What if I’m retired but not eligible for Medicare?



If you’re retired and need coverage, you may use the Marketplace to buy health insurance. If you don’t have coverage you may have to pay a fee.

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.

Important. Marketplace Open Enrollment ended March 31. You can still buy a Marketplace health plan only if you qualify for a special enrollment period.

If you had health insurance through your employer but lost it when you retired, you may qualify for a special enrollment period. Learn about special enrollment periods and other coverage options after Open Enrollment. Open Enrollment for 2015 coverage starts November 15, 2014.

If you apply for insurance through the Marketplace, you may be able to get premium tax credits and lower out-of-pocket costs. This will depend on your income and household size.

Learn whether you may be eligible for lower costs.

See plans and prices available to you, including any lower costs you're eligible for.

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 fee 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.