Health insurance if you retire before 65

If you stop working before 65, one of the first questions is how you'll be covered until Medicare starts. For many early retirees, health insurance is the largest new cost in those years. The good news is that you have options, and some of the choices you make about your money can lower what you pay.

A spouse's or partner's job

If your spouse is still working, their employer's plan is often the simplest bridge. Leaving your own job usually lets you join their plan outside the normal enrollment period, but there's a short deadline, often 30 days, so ask their benefits office before you leave.

Coverage from your former employer

Some employers offer health coverage to retirees. It's less common than it used to be, so check what yours offers, what it costs, and whether it can change.

COBRA

COBRA lets you keep your employer's plan after you leave, usually for up to 18 months. You keep your doctors and your coverage, which can be a relief mid-treatment. The catch is the price: you pay the full premium, including the share your employer used to pay, plus a small fee. For many people it's a short-term bridge rather than a long-term answer.

The Marketplace

The Health Insurance Marketplace, at HealthCare.gov or your state's own site, sells individual plans to anyone, regardless of health. Losing job-based coverage opens a special enrollment period, generally 60 days, to sign up outside the usual fall window.

What you pay depends a great deal on your household income. People with incomes in a certain range can get a tax credit that lowers their monthly premium. For 2026, that help generally goes to households earning between 100% and 400% of the federal poverty level; above that, there's no help, so a small change in income can mean a big change in cost. Congress has debated changing these rules, so check the current limits before you plan around them.

Why early retirees have more control than they think

For Marketplace help, "income" means your modified adjusted gross income. In early retirement, that's largely up to you, because it depends on where your money comes from:

• Withdrawals from traditional IRAs and 401(k)s count in full.
• Selling investments in a regular account counts only the gain, not the whole amount you take out.
• Money in the bank, and the contributions you made to a Roth IRA, don't count when you withdraw them.
• Social Security counts, including the part that isn't taxed.

So two households spending the same amount can show very different incomes, depending on which accounts they draw from. Planning your withdrawals around this, year by year, can save thousands of dollars in premiums.

If your income is low enough, you may qualify for Medicaid instead, depending on your state.

Don't forget the end date

Whatever bridge you choose, mark the date you turn 65. Your Medicare sign-up window opens three months before your birthday month, and it's worth getting right. If your spouse is younger, they'll need their own coverage until they turn 65 too.

This is general information. Plans, prices and the rules for premium help vary by state and can change, so check HealthCare.gov or your state's Marketplace for current details.