare transition. Check official enrollment timing based on age, Social Security status, and any active employer coverage before ending other coverage.

Frequently asked questions

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