Read time: 5 to 6 minutes
Your need for medical coverage doesn’t stop when you stop working. But your options after you leave your employer can vary. Here, we’ll tell you what’s available for you and how to sign up.
It depends on your age
Under age 65
Age 65 and over
Medicare is the government health insurance program that insures most Americans who are age 65 or older. You and your nonworking spouse qualify for Medicare if you’ve worked long enough to receive Social Security retirement benefits (typically 10 years).
Find coverage if you’re under age 65
From your employer
If you’re under age 65, you may be eligible to continue your employer-based medical insurance, usually for 18 months, under a law known as COBRA.
However, COBRA coverage is often more expensive than current coverage because you may pay both the premium plus any insurance subsidy that your employer previously paid.
From the Marketplace
You may find more affordable insurance coverage through another group health plan (such as a spouse’s workplace insurance) or by shopping the federal Health Insurance Marketplace.
You can apply for Marketplace coverage at HealthCare.gov* or by calling 800-318-2596 (TTY 855-889-4325). To qualify for special enrollment in a Marketplace plan, you must select a plan within 60 days before or 60 days after losing your job-based coverage. Through the Marketplace you can also learn if you qualify for Medicaid, which is free or low-cost coverage offered to low-income Americans.
Medicare begins at age 65
Part A
- Covers hospital costs.
- Provided at no charge.
- If you receive Social Security at age 65, you’re automatically enrolled.
Part B
- Covers outpatient care, such as doctor visits and X-rays.
- Most people pay a monthly premium of around $105.
- If you receive Social Security at age 65, you’re automatically enrolled.
Part D
- Covers prescription drug costs outside a hospital.
- Private insurance that you must buy on your own.
- Compare costs and coverages of plans in your area at Medicare.gov/find-a-plan.*
Medigap
- Also called Medicare Supplement Insurance.
- Covers deductibles, co-payments, and out-of-pocket costs Medicare doesn’t cover.
- Private insurance that you must buy on your own.
- Compare costs and coverages of the plans in your state at Medicare.gov.*
When to enroll
Look at Medicare Advantage plans
Medicare Advantage Plans are offered by private insurers. They operate more like Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs) than does original Medicare.
You can only go to doctors, hospitals, and other health care providers in the plan’s network, except in an emergency situation.
Medicare Advantage Plans must cover all of the services of original Medicare except for hospice. But many offer additional types of coverage, such as vision and dental care or prescription drug coverage.
Consider long-term care insurance
Personal resources
Medicaid
This federal-state program pays for most of the nursing home care in the United States today. To qualify, patients have had to use up substantially all of their savings. This can leave any surviving spouses with very little money.
Long-term care insurance
If you purchase a long-term care policy, consider buying it around age 55. At that age your risk of needing long-term care may not be high enough to warrant coverage, but you’re still young enough to be offered a relatively reasonable premium.
Look for a policy from a highly rated insurance company and consider an inflation rider that will raise the value of your daily benefit over time. You may be able to lower the premium if you limit your coverage to, say, three years rather than lifetime coverage, and have a 60- or 90-day waiting period before coverage begins. You would have to cover all costs during the waiting period, so be sure to choose a length of time you can afford.
You can learn more from "A Shopper’s Guide to Long-Term Care Insurance," a free booklet available from the National Association of Insurance Commissioners.*