Best Health Insurance for Retirees & Seniors

Medicare is the best health insurance for most retirees once they turn 65. The standard Part B premium is $202.90 a month in 2026, and most people pay no Part A premium. Enrollment opens three months before your 65th birthday month. Delaying Part B without other qualifying coverage adds 10% of the standard premium, $20.29 a month in 2026, for each full year you went without it, usually for as long as you have Part B. 

Original Medicare has no yearly out-of-pocket limit, unlike Marketplace plans, which cap in-network costs at $10,600 for an individual in 2026. A Medicare Supplement (Medigap) plan helps pay your share of costs in Original Medicare.   

Before 65, the Affordable Care Act (ACA) Marketplace is the main option for early retirees. Silver plans are the starting point if your household income is at or below 250% of the federal poverty level, because Silver is the only tier where cost-sharing reductions lower your deductible and copays.

Kaiser Permanente (HMO), Medica (EPO), Blue Cross Blue Shield (POS) and Oscar (PPO) have the highest scores in their plan types for a 60-year-old buying a Silver Marketplace plan. Kaiser has the lowest premium of the four at $1,166 a month, which suits retirees whose doctors are all in Kaiser’s network.   

HMO and EPO plans generally cover only in-network care apart from emergencies, while POS and PPO plans also pay for out-of-network care at a higher cost. Oscar’s PPO adds that coverage for retirees with outside doctors at $76 a month more than Kaiser’s HMO, which still covers urgent care outside its service area. 

Medica and Blue Cross Blue Shield suit retirees who see doctors often. Medica charges a $5 primary care copay, $20 less than Blue Cross Blue Shield’s $25, with no referral for specialists. Blue Cross Blue Shield’s $2,330 deductible is the lowest of the four winners, $1,072 below Oscar’s $3,402, and its generic drugs cost $0.

*Rates are average monthly premiums for a 60-year-old buying a Silver Marketplace plan. Your premium will differ by location and tobacco use. In 2026, households earning 100% to 400% of the federal poverty level can get a premium tax credit that lowers what they pay.

Oscar's $5,925 out-of-pocket maximum, the most you pay for covered in-network care in a year, is $1,575 below Kaiser Permanente's $7,500. In a year that hits the maximum, Oscar costs $20,829 in premiums and in-network cost-sharing, $663 less than Kaiser's $21,492, which suits retirees expecting a high-cost year.

Oscar and Blue Cross Blue Shield are the only winners that pay for out-of-network care, which fits retirees whose specialists span networks.

ACA Marketplace plans sold through HealthCare.gov cover 10 essential health benefits. For early retirees, the most relevant are prescription drug coverage, chronic disease management and specialist visits. Blue Cross Blue Shield charges $0 for generic drugs and Oscar charges $3 per prescription, which matters most for retirees on maintenance medications. Each plan's Summary of Benefits and Coverage lists what it charges for drugs such as insulin.

Covered services include:

• Hospital stays and emergency care
• Doctor and specialist visits
• Prescription drugs, including maintenance medications
• Preventive screenings and annual wellness visits
• Mental health care
• Laboratory tests and diagnostic imaging
• Physical therapy and rehabilitative services
• Chronic disease management programs

Silver is the best starting metal tier for early retirees whose household income is at or below 250% of the federal poverty level. It’s the only tier with cost-sharing reductions, which lower your deductible and copays. 

In our sample Ambetter plans for a 60-year-old, Gold costs $163 a month more than Bronze ($1,524 vs. $1,361) and cuts the deductible by $6,193, from $7,250 to $1,057. Gold’s $7,272 out-of-pocket maximum (MOOP, the most you pay for covered in-network care in a year) is $22 higher than Bronze’s, so in a year that reaches the maximum, Gold costs $25,560 in premiums and cost-sharing, $1,978 more than Bronze’s $23,582.

*Each row is one sample plan for a 60-year-old, not a tier average, so one row’s premium doesn’t show what the whole tier costs. The Silver row isn’t the cheapest Silver plan, since Kaiser Permanente’s Silver HMO costs $1,166, $254 less.   

Catastrophic plans are sold only to people under 30 or to people 30 and older with a hardship or affordability exemption. The $1,122 Blue Cross Blue Shield Catastrophic plan, $44 a month less than Kaiser Permanente’s Silver HMO, is open to a 60-year-old only with one of those exemptions.   

A hardship exemption covers a situation in the past two years that kept you from getting coverage, such as eviction, bankruptcy or medical bills you couldn’t pay. An affordability exemption applies when the lowest-priced coverage costs more than 7.7% of your household income in 2026. You apply through HealthCare.gov or your state’s Marketplace.   

Ambetter’s standard Bronze plan has a $7,250 deductible equal to its out-of-pocket maximum, so outside free preventive care you pay most costs yourself up to that point, which suits early retirees in good health.   

Expanded Bronze plans either pay for at least one major service, other than preventive care, before the deductible or qualify as high-deductible plans that work with a health savings account. Federal rules let them cover up to 65% of average covered costs, compared with up to 62% for standard Bronze plans.   

