One of the biggest challenges that can confront retirees is figuring out how they will manage their health insurance expenses. For many, a major new expense can emerge when they transition from employer-sponsored group health coverage to Medicare at age 65. This is especially true if they have retired early due to health concerns or family circumstances.
Fortunately, the Affordable Care Act makes it much less challenging for individuals to secure coverage in this situation than it was before. In addition, for those who are unable to get health insurance through the ACA marketplace, financial help is available from both the state and federal government.
When you retire before age 65, you will have several options for securing healthcare coverage until your Medicare benefits kick in. These include: enrolling in a state health insurance marketplace, continuing employment-related health benefits through COBRA or state continuation, using your spouse’s health insurance, or applying for Medicaid.
For those who choose to enroll in Medicare, they can do Learn more here so during the initial enrollment period that begins three months before the month you turn 65 and ends 3 months after your birthday month—a total of 7 months. In order to avoid penalties, you should apply for Medicare during this window, if possible.
Individuals who are unable to secure Medicare during the initial enrollment period can also sign up during a special enrollment period, which typically lasts 6 months following the end of their employment or the dissolution of their partnership, if applicable. They can also sign up for an extended benefits plan through their former employer, if offered, or through the private health insurance marketplace.
The ACA offers financial assistance for some individuals who have to purchase private insurance in the marketplace, including premium tax credits and cost-sharing reductions. These can significantly lower the amount of health insurance you will have to pay.
Aside from the ACA’s financial support, there are also resources available through local community organizations and hospitals for low-income individuals who may need help with out-of-pocket costs associated with Medicare or other medical procedures. Contact NY Connects or the Health Insurance Information, Counseling and Assistance Program to learn more.
Finally, remember to talk with your loved ones about what your wishes are for end-of-life care. This can alleviate stress for your family members and provide clarity about how to meet your healthcare needs at the end of life. You can find helpful conversation starters in our Working Out What’s Right for You suite of resources.