What are the health insurance options for early retirees before Medicare?
Early retirees who leave work before age 65 typically bridge to Medicare with an individual ACA-compliant private plan bought off-exchange at full-price premium, an on-exchange plan through HealthCare.gov, or COBRA continuation coverage for up to 18 months from the former employer (Medicare.gov; DOL COBRA).
Reviewed by Jason Burns, Editor & Steward · Last verified 2026-07-19
What it means
- Medicare eligibility generally begins at age 65. Between retirement and 65, the ACA individual market and COBRA are the two mainstream self-pay bridges. Off-exchange private plans are commonly chosen by early retirees with pension or investment income who pay the full-price premium out of pocket.
Action steps
- Confirm your Medicare eligibility date and count months back to your retirement date.
- Compare a private off-exchange plan against your COBRA premium at full unsubsidized cost.
- If you have an HSA, plan the last contribution year around your Medicare enrollment.
Risks & deadlines
- Enrolling in any part of Medicare stops HSA contributions.
- COBRA elections must be made within 60 days of loss of coverage.
Sources
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