Ambetter’s sample Expanded Bronze plan has a $5,873 deductible and $7,133 out-of-pocket maximum, $1,377 and $117 below its standard Bronze plan, in line with Expanded Bronze’s higher coverage limit. That matters to retirees who expect care beyond preventive visits.

Plan-type averages for a 60-year-old range from $1,401 a month for POS plans to $1,675 for PPOs, a difference of $274, or $3,287 a year. PPOs average $253 to $274 a month more than the other three plan types, though POS plans also pay for out-of-network care.

Among the Silver winners, Kaiser Permanente's HMO costs a 60-year-old $1,166 a month, $76 less than Oscar's PPO, for retirees who stay in-network. Your premium also varies by location, age and tobacco use, and households earning 100% to 400% of the federal poverty level in 2026 can get a premium tax credit.

*Average monthly and annual premiums for a 60-year-old by plan type, from MoneyGeek’s 2026 Marketplace rate data.

The five options until Medicare at 65 are a spouse's employer plan, COBRA, a Marketplace plan, a short-term plan and Medicaid. Medicaid is free or low-cost for expansion-state households at or below 138% of the federal poverty level, so check it before Kaiser Permanente's $1,166 Silver HMO or COBRA.

For retirees above the Medicaid limit, the main choice is COBRA, which keeps your current doctors at the full premium, or a Marketplace plan such as Kaiser Permanente's $1,166 Silver HMO. Households earning 100% to 400% of the federal poverty level can get a premium tax credit on 2026 Marketplace plans.

The best Marketplace plan for a retiree under 65 depends on three things in your ZIP code: what insurers charge, whether your doctors are in-network and whether your income qualifies for cost-sharing reductions. Together they set your yearly cost, not just your premium. Among our four winners, deductibles range from $2,330 with Blue Cross Blue Shield to $3,800 with Kaiser Permanente.

Kaiser Permanente is the best pick for early retirees who can keep all their care in one network. Its Silver HMO costs a 60-year-old $1,166 a month, the lowest premium of our four winners.

If your doctors are outside Kaiser's network or you live outside its eight states and Washington, D.C., Oscar's PPO costs $76 a month more, or $912 a year, and covers out-of-network specialists. Oscar sells plans in 20 states.

Start with Silver if your household income is at or below 250% of the federal poverty level, since cost-sharing reductions apply only there. Above that, price your expected prescriptions and specialist visits against each plan's deductible and out-of-pocket maximum before you pick a metal tier.

We ranked insurers for 60-year-olds bridging the gap until Medicare on three factors: affordability (60%), quality (30%) and denial rate (10%).

Affordability Score (60%): Health care costs come straight out of a retirement budget, so affordability gets the most weight. We evaluate three cost factors:

• Monthly premium: The provider with the lowest average monthly cost scores highest. Premiums are your most predictable health care expense.
• Deductible: The amount you pay before insurance kicks in. Providers with the lowest average deductible score highest.
• Maximum out-of-pocket: The MOOP caps what you'll pay annually beyond premiums. Lower MOOPs score better since unexpected medical costs can set back retirement plans.

Quality Score (30%)

We evaluated plan performance using the Quality Rating System, a 5-star rating that measures medical care, member experience and plan administration. Providers with higher scores rank better. Quality Rating System data is from CMS for the 2026 plan year.

Denial Rate Score (10%)

Lower denial rates mean fewer disputes over covered services. Insurers that deny fewer claims score highest.

How We Score Different Plan Types

We normalized provider scores for each plan category for fair comparisons. When analyzing HMO, PPO, EPO or POS plans, we curve scores so the top-performing insurer in that category receives a 5 out of 5, with other providers scored proportionally. The best HMO pick has the highest HMO score, and the best PPO pick has the highest PPO score. Each plan type is evaluated independently since they serve different needs and cost structures.

Subscores are also scored within each plan type, so Blue Cross Blue Shield's 5/5 affordability compares it with other POS plans, and Kaiser Permanente's 4/5 compares it with other HMOs. That's why Kaiser shows 4/5 for affordability with the lowest premium of the four winners.

Our Sample Profile

All quoted premiums reflect rates for a 60-year-old buyer. We analyzed Catastrophic, Bronze, Expanded Bronze, Silver, Gold and Platinum plans to cover the full range of options early retirees consider. The Catastrophic plan in our sample had the lowest premium, at $1,122 a month. Platinum plans cost more monthly but cover more expenses.

Premiums come from CMS Marketplace data released in October 2025 for the 2026 plan year, plus plan data collected from the 22 state marketplaces outside that dataset. Denial rates come from the CMS Transparency in Coverage public use file. Plan-type and provider averages are calculated from the individual Marketplace plans in that data. Insurer details, including the states each insurer sells in, are for the 2026 plan year.

Why This Approach Works for Seniors

Retirees switching from a paycheck to retirement savings need predictable costs and insurers that pay claims reliably. Most also need coverage for only a few years until Medicare starts at 65, so short-term affordability matters as much as strong benefits.