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Matthew R. Harris

What happens to your health insurance if you retire before 65?


Happy Friday Reader ☀️

Most people assume they have to work until 65 because of one thing:

Health insurance.

But the reality is many retirees stop working years earlier — and there are several ways they bridge the gap before Medicare begins.

One of the most common questions I hear from people considering retirement is this:

“If I retire before 65… what do I do about health insurance?”

Since Medicare doesn’t begin until age 65, it’s a legitimate concern. For many people, the fear of losing employer health coverage is actually one of the biggest reasons they delay retirement.

But the reality is that many people retire before Medicare — and there are a few common ways they bridge the gap.

1️⃣ Spouse Coverage

If one spouse continues working, the other can often remain on the employer health plan. This is one of the simplest and most common solutions for couples approaching retirement.

2️⃣ COBRA

COBRA allows you to continue your employer plan for up to 18 months after leaving a job. The downside is that you must pay the entire premium yourself, which can be expensive. Still, it can serve as a helpful short-term bridge while transitioning into other coverage options.

3️⃣ ACA Marketplace Plans

Many early retirees ultimately purchase insurance through the marketplace created under the Affordable Care Act, often through the federal exchange at HealthCare.gov.

This is where things become particularly interesting from a planning standpoint.

Premiums on these plans are largely based on income, and many households qualify for significant subsidies depending on their Modified Adjusted Gross Income (MAGI).

That means the way you structure your retirement withdrawals can influence what you pay for health insurance during those early retirement years.

For example, some retirees manage their income by:

• harvesting investments with a large cost basis, keeping taxable gains lower
• using Roth distributions, which generally do not count toward taxable income
• controlling IRA withdrawals to stay within certain income ranges

In some cases, retirees may even pause larger tax strategies temporarily.

For example, delaying significant Roth conversions for a few years may allow them to qualify for larger healthcare subsidies before Medicare begins.

The Big Takeaway

Health insurance before age 65 is something that should absolutely be planned for.

But for many retirees, it ends up being far more manageable than they initially expect.

And perhaps more importantly, it highlights a broader truth about retirement planning:

The way you structure your income can affect far more than just taxes — it can influence healthcare costs, investment strategy, and long-term financial security.

If you're exploring whether your current strategy is positioned correctly for retirement, you can learn more about the Retirement Income Review below.

Now as usual, all of the new resources (videos and blogs) of the week, are linked below. Enjoy!

Featured Blog of the Week:

5 Proven Strategies to Ensure Long-term Success in the Market During Retirement

Many investors spend decades focused on growing their portfolios, but retirement changes the rules. Once your paycheck disappears, the market may suddenly become responsible for funding your lifestyle — and that can create a major risk known as sequence of returns risk. In this week’s featured article, I explain why the goal in retirement isn’t avoiding the market, but designing an income structure that allows your portfolio to remain invested without carrying the full burden of funding your spending.

The article walks through five proven strategies that help retirees stay invested confidently over the long term, including diversification, disciplined rebalancing, flexible withdrawal guardrails, building a reliable income foundation, and reducing investment fees. When these pieces are structured correctly, market volatility becomes far less threatening — allowing retirees to stay invested calmly and give their portfolio the time it needs to grow.

👉 Read the full article here

As always, thank you for allowing me into your inbox.

The years leading into retirement are often the most financially sensitive. Small structural decisions can have long-term consequences.

If you would like to understand how your current income and tax strategy measures up, you can learn more about my Retirement Income Review process here:

Retirement Income Review

Additional resources and case studies:
Safe Wealth Planning

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Matthew R. Harris

I help individuals and families transition from the accumulation phase of retirement to the income phase through structured income planning and tax-smart withdrawal strategies.

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