En español | No, you can’t qualify for Medicare before age 65 unless you have a disabling medical condition.
People younger than 65 who receive Social Security Disability Insurance (SSDI) benefits can generally get Medicare 24 months after they become eligible for disability benefits. This waiting period is waived for people who have permanent kidney failure, known as end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS), better known as Lou Gehrig’s disease.
Everyone else needs to wait until age 65 to become eligible for Medicare, no matter when they retire. You can sign up during your seven-month initial enrollment period (IEP), which begins three months before the month you turn 65 and lasts for three months after your birthday month. The coverage begins no earlier than the month you turn 65. If your birthday is on the first of the month, coverage starts at the beginning of the previous month.
How to get health insurance before age 65
If you’re retiring at 62 and losing your employer’s health insurance, you’ll need to find other coverage until Medicare begins. You have several options. Most of these options also can help if you need coverage for other reasons, such as losing your job or facing the two-year waiting period for Medicare if you receive SSDI.
- You can transition to retiree health insurance if your employer offers it. But few companies offer retiree health insurance benefits these days.
- You can get insurance through your spouse’s employer if the company offers coverage to dependents. You can qualify for a special enrollment period (SEP) to switch to this coverage within 30 days of losing coverage under your plan, or your spouse can add you to the coverage during the company’s annual open enrollment period (OEP).
- You can keep your employer’s coverage through COBRA, a federal law that requires employers with 20 or more employees to continue coverage after you leave your job. Many states have similar requirements for smaller employers.
You’ll have up to 60 days after your employer-sponsored health insurance ends to sign up for COBRA. The coverage can last for up to 18 months after you leave your job.
If you continue your current coverage on COBRA, your benefits and provider network won’t change. Any money you’ve paid toward this year’s deductible will still count.
But your premiums will increase. You’ll usually have to pay both the employer’s and the employee’s share of premiums after you leave your job, plus up to 2 percent in administrative expenses. Most employers cover 70 to 80 percent of the premiums for their employees.
Some government-affiliated insurance options
- You can buy individual health insurance through the Affordable Care Act (ACA) federal marketplace or a state that has its own exchange. Open enrollment generally runs from Nov. 1 to Dec. 15 for new coverage starting Jan. 1, although some states have longer time frames. You can find links to the federal or state marketplace in your area at HealthCare.gov.
If you’re losing medical coverage because you’re retiring, you can qualify for a special enrollment period to get marketplace coverage within 60 days after the end of your health coverage.
You may qualify for a subsidy to help pay premiums based on your household income for the year, which is likely to be lower after you retire. The subsidy can reduce premiums significantly, and 2021 COVID-19 relief legislation expanded them for 2021 and 2022.
For example, a single, nonsmoking 62-year-old in Chicago whose household income is $50,000 in 2022 could qualify for a premium subsidy of $355 a month, lowering the monthly cost of a mid-level plan — called a silver plan in the federal marketplace — to $342 from $696 without the subsidy. The Kaiser Family Foundation’s subsidy calculator can help you estimate your premium assistance.
- You may qualify for Medicaid, a joint federal-state insurance program, if your household income is below certain a threshold that varies by state. The ACA allowed for the expansion of Medicaid coverage to adults with incomes of 138 percent of the federal poverty level, but not all states have expanded coverage. You can do a quick screening to see if you are eligible at Healthcare.gov or your state marketplace.
So far in 2022, 38 states and the District of Columbia have expanded Medicaid coverage to adults whose modified adjusted gross income is below $25,268 for a household of two in the continental United States. The income guidelines are $31,588 in Alaska and $29,063 in Hawaii.
These states have not expanded Medicaid to low-income adults: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin and Wyoming. But you may qualify under some states’ rules, especially if your family is caring for relatives age 18 and younger who live with you.
- You can search for a community health center near you if none of the options above works for you. The ACA increased federal money for these public or nonprofit clinics that in addition to treating diseases provide care to keep people healthy — no matter their income or age.
The health centers generally are located in areas with few doctor’s offices and hospitals, and with high rates of uninsured patients. Payment is on a sliding scale based on income.
- The BenefitsCheckUp website from the National Council on Aging also can lead you to benefit programs in your area. You’ll be asked a series of questions to determine what you want to learn more about, and you can remain anonymous.
Keep in mind
- If you retire and sign up for Social Security benefits before age 65, you’ll automatically be enrolled in Parts A and B of Medicare when you turn 65. (The rules are different in Puerto Rico.)
The Social Security Administration, which handles Medicare enrollment for the federal Centers for Medicare & Medicaid Services, will send you a Welcome to Medicare packet three months before your 65th birthday explaining decisions you’ll still need to make before your coverage starts. Your monthly premium will be deducted automatically from your monthly Social Security payment. If you want automatic enrollment, be sure to sign up for Social Security retirement benefits at least four months before your 65th birthday.
- If you haven’t signed up for Social Security at least four months before your 65th birthday, you’ll need to take steps to enroll in Medicare yourself, perhaps during your initial enrollment period. Now that the age to receive full retirement benefits is 66 and older, fewer people start Social Security before age 65 and continue to delay the retirement benefits while receiving Medicare.
Unless you or your spouse are still working and have health insurance through an employer, you’ll need to sign up for Parts A and B during your initial enrollment period. The easiest way is to enroll online at the Social Security website.
Updated May 31, 2022