# Health Insurance Before Medicare at 62 to 65

> Health insurance from 62 to 65: marketplace, COBRA, a spouse's plan, and Medicaid, with 2026 costs by age, subsidy limits, and the Medicare handoff at 65.

Canonical: https://christianbrinkleync.com/guides/health-insurance-before-medicare-62-to-65

## Quick answer

Between 62 and 65 you have four main routes: the marketplace, COBRA, a spouse's plan, or Medicaid. In 2026 a 60-year-old paid about $15,914 a year for a benchmark silver marketplace plan before subsidies, and COBRA averaged about $833 a month for one person.

## The four routes at a glance

Most people in this gap use one of four routes. The marketplace sells individual plans, with tax credits if your income qualifies. COBRA continues your old employer plan for up to 18 months at full price. A spouse's employer plan can cover you if their employer offers it. Medicaid covers adults with low income in North Carolina. The right route depends on your income, your doctors, and how long you need coverage.

## What the marketplace costs at 60 to 64

Age is the biggest price driver: federal rules let insurers charge a 64-year-old up to three times what a 21-year-old pays for the same plan. KFF put the 2026 national average benchmark silver premium at $625 a month for a 40-year-old. For a 60-year-old, the 2026 national average was $11,625 a year for the lowest-cost bronze plan, $15,914 for the benchmark silver plan, and $15,672 for the lowest-cost gold plan, all before subsidies. Average deductibles in 2026 were $7,476 for bronze, $5,304 for silver, and $1,722 for gold. KFF's October 30, 2026 analysis put the 2027 benchmark average at $703 a month for a 40-year-old, up 13%.

## Subsidies now stop at 400% of poverty

The enhanced premium tax credits expired on December 31, 2025. For 2027 coverage, tax credits run from 100% to 400% of the federal poverty level, which is $15,960 to $63,840 a year for one person. You are expected to pay 2.15% to 10.22% of your income toward the benchmark plan, and the credit covers the rest. Above 400%, there is no credit. One exception matters in North Carolina: if your income qualifies you for Medicaid, you cannot also claim a marketplace tax credit. KFF found that a 60-year-old earning $65,000 pays $10,389 more a year, about $865 a month, than when the enhanced credits were in place.

## COBRA: the same plan at full price

COBRA lets you keep your employer plan for up to 18 months after leaving a job, but you pay the whole premium plus up to a 2% fee. At the KFF 2026 employer survey averages, that is about $833 a month for one person and $2,406 a month for a family. You have 60 days to elect COBRA after leaving. COBRA has no subsidies, and it does not count as current employer coverage for Medicare's Part B enrollment rules, so read the COBRA versus Medicare guide before you turn 65.

## A spouse's plan and Medicaid

A spouse's employer plan is often the cheapest route when it is available, because the employer still pays part of the premium. Check whether your spouse's open enrollment or a qualifying life event lets you join. North Carolina expanded Medicaid on December 1, 2023. Adults ages 19 through 64 qualify with household income up to 138% of the federal poverty level, about $1,835 a month for one person under the 2026 figures. Starting January 1, 2027, most expansion adults must meet a work or community engagement requirement to keep coverage.

## Dates, and the Medicare handoff at 65

Open enrollment for 2027 marketplace coverage runs November 1, 2026 through January 15, 2027 on HealthCare.gov. Enroll by December 15, 2026 for coverage starting January 1, 2027. Medicare starts at 65: your initial enrollment period begins three months before the month you turn 65. Mark the month you turn 64 and a half, and line up the Medicare side early, because a gap between your bridge coverage ending and Medicare starting can leave medical bills with no coverage behind them.

## Four routes from 62 to 65

| Route | Cost and how long it lasts |
| --- | --- |
| Marketplace | About $15,914 a year for a 60-year-old benchmark silver plan in 2026, before subsidies. Renews yearly. |
| COBRA | About $833 a month for one person at 2026 averages. Lasts up to 18 months. No subsidies. |
| Spouse's plan | Often the cheapest route when available. Employer still pays part of the premium. |
| Medicaid | No premium for most who qualify. Adults 19 to 64 up to 138% of poverty, about $1,835 a month for one person. |

## Checklist

- [ ] Price the marketplace for your age and county before assuming COBRA is cheaper.
- [ ] Check whether your income qualifies for a tax credit, and where the 400% line falls.
- [ ] Confirm your doctors are in the plan's network before enrolling.
- [ ] Put your 65th birthday month on the calendar and start the Medicare steps three months before.
- [ ] If you are on COBRA, check the Medicare Part B rules before you turn 65.

## Frequently asked questions

### What is the cheapest health insurance before Medicare?

It depends on income. With a low income, Medicaid or a subsidized marketplace plan is usually cheapest. With a higher income, a spouse's plan often wins. COBRA is rarely the cheapest, but it keeps your doctors and plan.

### Can I get a subsidy at 62?

Yes, if your household income is between 100% and 400% of the federal poverty level and you do not qualify for Medicaid or other qualifying coverage. For 2027 coverage that is $15,960 to $63,840 a year for one person. In North Carolina, adults with income up to 138% of poverty generally qualify for Medicaid instead, and Medicaid coverage means no marketplace tax credit. Above 400%, there is no credit.

### Does COBRA count for Medicare enrollment?

No. COBRA does not count as coverage based on current employment for Medicare Part B, so it does not open a special enrollment period. Check the COBRA versus Medicare guide before you turn 65.

### When should I start planning for Medicare at 65?

Three months before the month you turn 65, when your initial enrollment period opens. If you are on a bridge plan, line up the switch early so coverage does not gap.

## Sources

- [KFF: Marketplace average benchmark premiums](https://www.kff.org/affordable-care-act/state-indicator/marketplace-average-benchmark-premiums/)
- [KFF: How the loss of enhanced premium tax credits affects older adults](https://www.kff.org/affordable-care-act/how-will-the-loss-of-enhanced-premium-tax-credits-affect-older-adults/)
- [Medicare.gov: When does Medicare coverage start](https://www.medicare.gov/basics/get-started-with-medicare/sign-up/when-does-medicare-coverage-start)
- [NC Medicaid: Eligibility](https://medicaid.ncdhhs.gov/eligibility)

## Related

- [COBRA vs Medicare at 65](https://christianbrinkleync.com/guides/cobra-vs-medicare-at-65)
- [Turning 65 with a marketplace plan](https://christianbrinkleync.com/guides/turning-65-aca-marketplace-plan)
- [Your Medicare checklist for turning 65](https://christianbrinkleync.com/turning-65)
- [What Medicare does not cover](https://christianbrinkleync.com/guides/what-medicare-does-not-cover)

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Educational content only, not financial or tax advice. Published by Christian Brinkley, christianbrinkleync.com.