The short answer
Medicare starts at 65, so retiring earlier means self-funding health coverage for the gap: five years at 60, three at 62, one at 64. The length of that bridge shapes everything — how much you need saved for premiums, how aggressively you manage income for subsidies, and whether short-term tactics like COBRA can cover part of it. A one-year bridge at 64 is a very different problem from a five-year bridge at 60.
So the first question in early-retirement health planning is simply how many years you need to bridge, because that drives the whole plan.
How the bridge changes by age
At 64, a single year to cover means COBRA (up to 18 months) can plausibly carry you to Medicare, and an ACA plan is a simple one-year expense. At 62, three years means COBRA alone will not stretch the whole way, so an ACA plan becomes central, and Social Security timing may enter the picture. At 60, five years is long enough that income management for subsidies, plan-level choices, and dental and vision gaps all compound. Our early retiree cost guide breaks down the numbers.
The longer the bridge, the more the small annual choices — subsidies, metal level, supplemental gaps — add up over time.
Funding the bridge
Because premiums are subsidized based on income, the bridge years are often when careful income planning pays off most, before Social Security and required withdrawals push income up. Budget for the full number of bridge years, not just the first, and plan the handoff to Medicare so coverage is continuous. Our health insurance before Medicare guide covers the transition.
The takeaway: count your bridge years first, then build a plan sized to that length — the strategy at 60 is not the strategy at 64.
Frequently Asked Questions
How many years of health insurance do I need before Medicare?
Medicare starts at 65, so retiring at 60 means about five years to bridge, 62 means three, and 64 means about one. The length drives your whole coverage plan.
Can COBRA bridge me to Medicare if I retire early?
Only for short bridges. COBRA typically lasts up to 18 months, enough to cover a retirement at 64 but not the multi-year gap from retiring at 60 or 62.
Why does my retirement age change my coverage plan?
A longer bridge means more years of premiums and more chances for income management, plan choices, and supplemental gaps to compound, so the plan at 60 differs from the plan at 64.
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