The short version
- Medicare generally starts at 65, no matter when you stop working or claim Social Security.
- Bridge options include retiree coverage, a spouse's plan, COBRA and a Marketplace plan.
- Marketplace help is based on income, so how you draw retirement income can change what you pay.
The gap
For most people, Medicare eligibility starts at 65. Retiring earlier, or claiming Social Security early, doesn't change that. If your health insurance comes from your job, retiring before 65 means finding coverage for the years in between.
Your options
Retiree coverage from your employer
Some employers offer health coverage to retirees. Ask HR what's available, what it costs and what happens to it when you reach 65.
A spouse's employer plan
If your spouse is still working and their plan covers spouses, joining it can be simple. Losing your own coverage when you retire generally lets you join outside their normal enrollment period, though there's usually a short deadline.
COBRA
You can usually keep your employer's plan for up to 18 months after you leave, paying the full premium plus up to a 2% fee. It works well as a short bridge if you're retiring within 18 months of turning 65, or if you want to keep the plan and deductible you already know.
A Marketplace plan
Losing job-based coverage when you retire opens a Special Enrollment Period, so you can buy an individual plan straight away. You can't be turned down or charged more because of a pre-existing condition.
Premiums do rise with age, which is why income-based help matters so much in these years.
How retirement income affects the price
Premium tax credits are based on your household's modified adjusted gross income for the year. In retirement, that can include pension payments, withdrawals from traditional IRAs and 401(k)s, and Social Security benefits.
Because you often have some say over when and how you draw that income, the same retirement can lead to quite different premiums. It's worth planning with your financial adviser or tax preparer before you retire, not after.
Plan the handover to Medicare
Your Initial Enrollment Period for Medicare lasts seven months: the three months before the month you turn 65, that month, and the three months after.
A Marketplace plan doesn't end on its own when Medicare starts. You'll need to cancel it yourself, timed so there's no gap and no overlap. Once you qualify for premium-free Medicare Part A, you can no longer get premium tax credits.
How I can help
Tell me when you plan to retire, your state and a rough idea of your household income in those years. I'll show you what bridge coverage would cost and help you compare it with COBRA or a spouse's plan.
See the states where I'm licensed
This article is general information, not tax, financial or legal advice about your own situation. Rules, plans and prices vary by state and can change from year to year.
