Medicare eligibility based on age generally starts at 65, but many people stop working earlier. If you retire at 62, 63, or 64, you’ll need health coverage to bridge the gap, and the choices you make in those years can affect what you pay even after Medicare begins. Here’s how to plan the stretch from 62 to 65.
Your options before Medicare
| Option | Good to know |
|---|---|
| Employer retiree coverage | Less common than it used to be. If offered, compare its cost and network with the options below. |
| COBRA | Keeps your job-based plan, usually for up to 18 months, but you typically pay the full premium plus up to 2%. It can be a clean bridge if you retire within about 18 months of 65. |
| A spouse’s employer plan | Often the simplest choice if your spouse is still working. Leaving your job coverage generally lets you join. |
| ACA Marketplace plan | Can’t turn you down or charge more for health conditions. Tax credits depend on household income. |
| Plans bought off the Marketplace | ACA-compliant plans are also sold directly by insurers and through agents, without tax credits. Non-ACA options may limit benefits or exclude pre-existing conditions. |
For a deeper look at each option, see our guide to health insurance for early retirees and COBRA vs. Marketplace.
Why coverage costs more in your early 60s
Marketplace insurers can charge older adults more than younger ones, up to three times the premium for a 21-year-old on the same plan. Health status can’t affect your price, but age can, so full-price premiums in your 60s are often among the highest you’ll see on the Marketplace.
That’s why tax credits matter so much at this age. For 2027 coverage, credits are generally available only if household income is at or below 400% of the federal poverty level, about $63,840 for a single person or $86,560 for a couple in most states. Go even a dollar over and you generally lose the credit entirely. Our 2027 open enrollment guide covers the other changes this year.
A year-by-year plan
Around 62: price it before you retire
- Get real quotes for every option before you set a retirement date. Health coverage can be one of your largest monthly costs until 65.
- Decide how you’ll draw income. Traditional IRA and 401(k) withdrawals, pensions, capital gains, and Social Security benefits generally count toward the income the Marketplace uses. Qualified Roth withdrawals generally don’t.
- If you claim Social Security early, remember that the full benefit counts as income for Marketplace purposes, including any portion that isn’t taxed.
63 and 64: manage income carefully
- Update your Marketplace income estimate whenever things change. Starting with the 2026 tax year, any excess tax credit has to be repaid in full when you file.
- Be careful with large one-time income such as Roth conversions or selling investments. It can push you over the 400% line for the year.
- Keep in mind that Medicare Part B and Part D premiums for higher earners are based on your tax return from two years earlier. Income in the year you turn 63 can affect what you pay for Medicare at 65.
The months before 65: switch to Medicare
- Know your window. Your initial Medicare enrollment period generally runs for seven months: the three months before your birthday month, your birthday month, and the three months after. Signing up in the months before your birthday helps your coverage start on time.
- If you already get Social Security, you’re generally enrolled in Parts A and B automatically and should get your Medicare card in the mail.
- End your Marketplace plan yourself. Marketplace coverage doesn’t stop automatically when Medicare starts, and once you’re eligible for premium-free Part A you generally can’t keep getting tax credits. Set the end date to the day before Medicare begins.
- Stop HSA contributions before Medicare starts, since you generally can’t contribute once enrolled. A tax professional can help with timing.
If your spouse is younger than you
Medicare covers individuals, not couples. When you move to Medicare, a spouse under 65 still needs their own coverage until they qualify. If they buy a Marketplace plan, your combined household income generally still counts toward their tax credit, so plan withdrawals with both of you in mind.
A simple checklist
- List your doctors and prescriptions and check them against each plan.
- Estimate household income for each year until 65, and note how close you are to the 400% line.
- Compare total yearly costs, including premiums, deductibles, and out-of-pocket maximums.
- Put your Medicare window on the calendar and plan when to end any Marketplace or COBRA coverage.
- Talk to a licensed agent or tax professional about the details that apply to you.
Please note: LocalQuotes.online is not an insurance company, agency, or broker and is not affiliated with HealthCare.gov, Medicare, or any government agency. We connect you with licensed agents and marketing partners who may contact you about plans. Not all plans are available in all states, and plan details vary. We may be compensated by the agents and partners we connect you with. This page is general information, not insurance, legal, or tax advice.