How do I get health insurance if I retire before 65?
Medicare starts at 65 no matter when you retire. If you retire earlier, you need coverage for the years in between. Federal retirees can usually keep their FEHB plan. Oregon PERS retirees can buy a PERS plan made for retirees not yet on Medicare. Other choices include COBRA, a spouse's plan, or a HealthCare.gov plan, which may come with help paying the premium.
Your choices, side by side
| Option | Who can use it | Good to know |
|---|---|---|
| Keep FEHB | Federal retirees enrolled in FEHB for the 5 years of service just before retiring | You keep the same kind of coverage, and the government keeps paying its share (5 U.S.C. 8905). |
| PERS Health Insurance Program (PHIP) | PERS retirees, their spouses and eligible dependents | Includes plans for people not yet on Medicare, from Kaiser and UnitedHealthcare (PERS: PHIP). |
| Your employer's retiree plan | Depends on your employer | Some public employers let retirees stay on the group plan until 65. Ask your benefits office before you set a date. |
| Your spouse's job plan | If your spouse is still working and has family coverage | Losing your own coverage usually lets you join their plan outside its normal sign-up time. Ask their plan how long you have. |
| COBRA | Most state and local government workers, and private-sector workers | Keeps your job's plan for up to 18 months. You may pay the full cost plus 2%. You have 60 days to choose it (Labor Department COBRA guide). Federal plans aren't covered by COBRA. |
| A HealthCare.gov plan | Anyone not on Medicare or a job plan | Losing job coverage lets you sign up from 60 days before it ends to 60 days after. Help with premiums depends on your income, and a pension often means lower income than your paycheck (HealthCare.gov). |
How to choose
- Price the whole year, not just the premium. Add up the premium, the deductible and what you'd pay for your usual doctors and prescriptions.
- Check your doctors and drugs. Make sure the plan's network includes them before you switch.
- Avoid a gap. Line up the new plan so it starts the day after your job coverage ends.
- Plan for your spouse too. If your spouse is younger, they may need coverage after you've moved to Medicare.
When you turn 65
Sign up for Medicare during your 7-month window around your 65th birthday. COBRA and retiree plans don't let you put off Part B without a penalty. Only coverage from a current job does. Signing up late adds 10% to your Part B premium for each full year you could have signed up, for as long as you have it (Medicare: when coverage starts and avoiding penalties).
FEHB and PHIP both work alongside Medicare after 65, so ask your plan how the two fit together before you decide on Part B.
Retiring before 65? Our planner marks when Medicare can start on your income timeline, and the countdown checklist lists every deadline.
Open the countdown checklistGeneral information, not advice. Plans, prices and rules change every year. Check with your plan, your benefits office or HealthCare.gov before you decide.