Health Insurance If You Retire Before 65
Ready to shop for a plan? Oregon’s Health Insurance Marketplace is where you apply, see what help you qualify for, and compare plans.
Want free local help? Oregon’s Marketplace lists free local helpers here: healthcare.oregon.gov/Pages/find-help.aspx
Your Options Before Medicare
| Option | How it works | Good to know |
|---|---|---|
| Marketplace plan | Buy a plan through Oregon’s Marketplace, Explore Health | Subsidies available for household income from 100% to 400% of the poverty level |
| COBRA | Keep your former employer’s plan for a limited time | You usually pay the full cost. Keeps the same doctors and network |
| Retiree coverage | Some employers offer health coverage to retirees | If you’re enrolled in it, you can’t get Marketplace subsidies |
| OHP Bridge | Free coverage for adults under 65 earning 133% to 200% of the poverty level | $21,228 to $31,920 a year for one person. See the Oregon Health Plan |
| Spouse’s job-based plan | Join your spouse’s plan if they’re still working | Often the simplest option if available |
More on OHP Bridge: the Oregon Health Plan. Losing job-based coverage also opens a Special Enrollment Period.
COBRA vs the Marketplace
COBRA lets you keep your old plan, which is nice if you’re mid-treatment or love your doctors. But you usually pay the full premium. A Marketplace plan may cost less, especially with a subsidy.
Timing rules matter here:
- During Open Enrollment, you can switch from COBRA to a Marketplace plan for any reason.
- Outside Open Enrollment, you can switch only in certain cases, like when your COBRA is running out or your former employer stops contributing.
- Voluntarily dropping COBRA early doesn’t open a Special Enrollment Period. Plan the switch carefully.
- When COBRA ends, you have 60 days to enroll in a Marketplace plan.
Oregon’s Health Insurance Marketplace is where you apply, see what help you qualify for, and compare plans.
Want free local help? Oregon’s Marketplace lists free local helpers here: healthcare.oregon.gov/Pages/find-help.aspx
How Retirement Income Affects Your Subsidy
This is where early retirees can save, or lose, thousands. Marketplace subsidies are based on your household’s modified adjusted gross income for the year. When you estimate it:
- ✓ Include most IRA and 401(k) withdrawals
- ✓ Include all Social Security benefits, taxable and non-taxable
- ✓ Include interest and dividends, including tax-exempt interest
- ✓ Don’t include qualified withdrawals from a Roth account
For 2027 coverage, subsidies end completely above 400% of the poverty level: $63,840 for one person or $86,560 for two. Because where your income comes from changes what counts, talk to your tax or financial professional before you plan your withdrawals. Here’s more on how subsidies work.
Getting to 65: The Handoff to Medicare
Your Medicare Initial Enrollment Period starts 3 months before the month you turn 65. Sign up then and your coverage starts the month you turn 65. One trap: COBRA doesn’t count as coverage from a current job, so it won’t let you delay Medicare without a penalty. Start with our Turning 65 in Oregon checklist.
Oregon’s Health Insurance Marketplace is where you apply, see what help you qualify for, and compare plans.
Want free local help? Oregon’s Marketplace lists free local helpers here: healthcare.oregon.gov/Pages/find-help.aspx
FAQs
What are my health insurance options if I retire before 65?
A Marketplace plan, COBRA, retiree coverage if your employer offers it, a spouse's plan, or OHP Bridge if your income qualifies.
Does retiring early qualify me for a Special Enrollment Period?
Yes. Losing job-based coverage when you retire qualifies you to enroll in a Marketplace plan outside Open Enrollment, generally within 60 days.
Is COBRA or a Marketplace plan cheaper?
Often the Marketplace, especially with a subsidy, since COBRA usually means paying the full premium. Compare both before you decide.
Does my retirement income count for Marketplace subsidies?
Yes. Most IRA and 401(k) withdrawals and all Social Security count. Qualified Roth withdrawals don't.
Can I get Marketplace subsidies if I have retiree coverage?
Not if you're enrolled in it. If you're eligible but not enrolled, you may qualify.
Oregon’s Health Insurance Marketplace is where you apply, see what help you qualify for, and compare plans.
Want free local help? Oregon’s Marketplace lists free local helpers here: healthcare.oregon.gov/Pages/find-help.aspx
