How to Find Affordable Health Insurance for Retirees Under 65

Updated: June 4, 2024

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Early retirees under the age of 65 have a variety of health insurance options to choose from while waiting for Medicare to kick in. These include Medicaid, short-term health insurance, insurance through employment, COBRA and private marketplace plans — all of which can vary in cost. The average marketplace health insurance plan without Medicare costs about $946 for a Bronze plan for 60-year-olds, but this can change depending on the desired coverage level.

Medicare is available to those 65 or older or those who are younger but disabled or have specific medical conditions like end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). However, most people retire before they qualify for Medicare, creating a need to bridge the coverage gap.

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Key Takeaways

Medicaid is the most affordable health insurance for retirees under 65. However, eligibility is dependent on your household's income.

The average monthly cost for a Silver health plan on the marketplace for seniors aged 60 is $1,231, but a lower coverage plan can decrease monthly premiums.

Health insurance options for early retirees include Medicaid, COBRA, short-term insurance and marketplace policies.

Early Retirement Health Insurance Costs

Health insurance for retirees is typically more expensive, given that older adults generally require more frequent care. While lower premium plans may be attractive, they may not offer the best maximum out-of-pocket costs (MOOP) or coverage.

Insurance plans are categorized into metal tiers, and your premiums will vary accordingly. If rates are your chief concern, review the average cost of health insurance for a typical 60-year-old in the table below to compare metal tiers. Many consumers prefer to start with a Silver plan and are able to review its preferred in-network physicians before upgrading, if necessary.

Average Cost of Marketplace Health Insurance Plans for Seniors
CatastrophicMonthly Cost$726Maximum-Out-Of-Pocket$9,450
BronzeMonthly Cost$946Maximum-Out-Of-Pocket$9,356
Expanded BronzeMonthly Cost$974Maximum-Out-Of-Pocket$8,915
SilverMonthly Cost$1,231Maximum-Out-Of-Pocket$5,186
GoldMonthly Cost$1,304Maximum-Out-Of-Pocket$7,576
PlatinumMonthly Cost$1,925Maximum-Out-Of-Pocket$2,441

Note that Catastrophic plans are only available in some areas and are limited to a specific population. Generally, Catastrophic plans are only available to people under 30. However, older adults can purchase them if they do not have any other choices that cost less than 8.09% of their monthly income.

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SENIOR HEALTH CARE COSTS: DO THE MATH

Low premiums often result in high deductibles, which may not be ideal for seniors who need to visit the doctor regularly. Instead, seniors may want to opt for a policy with a higher premium, lower deductible and better coverage. This way, cost-sharing can begin sooner, benefiting people frequently seeking care.

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Cheapest Health Insurance Plans for Early Retirees

For a typical 60-year-old, the most inexpensive insurance provider in the Bronze tier, excluding eligibility-restricted Catastrophic plans, is Oscar, at an average monthly rate of $736.

In contrast, the top-tier Platinum plan by Blue Cross Blue Shield offers an average premium of $1,996 monthly, a substantial increase in cost that comes with significantly lower out-of-pocket risks.

While lower premiums can be appealing, they often mean higher total costs when seeking care due to higher maximum out-of-pocket amounts, potentially discouraging you from seeking the care you need.

The table below displays the cheapest average health providers nationwide and their premiums, sorted by metal tier:

OscarMetal TierBronzeMonthly Cost$736Maximum-Out-Of-Pocket$9,100
MedicaMetal TierCatastrophicMonthly Cost$584Maximum-Out-Of-Pocket$9,450
AetnaMetal TierExpanded BronzeMonthly Cost$920Maximum-Out-Of-Pocket$9,403
AetnaMetal TierGoldMonthly Cost$1,093Maximum-Out-Of-Pocket$8,965
Blue Cross Blue ShieldMetal TierPlatinumMonthly Cost$1,996Maximum-Out-Of-Pocket$2,977
AetnaMetal TierSilverMonthly Cost$1,100Maximum-Out-Of-Pocket$8,780

