What if I’m retired but not eligible for Medicare?
If you’re retired and don’t have coverage, you may use the Marketplace to buy health insurance. If you don’t have coverage you may have to pay a fine.
If you have retiree coverage, you have different choices to consider.
If you retire before age 65 without coverage
If you retire before you’re 65 and don’t have coverage, you may use the Health Insurance Marketplace to buy a plan that meets your needs. Depending on your income and family size, you may be able to get lower costs on your monthly premiums and out-of-pocket costs.
When you apply for coverage in the Marketplace, you’ll also find out if you’re eligible for Medicaid.
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If you don’t have any health coverage, you may have to pay a fine.
Have Medicare? Learn more about Medicare and the Marketplace.
If you have retiree health benefits
If you have retiree health benefits, you’re considered covered under the health care law. You don’t have to pay the fine that some people without insurance must pay.
If you have retiree coverage and want to buy a Marketplace plan instead, you can. But:
- You may not be eligible for premium tax credits or lower out-of-pocket costs based on your household size and income. This will depend on whether your retiree health plan is considered affordable or meets certain minimum standards. Learn more on this page for people covered by job-based plans.. The same rules about affordability and minimum standards apply to both retiree and job-based plans.
- When your retiree coverage plan year ends, you can end the retiree coverage and enroll in a Marketplace plan instead. You may be eligible for lower costs based on your household size and income. You can enroll in a Marketplace plan during Open Enrollment. Or you can enroll outside Open Enrollment, since the fact that your coverage is ending qualifies you for a special enrollment period.
Note: If you voluntarily drop your retiree coverage in the middle of a plan year, you won’t qualify for a special enrollment period to enroll in a new Marketplace plan. You won’t be able to enroll in health coverage through the Marketplace until the next Open Enrollment period.
Note: If you’re eligible for but not enrolled in retiree coverage, you can get lower costs on Marketplace coverage based on your household size and income.
More Answers: Coverage for retirees without Medicare
What if I become eligible for Medicare in 2014?
You can get a Marketplace plan that will cover you until you become eligible for Medicare. You can then cancel the Marketplace plan when your Medicare coverage begins.
What if I’m 65 or older but not eligible for Medicare?
You may be able to buy insurance in the Marketplace and get lower costs on monthly premiums and out-of-pocket costs based in your household size and income. If you don’t enroll in health coverage by March 31, 2014, you may have to pay a fee.
What if I retire from my job and am self-employed?
If you have retiree insurance, see “If you have retiree insurance,” above. If you don’t have retiree insurance or Medicare and are self-employed, you have the same insurance choices and responsibilities as anyone else who’s self-employed.