10 Essential ACA Benefits
ACA Plan Types
Understanding the Affordable Care Act
How the Insurance Exchanges Work
Income Requirements for ACA
How Does the ACA Affect Insurance Premiums?
Government Subsidy Overview

Early Retiree

For retirees under age 65 who are not Medicare eligible and are researching their health insurance coverage options. Learn about your coverage options and see if you are eligible for a subsidy.

2018 Open Enrollment Period

November 1, 2017 - December 15, 2017

The Government Open Enrollment period is no longer open. To enroll in a qualified insurance plan before the marketplace reopens on 11/01/2017 you must have experienced a qualifying life event.

Are you eligible for financial assistance?

You have many health coverage options available. Use our Coverage Calculator to get your personalized coverage roadmap.

Coverage Calculator »

Get Educated

Take control of your health coverage by learning everything you need to know about healthcare laws and the government subsidy program.

Learn More »

New beginnings and a new health plan

Leaving your employer doesn't mean you have to leave your doctors.

show more

Your employer may offer you coverage as a retiree or, if you have recently retired and are under age 65, you may elect to continue your existing insurance via COBRA. While COBRA will allow you to continue the same coverage, it is possible you could find similar coverage, keep the same doctors and pay less for your premiums by investigating individual insurance coverage. Most doctors typically accept more than one type of insurance so shopping for an individual insurance plan may allow you to reduce your insurance premiums while keeping comparable coverage.

Shopping for insurance can save you a significant amount on your insurance premiums.

show more

You have 60 days from the date of separation from your former employer to elect COBRA. Alternatives to COBRA typically offer similar benefits and provider networks, as well as a significant savings.

You may be eligible for a government subsidy.

show more

As a young retiree you may be one of the biggest beneficiaries of the Affordable Care Act. Government subsidies are awarded based on income and family size. As a retiree, it is possible that your income may qualify you for a government insurance subsidy. To see if you qualify check our Coverage Calculator

If you're uninsured for more than 3 consecutive months, you could face tax penalties.

show more

The 2016 tax penalty for going without coverage is 2.5% of your income or $695 per adult and $347.50 per child. You’ll pay the higher of the amounts. In future years, the fee is adjusted for inflation.

Have More Questions?

Below are our lists of available resources that can help guide you through this process. We also have a thorough knowledge base of FAQ's available.

Early Retirees Knowledge Base

Retiring before the age of 65 means you likely don't qualify for Medicare yet. Early retirees must obtain health insurance in order to avoid tax penalties. While you can elect COBRA coverage in order to continue the coverage offered by your previous employer, shopping for alternative coverage may allow you to obtain coverage that better suits your needs and even reduces your monthly premium. Additionally, factors such as your age, income, and family size may qualify you for a government insurance subsidy.

A common concern among early retirees is that a change in coverage means they'll have to leave their doctors and pediatricians in order to find healthcare providers in a new network. Shopping for your own alternative coverage can also prevent you from having to abandon the relationships you've built with your current doctors.

Note that if you're enrolled in retiree coverage provided by your employer, you are not eligible for private individual health coverage until the next annual enrollment period. It's important to understand all your options in order to find a plan that suits you in this new stage of life.

FAQ's

How old do I have to be to qualify for Medicare?

Typically you must be 65 to qualify for Medicare and can sign up 3 months before your 65th birthday. There are also a few limited circumstances where you may be eligible for Medicare, regardless of your age if:

  • You are entitled to Social Security disability benefits for 24 months
  • You receive a disability pension from the Railroad Retirement Board (and meet certain conditions)
  • You have end stage renal disease
  • You have Lou Gehrig's disease (amyotrophic lateral sclerosis)

How do I know if I qualify for Medicaid?

Eligibility for Medicaid is based on income and family size. These limits differ somewhat from state to state. To determine if you are eligible for Medicaid we recommend you use our Coverage Calculator.

If I am on Medicaid could I switch to a marketplace plan and receive a subsidy?

No. If you are eligible for Medicaid you don't need to buy a marketplace plan and, therefore, would not need a subsidy. Marketplace plans are more expensive than Medicaid and typically do not provide any additional coverage or benefits.

My employer offers health insurance coverage for retirees, am I still eligible for a subsidy?

Yes. If your income and household size qualify you for a subsidy you may elect coverage via the marketplace rather in lieu of your employer's retiree plan. The choice is yours. Before you choose a plan there are some things to consider:

  • If you can't afford the health insurance offered to you through your employer or in a marketplace, you may qualify for Medicaid, or your children may qualify for the Children's Health Insurance Program. Each state has its own eligibility requirements for these programs.
  • Think about the insurance coverage. What does your insurance "buy" you? That is, how much will you pay out of your own pocket when you use medical services?
    • How often do you expect to use your insurance? Do you see the doctor fairly often and take one or more prescription drugs for an ongoing condition, like high blood pressure or diabetes? Or do you only see the doctor once or twice a year for checkups and the occasional illness?
  • Think about the network. If you have a doctor, it is important that you continue to see him or her? You'll pay less for care you get from in-network providers. So if you want to keep your doctor and pay lower, in-network rates, make sure that he or she is in your plan's network. If you need to find a doctor, does the plan's network have a wide selection of nearby doctors for you to choose from?

I thought the new rules required my employer to provide health insurance coverage to all employees?

No. The new healthcare rules under the Affordable Care Act require only that employers provide health insurance for active employees that work, on average, more than 30 hours per week. The law does not address retiree insurance offerings.

Do I have to purchase health insurance?

Yes. One of the elements of the Affordable Care Act was the Individual Mandate which requires that nearly everyone purchase health insurance or be subject to a penalty.

What health coverage options are available to me?

There are a few options that you should investigate:

  • It is possible that your income and household size make you eligible for Medicaid.
  • If your spouse is still working you should investigate whether you may be eligible to participate in an insurance plan offered through your spouse's employer.
  • You may qualify for a government subsidy to help reduce your insurance costs.
You can investigate these options further using our Coverage Calculator.

Do I Qualify for a Subsidy?

Find out if you qualify for a Government insurance exchange subsidy by completing our simple questionnaire with our coverage calculator.