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Health insurance for early retirees under 65
If you retire before Medicare age, compare Marketplace plans, COBRA, a spouse’s plan, and private off-exchange coverage to bridge the gap. Medicare has its own rules and is a different program.
The gap is the years before Medicare
Medicare is generally for people 65 or older and for certain younger people with disabilities or end-stage renal disease. If you retire earlier, you need another way to stay covered until you become eligible. HealthCare.gov and the Department of Labor list Marketplace coverage, COBRA, another group plan (including a spouse’s), and Medicaid or CHIP as official options to consider.
Marketplace, COBRA, and a spouse’s plan
If you leave a job and lose job-based coverage, the usual Marketplace Special Enrollment Period and COBRA election windows can apply, including during Open Enrollment. A Marketplace plan may include premium tax credits based on your retirement-year income, which can be lower than your working income. Check current rules on HealthCare.gov rather than assuming a credit amount.
COBRA can keep the same doctors and benefits for a limited time, often at the full group premium plus a fee. A spouse’s job-based plan may be more affordable if you can enroll during a special enrollment period, often 30 days from losing coverage.
Private plans as a bridge
Some early retirees compare private, off-exchange plans, including medically underwritten major-medical coverage, while they look at Marketplace and COBRA quotes. Underwriting, networks, and prescription coverage vary, and short-term plans are not comprehensive coverage. A licensed agent should also tell you if a Marketplace plan would cost you less.
This site is not Medicare.gov and does not sell Medicare Advantage or Medigap. If you are already eligible for Medicare, use Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
Common questions
Is early-retiree coverage the same as Medicare?
No. Medicare is a different federal program, generally starting at 65. This page is about coverage for people who retire before they are eligible for Medicare.
Should I keep COBRA until I turn 65?
It depends on the COBRA premium, how long the COBRA period lasts, and what Marketplace or private plans cost. Compare those options with a licensed agent before the COBRA election window closes.
Related guides
Reviewed November 13, 2026. Educational only — not insurance, tax or legal advice. This is not a government website.
Sources
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