Health Insurance for Early Retirees in Maryland (Ages 55 to 64)

Bridging to Medicare in Maryland

Retiring before 65 in Maryland means finding coverage until Medicare starts. Marketplace plans are the main option for most people, and subsidies are based on your expected income for the year, not your savings.

Income planning matters more now. With the enhanced federal credits gone, help stops at 400% of the federal poverty level, and Maryland's state help also stops there. Keeping your income just under that line, for example by choosing which accounts to draw from, can make a large difference in what you pay.

If your income in a given year is very low, you may qualify for Maryland Medicaid instead. Maryland expanded Medicaid, so adults up to 138% of poverty can qualify regardless of age before Medicare.

Why your income estimate matters so much

Marketplace subsidies are based on your modified adjusted gross income (MAGI) for the coverage year. For early retirees, that number is partly in your control: it depends on which accounts you draw from and when.

Withdrawals from traditional IRAs and 401(k)s count as income. Qualified Roth withdrawals generally don’t. For ACA purposes, MAGI also adds back tax-exempt interest and any Social Security benefits that aren’t taxed. A tax professional and a licensed agent working from the same income plan can make a large difference to what you pay.

Subsidies in 2026

Congress did not extend the enhanced federal premium tax credits, so they ended after 2025. For 2026, federal help again stops at 400% of the federal poverty level, and Maryland's individual market rates rose an average of 13.4%. Maryland stepped in with its own premium assistance for households under 400% of poverty, but people above that line get no state or federal help.

Maryland Premium Assistance: for 2026 it replaces all of the lost enhanced federal help for incomes under 200% of poverty, tapers between 200% and 250%, and replaces half of it from 250% to 400%. People who enrolled through a special enrollment period after April 1, 2026 did not get the state help for 2026, and the exchange board voted in August 2026 to keep the same structure for 2027. A separate young adult subsidy for ages 18 to 37, created in 2022 and made permanent in 2025, stacks on top.