ACA / Health Insurance · Wisconsin
Retiring Before 65 in Wisconsin: Health Coverage Until Medicare
If you retire before 65 in Wisconsin, the Health Insurance Marketplace is almost always the bridge — and the single number that decides what that bridge costs is not your age or your health. It is the household income you expect for the year. For 2026 coverage, the premium tax credit disappears completely above 400% of the federal poverty level, and we tested the edge live: a 62-year-old in La Crosse County with $62,600 of income was quoted a $909 monthly credit. The same person with $62,601 was quoted nothing. Here is how the bridge actually works, what it costs in this county for the 2026 plan year, and how to hand it off to Medicare at 65 without a penalty.
TL;DR — Key takeaways
- Retiring is a qualifying life event. Losing job-based coverage opens a 60-day Special Enrollment Period on the Marketplace — you do not wait for Open Enrollment.
- Premiums peak right when you need them. Federal law lets an adult's rate vary by 3 to 1 on age (42 U.S.C. § 300gg(a)(1)(A)(iii)), so the same plan that costs a 40-year-old $456.84 in La Crosse County costs a 64-year-old $1,072.41.
- For 2026 the credit is capped at 9.96% of household income in the 300–400% band, and the table ends at 400% (Rev. Proc. 2025-25).
- The cliff sits at $62,600 for a household of one and $84,600 for a household of two — 400% of the 2025 poverty guidelines, which are the ones the Marketplace uses for 2026 coverage (HealthCare.gov).
- For a La Crosse County couple aged 62 and 61, one dollar of income over $84,600 turned off $25,476 a year of credit in our live 2026 pull.
- At 65, the financial help stops. You can't get savings on a Marketplace plan once you're eligible for Part A, and advance credits used after that are repaid at tax time (HealthCare.gov).
- A Marketplace plan is not employer coverage. It earns you no Medicare Special Enrollment Period — miss the 7-month Initial Enrollment Period and the Part B penalty is permanent.
What actually happens to your coverage the day you retire?
Nothing automatic, and that is the part that catches people. Your employer plan ends on a date set by the plan document — usually the last day of the month in which you stop working, sometimes the last day you work. Nobody enrolls you in anything else. If you turn 65 that same month, Medicare is waiting. If you are 62, you are on your own for up to three years, and those are the three most expensive years of your life in the individual market.
Wisconsin uses the federal Health Insurance Marketplace at HealthCare.gov. There is no separate state exchange to learn, which simplifies things: the rules described in this article are the federal ones, and they apply the same way in Onalaska as they do in Milwaukee.
What changes is the math. While you were working, your employer was quietly paying most of your premium and your income was high. In retirement, you pay the whole premium yourself — and your income is often much lower, which is what makes the premium tax credit the most important number in the entire decision.
The counterintuitive part. Early retirees frequently qualify for a larger premium tax credit than they ever did as workers, because the credit is based on the income you expect this coverage year, not on what you earned last year or across your career. Retiring in March on a partial year of wages plus investment income can produce a very different eligibility picture than the same household looked like in December.
What are your four options between retirement and 65?
There are four, and only four, that cover most early retirees in western Wisconsin. They are not equally good, and the ranking flips depending on one variable — whether you qualify for a premium tax credit.
| Option | How long it lasts | What it costs you | Makes sense when |
|---|---|---|---|
| Marketplace plan | Until Medicare, renewed each year | Full premium, minus any premium tax credit | Your expected income puts you under 400% of the poverty level — often the lowest-cost option by a wide margin |
| COBRA | Generally 18 months | The entire group premium plus up to a 2% administrative fee; no tax credit is available while you are on it | You are mid-treatment and the network and deductible must not change, or your income is above the cliff and COBRA prices out below an unsubsidized individual plan |
| A spouse's employer plan | As long as the spouse works | Whatever the spouse's employer charges for the added adult | The spouse is still working and the employer subsidizes dependent coverage meaningfully |
| Employer retiree coverage | Whatever the plan promises | A negotiated retiree rate, sometimes partly employer-paid | You have it — it is increasingly rare, and it usually beats everything else when it exists |
Two structural notes that decide more cases than people expect:
- You cannot take a premium tax credit while you are enrolled in COBRA. That is why COBRA so often loses on price for a retiree whose income has dropped — the comparison is not "COBRA versus the sticker premium," it is "COBRA versus the premium after the credit." We walk through that comparison in detail in COBRA vs. ACA Marketplace in Wisconsin, and the ACA vs. COBRA calculator runs it with your own numbers.
- Your retirement opens a window on your spouse's plan too. Losing group coverage is a HIPAA special enrollment event for the spouse's employer plan, not just for the Marketplace. Those windows are typically 30 days, which is shorter than the Marketplace's 60 — so if a spouse's plan is in play, check it first.
Why is a Marketplace plan so expensive at 62?
Because federal law says it can be — up to a point, and that point is three times. 42 U.S.C. § 300gg(a)(1)(A) lists the only four things an individual-market premium may vary by: whether it covers an individual or a family, the rating area, tobacco use ("not more than 1.5 to 1"), and age, "except that such rate shall not vary by more than 3 to 1 for adults."
Not health. Not claims history. Not gender. Just those four — which is why an early retiree with a serious diagnosis pays the same as an early retiree who runs marathons. It is also why the last few years before Medicare are the most expensive years you will ever face in this market: you are sitting at the top of a legally permitted 3-to-1 curve, and there is nothing to do about it except wait for your 65th birthday.
