Health Coverage for Retirees

If you’re retired and need health insurance, the Health Insurance Marketplace® offers options for you. If you already have retiree health coverage, there are important considerations to keep in mind.

Important Notice:
If you have Medicare, learn more about how it interacts with Marketplace plans.

Retiring Before Age 65 Without Health Coverage

If you retire before turning 65 and lose your job-based health insurance, you can purchase a plan through the Marketplace. Losing your health coverage qualifies you for a Special Enrollment Period, allowing you to enroll in a new plan even outside the regular Open Enrollment Period.

When you apply through the Marketplace, you may find that you qualify for premium tax credits and reduced out-of-pocket costs, depending on your income and household size. Additionally, you might be eligible for free or low-cost coverage through your state’s Medicaid program.

If You Have Retiree Health Benefits

If you already have retiree health benefits but are considering a Marketplace plan, you can make the switch. However, keep in mind:

• No Tax Credits: If you’re enrolled in retiree coverage, you won’t qualify for premium tax credits or other savings. However, if you’re eligible for but not enrolled in retiree coverage, you may qualify for these savings based on your household size and income.

• Enrollment Restrictions: If you voluntarily drop your retiree coverage, you won’t qualify for a Special Enrollment Period to sign up for a Marketplace plan. You’ll have to wait until the next Open Enrollment period to get coverage through the Marketplace.

Additional Answers: Coverage for Retirees Without Medicare

• Turning 65 Mid-Year: If you turn 65 during the year, you can use a Marketplace plan to cover the gap until your Medicare coverage starts. You can cancel your Marketplace plan once Medicare begins. Learn more if you’re nearing Medicare eligibility.

• Over 65 and Not Eligible for Medicare: If you’re over 65 and not eligible for Medicare, you may still purchase insurance through the Marketplace. Depending on your household size and income, you could qualify for reduced premiums and out-of-pocket costs.

• Self-Employed After Retirement: If you retire and become self-employed, and you don’t have retiree insurance or Medicare, you have the same insurance options as any other self-employed individual.

• Losing Job-Based Insurance After Retirement: If you lose job-based insurance when you retire, you qualify for a Special Enrollment Period, allowing you to enroll in a Marketplace plan outside of Open Enrollment. You can apply anytime from 60 days before to 60 days after your job separation date.

• IRA or 401(k) Withdrawals as Income: Generally, withdrawals from IRA or 401(k) accounts count as income. Learn more about reporting retirement income on pages 24 and 25 of this IRS guide (PDF).

• Switching from COBRA to Marketplace Coverage: If your COBRA coverage ends outside the Open Enrollment Period, you qualify for a Special Enrollment Period to enroll in a Marketplace plan. However, you can’t drop COBRA outside of Open Enrollment and switch to a Marketplace plan unless your COBRA coverage is expiring. During Open Enrollment, you can drop COBRA and replace it with a Marketplace plan, even if your COBRA is not ending.