Can You Get Health Insurance If You Retire at 62?

Navigating health insurance options when retiring before reaching Medicare eligibility can present a significant challenge. Individuals often retire at age 62, creating a gap in health coverage until they become eligible for Medicare at 65. Several viable pathways exist to ensure continuous medical coverage during this three-year period. Understanding these options is important for a smooth transition into retirement.

Employer-Sponsored Health Coverage

Individuals retiring at age 62 may consider continuing health coverage through a former employer. The Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA) generally requires employers with 20 or more employees to offer temporary continuation of group health coverage after a qualifying event, such as retirement.

COBRA coverage typically lasts for 18 months for the employee. Dependents may be eligible for up to 36 months of coverage in specific situations, such as the death of the covered employee or divorce. An extension of up to 11 months, totaling 29 months, may be available if a covered individual is determined to be disabled by the Social Security Administration.

Individuals electing COBRA are generally responsible for paying the entire premium, which can include up to 102% of the plan’s cost. Employers are required to provide COBRA information within 14 days of a qualifying event, and individuals usually have a 60-day window to elect coverage. The initial premium payment is typically due within 45 days of election, with subsequent payments due monthly within a 30-day grace period.

Beyond COBRA, some employers may offer health benefits directly to retirees, though their prevalence has declined. Private-sector employers are not legally obligated to provide retiree health benefits and can modify or terminate them unless a specific, legally binding promise exists. Retiree health plans vary widely in their scope and cost-sharing requirements. Retirees should consult their Summary Plan Description (SPD) and other plan documents, available from the employer, to determine eligibility and plan specifics.

Individual Market Health Insurance

When employer-sponsored options like COBRA or retiree benefits are not sufficient or available, the individual health insurance market, primarily through the Affordable Care Act (ACA) Marketplace, offers another pathway to coverage. The ACA Marketplace, accessible via HealthCare.gov or state-specific exchanges, allows individuals to purchase health insurance plans. Enrollment typically occurs during the annual Open Enrollment Period, from November 1 to January 15 in most states.

Losing job-based health coverage due to retirement qualifies individuals for a Special Enrollment Period (SEP), allowing enrollment outside the standard Open Enrollment Period. Coverage elected during an SEP can begin as early as the first day of the month following plan selection.

Marketplace plans are categorized into “metal tiers”—Bronze, Silver, Gold, and Platinum—indicating how costs are shared. Bronze plans typically have the lowest monthly premiums but the highest out-of-pocket costs, covering approximately 60% of medical expenses. Silver plans feature moderate premiums and out-of-pocket costs, generally covering about 70% of expenses. Gold plans have higher premiums but lower out-of-pocket costs, while Platinum plans carry the highest premiums but the lowest out-of-pocket expenses, covering around 90% of costs.

The ACA Marketplace offers financial assistance to make coverage more affordable. Premium Tax Credits (PTCs) are subsidies that reduce monthly premium payments, with eligibility based on household income relative to the Federal Poverty Level (FPL).

Through 2025, individuals with incomes above 400% of the FPL may qualify for PTCs if their benchmark plan premium exceeds 8.5% of their household income. PTCs are generally available for those with incomes between 100% and 400% of the FPL.

Cost-Sharing Reductions (CSRs) are available to individuals with incomes up to 250% of the FPL. These subsidies lower out-of-pocket expenses like deductibles, copayments, and coinsurance. To receive CSRs, individuals must enroll in a Silver-tier plan.

Plans cannot deny coverage or charge more based on pre-existing conditions under the ACA. While some plans can be purchased directly from an insurance company outside the Marketplace, these direct plans do not qualify for premium tax credits or cost-sharing reductions.

Preparing for Medicare

As individuals approach age 65, preparing for the transition to Medicare becomes a primary focus. Medicare typically begins at age 65. This federal health insurance program consists of several parts covering different types of medical expenses.

Medicare Part A, known as Hospital Insurance, generally covers inpatient hospital stays, care in a skilled nursing facility, and hospice care. Most individuals receive Part A without paying a monthly premium if they or their spouse paid Medicare taxes through employment for at least 10 years.

Medicare Part B, or Medical Insurance, helps cover doctor services, outpatient care, durable medical equipment, and certain preventive services. Most beneficiaries pay a monthly premium for Part B, which was $185 in 2025 for most individuals, though higher-income earners pay more.

Beyond Original Medicare (Parts A and B), individuals can choose additional coverage options. Medicare Part C, also referred to as Medicare Advantage, is offered by private insurance companies approved by Medicare. These plans bundle Part A, Part B, and typically Part D (prescription drug coverage), often including additional benefits like vision or dental care. Medicare Part D provides prescription drug coverage, also through private plans. Separately, Medicare Supplement Insurance, or Medigap, helps cover out-of-pocket costs such as copayments, coinsurance, and deductibles that Original Medicare does not cover.

Enrollment in Medicare is time-sensitive to avoid potential penalties. The Initial Enrollment Period (IEP) is a seven-month window that begins three months before the month an individual turns 65, includes their birthday month, and extends for three months after.

Delaying Part B enrollment can result in a permanent 10% premium increase for each full 12-month period it was delayed, unless a Special Enrollment Period applies. A late enrollment penalty for Part D can be assessed, calculated as 1% of the national base beneficiary premium for each month delayed, added to the monthly premium for as long as the individual has Part D.

Individuals receiving Social Security benefits at least four months before their 65th birthday are typically automatically enrolled in Parts A and B. When Medicare coverage begins, any existing COBRA or ACA Marketplace coverage will either cease or coordinate with Medicare, depending on the specific plan terms. If still working at age 65 and covered by an employer’s group health plan, it may be possible to delay Part B enrollment without penalty.