Cheapest Health Insurance Plans for Early Retirees by State

Health insurance plan costs differ vastly by location and chosen coverage levels. The three least expensive Silver health insurance plans across all states for a typical 60-year-old are:

  • Valley Health Plan: $424 per month
  • WellSense Health Plan: $691 per month
  • Blue Cross Blue Shield: $687 per month

Actual rates for health insurance plans are subject to change due to specific factors such as the region where you live, whether you use tobacco, your income and your household size. Remember to balance monthly premiums against potential out-of-pocket costs. The most cost-effective plan should align with both your health care needs and financial situation.

The table below highlights the premiums and maximum out-of-pocket costs of each state's cheapest health insurance plans for a typical 60-year-old adult:

Data filtered by:Results filtered by:
State:
State:AK
AKCompanyModaPlanModa Pioneer Bronze 5500Monthly Cost$1,188Maximum-Out-Of-Pocket$9,250
AKCompanyModaPlanModa Pioneer Alaska Standard BronzeMonthly Cost$1,115Maximum-Out-Of-Pocket$9,400
AKCompanyModaPlanModa Pioneer Bronze 6500Monthly Cost$1,192Maximum-Out-Of-Pocket$9,000
AKCompanyBlue Cross Blue ShieldPlanPremera Blue Cross Standard Bronze IIMonthly Cost$1,345Maximum-Out-Of-Pocket$9,400
AKCompanyBlue Cross Blue ShieldPlanPremera Blue Cross Alaska One BronzeMonthly Cost$1,386Maximum-Out-Of-Pocket$8,700
AKCompanyBlue Cross Blue ShieldPlanPremera Blue Cross Preferred Bronze 6350Monthly Cost$1,388Maximum-Out-Of-Pocket$8,700
AKCompanyBlue Cross Blue ShieldPlanPremera Blue Cross Preferred Bronze 5800 HSAMonthly Cost$1,394Maximum-Out-Of-Pocket$7,300
AKCompanyModaPlanModa Pioneer Gold 1500Monthly Cost$1,669Maximum-Out-Of-Pocket$6,000
AKCompanyModaPlanModa Pioneer Alaska Standard GoldMonthly Cost$1,672Maximum-Out-Of-Pocket$8,700
AKCompanyBlue Cross Blue ShieldPlanPremera Blue Cross Standard GoldMonthly Cost$1,812Maximum-Out-Of-Pocket$8,700
AKCompanyBlue Cross Blue ShieldPlanPremera Blue Cross Alaska One GoldMonthly Cost$1,823Maximum-Out-Of-Pocket$6,300
AKCompanyBlue Cross Blue ShieldPlanPremera Blue Cross Preferred Gold 1500Monthly Cost$1,825Maximum-Out-Of-Pocket$6,300
AKCompanyModaPlanModa Pioneer Alaska Standard SilverMonthly Cost$1,829Maximum-Out-Of-Pocket$9,100
AKCompanyModaPlanModa Pioneer Silver 4500Monthly Cost$1,879Maximum-Out-Of-Pocket$7,750
AKCompanyBlue Cross Blue ShieldPlanPremera Blue Cross Standard SilverMonthly Cost$2,058Maximum-Out-Of-Pocket$9,100
AKCompanyBlue Cross Blue ShieldPlanPremera Blue Cross Preferred Silver 4500Monthly Cost$2,103Maximum-Out-Of-Pocket$8,200

Early Retirement Health Insurance Options

Early retirement can affect your health benefits, and finding affordable health insurance may take some consideration. While a senior’s Social Security benefits can be collected starting at 62, Medicare benefits do not kick in until age 65.

This means many seniors need to bridge the gap in health insurance until Medicare can apply. While it may be more affordable to wait, having health insurance while aged 62 to 65 is crucial to avoid hefty medical fees.

