If you’re retired and need health coverage, you can use the Marketplace to buy an insurance plan. If you have retiree health coverage, you have different choices to consider.

Are you a retiree under age 65 without health coverage?

If you retire before you’re 65 and lose your job-based health plan, you can use the Marketplace, like Inshura.com, to find an affordable healthcare plan. Losing health coverage qualifies you for a Special Enrollment Period. This means you can enroll in a health plan even if it’s outside the annual Open Enrollment Period.

When you fill out a Marketplace application, you’ll find out if you qualify for a private plan with premium tax credits and lower out-of-pocket costs. This will depend on your income and household size. You’ll also find out if you qualify for free or low-cost coverage through the Medicaid program in your state.

Are you 65+ and retired with retiree health benefits?

If you have retiree coverage and want to buy a Marketplace plan instead, you can. However, keep in mind:

  • You can’t get premium tax credits and other savings based on your income. This is true only if you’re actually enrolled in retiree coverage. If you’re eligible for but not enrolled in retiree coverage, you may qualify for premium tax credits and lower out-of-pocket costs based on your household size and income.
  • If you voluntarily drop your retiree coverage, you won’t qualify for a Special Enrollment Period to enroll in a new Marketplace plan. You won’t be able to enroll in health coverage through the Marketplace until the next Open Enrollment period.

Coverage for retirees without Medicare

What if I turn 65 in the middle of the year? Can I get Marketplace coverage to carry me over until I’m eligible for Medicare?

Yes. You can get a Marketplace plan to cover you before your Medicare begins. You can then cancel the Marketplace plan once your Medicare coverage starts.

What if I’m 65 or older, but not eligible for Medicare?

You may be able to buy insurance in the Marketplace and get lower costs on monthly premiums and out-of-pocket costs based in your household size and income.

What if I retire from my job and am self-employed?

If you don’t have retiree insurance or Medicare, you have the same insurance choices and responsibilities as anyone else who’s self-employed.

Do my IRA or 401k withdrawals count as income?

Generally, yes. Log into Inshura.com to learn more.

Can I drop COBRA and get Marketplace coverage instead. Will I qualify for lower costs based on my income?

It depends on your situation. For example:

  • If your COBRA coverage runs out outside Open Enrollment, you qualify for a Special Enrollment Period. This means you can enroll in a Marketplace plan outside the annual Open Enrollment Period.
  • But you can’t choose to drop your COBRA coverage outside Open Enrollment and enroll in a Marketplace plan instead. The Special Enrollment Period applies only if your COBRA coverage runs out.
  • During the annual Open Enrollment Period, you can drop your COBRA coverage even if it’s not running out and replace it with a Marketplace plan.
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About Inshura

Inshura is a FREE online ACA insurance tool, perfect for agents and agencies! Agents can boost their ACA and other enrollments using this easy-to-use solution for quoting, enrolling, automating renewals, and managing clients!

And inshura is CMS EDE PHASE III certified, so it automatically exchanges data directly from the Marketplace.


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