Get and Understand Your Coverage
There are three main sources of health coverage. The first is your job. The second is a plan that
you buy. The third is a government program for older, disabled or low-income people.
If You Are 64 Years Old and Younger
If you don’t have coverage from your job, you can buy coverage straight from an insurer. You can
also buy it through exchanges (or marketplaces) set up through the Affordable Care Act (ACA). The
marketplaces are open from November 1 to January 15 each year. You may be eligible to sign up at
other times—for instance, if you lose your job. You generally pay a monthly premium for coverage.
If you buy a plan through the marketplace, you might qualify for help paying your premium. You may
also have costs like deductibles, copays and coinsurance.
To buy a marketplace plan, visit
healthcare.gov, or your state’s marketplace
site. You’ll see the costs and benefits for all of the plans in your area. You can also find out
whether you qualify for premium help. Call 800-318-2596 for help understanding the different plan
choices. Or, visit localhelp.healthcare.gov
to find in-person help near you.
COBRA (Consolidated Omnibus Budget Reconciliation Act). COBRA allows you to stay on your
employer’s health plan for 18 months if you leave your job. If you are not yet eligible for
Medicare, you can apply for COBRA coverage. But you will have to cover the whole cost of the plan.
Learn more about coverage by reading Getting Covered, Health
Insurance in Retirement and Medicare.
If you are about to turn or are 65 years old, think carefully about your health coverage
If You Are 65 Years Old or Older
If you are 65 or older, you may be eligible for Medicare. You also may want to consider other
public insurance options offered by the government programs, such as Medicaid, Department of
Veterans Affairs and TRICARE.
Medicare. Medicare is the US health
insurance program for people 65 and older (and for those with disabilities or certain illnesses).
It has different parts that cover different things. You can choose the parts that best meet your
healthcare needs. If you have health insurance through your (or your spouse’s) employer, you can
probably wait and sign up for Medicare when you (or your spouse) retire. But in
some cases, you may need to enroll in Medicare when you turn 65, to avoid
gaps in coverage or late enrollment penalties.
Medicare does not cover all healthcare services, such as long-term care or most dental services.
Read more about Medicare here.
Visit the Medicare website to learn more.
Medicaid. Medicaid offers coverage for people with low incomes. If your income is below a
certain limit, you may qualify for Medicaid and get care for free or at a lower cost. If you have a
disability, you also can get free care or care at a lower cost. Visit the Medicaid website to learn more.
Dual eligibility for Medicare and Medicaid. You might qualify for both Medicare and Medicaid. If you are eligible for both
Medicare and Medicaid, you may be enrolled in both to cover your costs. In that case, the two
plans will “coordinate” the payments for your care. Make sure to show both your health insurance
ID cards when you visit the doctor or get care.
Please keep in mind that the medical and dental reimbursement cost estimates that you receive from
the FAIR Health Consumer website are relevant for private health plans, not public insurance plans.
Department of Veterans Affairs. The VA offers health benefits to people who served in the
active military and were discharged other than dishonorably. If your injury or illness is linked to
your military service, you can get free healthcare at any VA location. To learn more about VA health
benefits, visit the Department of Veterans Affairs website. Read about VA health benefits here.
TRICARE. TRICARE offers health benefits for active-duty military members, retirees,
dependents and military families. It covers healthcare services, mental health services, dental
services, services for special needs and vision services. Learn more on the TRICARE website.
Read about its benefits and eligibility here.