Fortunately, there are several ways to get health insurance for retirees under 65, including COBRA, short-term retirement insurance plans, Medicaid and marketplace plans.

1
Workplace Insurance

If your spouse is still working, you may be able to join their employer-sponsored health insurance plan. However, there may be cost implications, such as an increase in your spouse’s premiums. You may also find employer-sponsored insurance if you get another job after retirement.

2
COBRA

Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), employers are required to offer the option to let retirees, regardless of their age, continue their health benefits for a limited time. However, eligibility depends on your circumstances, such as if you voluntarily or involuntarily lose your job, reduce your hours worked, switch jobs or lose a spouse. Those who qualify must pay up to 102% of the policy's total cost.

3
Short-Term Insurance

A short-term insurance plan is another health insurance plan for retirees under 65. It replaces gaps in coverage for up to one year, although it can be extended. However, a short-term insurance plan does not provide comprehensive coverage and doesn’t provide long-term financial protection for most health needs. Not all individuals are eligible, as providers can deny an application based on your medical history.

4
Medicaid

Medicaid is an affordable health insurance option for low-income individuals and early retirees. However, eligibility is based on income and can vary from state to state. For instance, in Arizona, you must be 138% below the federal poverty level to qualify for Medicaid, while in the District of Columbia, the requirement is 215%. Make sure to check your state's Medicaid income eligibility limits for details.

5
Marketplace Plans

Seniors can get affordable health insurance through the Health Insurance Marketplace in their state. While there is typically an enrollment period, losing employer-based health insurance is a qualifying event that grants seniors a special enrollment period. Depending on their household income, seniors may also qualify for a premium tax credit.

6
Employer-Sponsored Retirement Plans

Some employers offer health insurance to retirees as part of their benefits package, such as coverage under 401(k) plans. However, coverage details and eligibility can vary widely. Always review these plans for cost, coverage scope and whether they extend to dependents.

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CAN YOU GET MEDICARE AT AGE 62?

Typically, you cannot access Medicare before age 65, even if you retire early. However, exceptions exist, such as if you have been on Social Security Disability Insurance (SSDI) for at least two years or have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).

Accessing the Health Insurance Marketplace as an Early Retiree

If alternative options aren’t a good fit, the marketplace offers health insurance for early retirees and is an excellent option for seniors looking to bridge health insurance until Medicare starts. The Affordable Care Act (ACA) makes marketplace plans more accessible and affordable for qualifying seniors.

Marketplace insurance plans provide various coverage levels and premiums for retirees under 65. The ACA has capped rates at no more than three times the cost for a 21-year-old to keep insurance costs in check for older individuals.

Through the Health Insurance Marketplace application process, you can determine if you are eligible for Medicaid or qualify for premium tax credits. Premium tax credits can help you reduce your monthly premiums and typically apply to households with incomes between 100% and 400% of the federal poverty level (FPL).

Additional savings are available through cost-sharing reductions for those with incomes between 100% and 250% of the federal poverty level and on a Silver plan, lowering deductibles, copayments and out-of-pocket maximums.

Unlike short-term insurance, you can enroll through the marketplace even with pre-existing health conditions. Remember that plans and eligibility can vary by state, and enrollment is typically only available during the annual open enrollment period. Qualifying life events like retirement can trigger a special enrollment period.

FAQ About Affordable Health Insurance for Retirees Under 65

Finding health insurance for retirees under 65 will help you stay protected. Review our answers to commonly asked questions on bridging the gap between retirement and Medicare eligibility.

What is the best health insurance for retirees under 65?
What's the cheapest health insurance for seniors under 65?
Can you get Medicare before age 65?
Can a spouse get Medicare before age 65?
How much does health insurance cost for early retirees?

About Mark Fitzpatrick

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Mark Fitzpatrick has analyzed the property and casualty insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. Currently, he leads P&C insurance content production at MoneyGeek. Fitzpatrick has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.

Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.

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