Healthcare options between retirement and Medicare

Are you retiring before you're 65 and won't have retiree healthcare coverage from your employer? Find out about the choices you may have available for coverage to help you bridge the gap until you're eligible for Medicare at age 65.


Cobra
Spouse's
Plan
Public
Marketplace1
Private
Insurance

See which options are best for you by answering a few questions.

Let's get started

First, a few questions...

We've provided some tips and additional help to assist you in answering these questions. If you're unsure, you can always change your answer to see how your results would vary.


Are you eligible to enroll in your spouse's or partner's plan?
You may be eligible to be added to your spouse's or partner's plan, whether it's their employer's plan or a private policy. You may only be able to do so at certain times of the year, or based on a life event that results in losing eligibility for an employer group plan.
Will you be at least age 63½ when you retire?
Under COBRA, your employer may offer you the ability to continue coverage under their plan when you retire. You can usually continue coverage for up to 18 months. Learn more.
Do you qualify for a federal premium tax credit for coverage from the Marketplace?
In most states, anyone making between 100% and 400% of the Federal Poverty Level (FPL) can get some type of premium assistance for plans purchased from the public Marketplace. Based on 2019 guidelines, an individual earning less than $48,560 is likely eligible for a premium tax credit; a family of 2 earning less than $65,840, and a family of 4 earning less than $100,400 are likely to be eligible. Learn more.
Does your employer offer any type of reimbursement account for health coverage for people who retire before the age of 65?
Your former employer may set up and contribute to an account that you can use to be reimbursed for certain retiree medical plan premiums and other qualified medical expenses. More

A retiree Health Reimbursement Arrangement or "HRA" can go by many different names, such as Retiree Medical Account, Retiree Health Account, Retiree Reimbursement Account, or similar. These plans are set up by employers for the benefit of their eligible retirees and usually provide a lump sum, annual, or other periodic credit into an account that may be used for the reimbursement of qualified medical expenses when the retiree meets certain reimbursement eligibility requirements. The qualified medical expenses are defined by the Plan, but will often include certain types of medical premiums, and out-of-pocket medical expenses such as deductibles and co-payments. IMPORTANT: Under the Affordable Care Act, a retiree may not receive these HRA benefits and also be eligible for a federal premium tax credit. If you think you might qualify for both an employer HRA and a federal premium tax credit, you will need to determine the value of each and choose one or the other. You will need to decline the use of the HRA if you want to apply for the tax credit.
Get results

Your results

Based on your selections, these are the health care options that best suit your situation.

View all options

Pre-Medicare healthcare options for retirees

COBRA
Spouse's Plan
Public Marketplace1
Private Insurance
Available to
Former employees of employers with 20+ full-time employees
Eligible spouses or partners of covered employees.
Anyone
Anyone
Cost
$$-$$$
Typically, you will pay the entire amount of what you and your employer contributed when you were an active employee (often, plus 2%); in most cases, expect to pay about 3 to 5 times what you were paying as an active employee.
$-$$
Depending on how much your spouse's employer contributes toward dependent coverage, this is quite possibly your least expensive option.
$-$$$
Prices range from the lowest cost "Bronze" plan to higher cost "Platinum" plans and may vary considerably by insurer, be based on your age, and may also vary significantly from year to year.
$$-$$$$
Prices can vary greatly based on plan design, the provider network, and insurance company. Prices may be based on your age and may vary significantly from year to year.

Your former employer may provide a reimbursement account (often in the form of a retiree Health Reimbursement Arrangement, or "HRA") that can help you pay a portion of the premium associated with a private plan.
Potential Advantages
Familiar plan.

Keep your existing network doctors.
Familiar plan.
Common plan design features in four "metal" plan categories allow you to compare plans offered by different insurers.

Automatically renews unless you fail to pay premiums or the insurance company withdraws from the public Marketplace (any insurer that does so must provide 180 days' notice).
If chosen carefully, can best meet your healthcare and budgetary needs.

Automatically renews unless you fail to pay premiums or the insurance company withdraws from your area (any insurer that does so must provide 180 days' notice).
Potential Disadvantages
Typically, lasts only up to 18 months when you retire/terminate employment.

Must enroll within 60 days of the later of loss of coverage or notification of your right to elect.
You may lose eligibility if your spouse terminates employment.
To keep prices competitive, some plans have limited networks of doctors and medical facilities.

Without careful needs assessment, you may become over or under insured.
Without careful needs assessment, you may become over or under insured.
Special Considerations
Some employers subsidize the cost of coverage under COBRA, but this is increasingly rare.

If you are covered by your spouse's plan and your spouse then enrolls in Medicare, you may be able to continue under COBRA for up to 36 months.
Some employers may have special rules or surcharges for spouse coverage...or it may not be offered at all, especially if your spouse is covered by their employer's retiree medical plan.
Depending on your household income, you may qualify for a federal premium tax credit which can substantially lower your premium cost.
If you receive a reimbursement account from your former employer (this will usually be in the form of a Retiree Health Reimbursement Arrangement or "HRA"), you cannot also receive a federal premium tax credit.

These Retiree HRAs might allow you to permanently opt out of and waive future reimbursements from the HRA at least annually so that you may qualify for a federal premium tax credit if you meet other criteria.