Here is what that curve looks like on one real plan. This is the identical policy — the lowest-premium plan in La Crosse County for the 2026 plan year — quoted at three ages:
The same La Crosse County plan, priced at three ages (2026 plan year, before any subsidy)
Source: CMS Health Insurance Marketplace API, retrieved September 21, 2026 — Quartz Gundersen Performance Bronze $10,150 Ded (plan 37833WI0510341), ZIP 54650, La Crosse County, WI (FIPS 55063, rating area 6), plan year 2026, non-tobacco. These are full premiums for one specific plan at one point in time, before any premium tax credit; they are not a quote for any individual.
A 64-year-old pays 2.35 times what a 40-year-old pays for the same contract, same network, same deductible. That is the age curve, operating exactly as written. The good news is that the premium tax credit is designed to absorb most of it — for the households that qualify.
How is the premium tax credit calculated for 2026?
The credit works backwards from a cap, not forwards from a discount. The government decides what share of your income you should have to spend on a mid-range plan; the credit pays whatever is left.
Three pieces make it up:
- Your household income as a percentage of the federal poverty level. For 2026 coverage the Marketplace uses the 2025 guidelines — $15,650 for a household of one, $21,150 for a household of two (HealthCare.gov).
- An applicable percentage from the table below, which caps your share.
- The benchmark plan — the second-lowest-cost silver plan available to you. The credit is the benchmark premium minus your capped share. You can then spend the credit on any metal level, which is why so many subsidized shoppers buy bronze.
| Household income (% of federal poverty level) | Initial percentage | Final percentage |
|---|---|---|
| Less than 133% | 2.10% | 2.10% |
| At least 133% but less than 150% | 3.14% | 4.19% |
| At least 150% but less than 200% | 4.19% | 6.60% |
| At least 200% but less than 250% | 6.60% | 8.44% |
| At least 250% but less than 300% | 8.44% | 9.96% |
| At least 300% but not more than 400% | 9.96% | 9.96% |
Read the last row twice: it is flat at 9.96%, and it stops at 400%. There is no row above it. Source: Rev. Proc. 2025-25, Internal Revenue Bulletin 2025-32.
In practice, for a household in that top band, the cap is 9.96% of household income — about $498 a month on $60,000 of income. The benchmark silver plan for a 62-year-old in La Crosse County was $1,435.19 a month for 2026, so the credit does the heavy lifting from there. When we ran that exact household live, the Marketplace quoted an advance credit of $931 a month and the county's lowest-cost bronze plan came out to $96.01 a month net.
Two honest caveats on those numbers. First, the Marketplace's own determination is the one that counts — a hand calculation from the table and the Marketplace's quoted credit can differ by a few dollars a month because of rounding inside the determination, and we have reported the quote as quoted rather than reverse-engineering it. Second, these figures are one county, one plan year, one age and one income. Yours will differ. Treat them as a demonstration of how the mechanism behaves, and get an actual quote before you budget.
Where exactly is the 400% subsidy cliff?
At $62,600 of household income for one person, and $84,600 for two, for 2026 coverage. Those are not estimates. They are 400% of the 2025 poverty guidelines — $15,650 × 4 and $21,150 × 4 — and we confirmed the boundary by quoting the same person a dollar apart.
The reason it is a cliff and not a slope is the table above. Because the applicable percentage table ends at 400%, there is no phase-out band: you are either under the line with a credit, or over it with nothing. Here is what that looked like for a 62-year-old in La Crosse County on the county's lowest-cost bronze plan, whose full premium is $1,027.01 a month at every one of these incomes:
What a 62-year-old in La Crosse County actually pays, by expected income (2026 plan year)
Source: CMS Health Insurance Marketplace API, retrieved September 21, 2026 — Quartz Gundersen Performance Bronze $10,150 Ded, ZIP 54650, La Crosse County, WI, plan year 2026, single non-tobacco enrollee aged 62. Advance premium tax credit amounts as quoted by the Marketplace. One county, one plan, one age — not a quote for any individual.
For a couple, the drop is larger because the credit was covering two aged premiums instead of one. We ran a La Crosse County couple aged 62 and 61 at exactly $84,600:
- At $84,600: an advance credit of $2,123 a month — $25,476 for the year — which fully covered the $2,031.50 premium of the county's lowest-cost bronze plan. Their net premium was $0.00.
- At $84,601: an advance credit of $0, and a net premium of $2,031.50 a month.
One dollar. $25,476. That is the single most consequential piece of arithmetic in early-retirement planning, and it is invisible unless somebody goes looking for it.
Why this matters more for retirees than for workers. A working household's income is mostly wages, and wages are hard to move. A retired household's income is often a set of choices — which account to draw from, whether to convert to a Roth this year, when to realize a capital gain. That makes the cliff both more dangerous and more manageable for early retirees than for anyone else.
Can you control the income that decides your credit?
Often, yes — more than you can at any other stage of life. But this is the point in the article where we stop giving answers and start telling you who to ask, because the levers here are tax levers, and we are insurance agents.
The figure the Marketplace uses is modified adjusted gross income for the household, estimated for the coverage year. What tends to move it for a newly retired household:
- Which account you draw from. A withdrawal from a traditional IRA or 401(k) is generally income; drawing from taxable savings or a Roth generally is not, though the earnings treatment differs by account and by circumstance.
- Roth conversions. The years between retirement and Medicare are the classic conversion window precisely because income is low. They are also exactly the years when added income can cost you a five-figure premium tax credit. These two goals are in direct conflict, and which one wins is a math problem specific to your balances.
- Realized capital gains. Selling appreciated stock in January versus the following January can put you on opposite sides of the line.
- When you start Social Security. A portion of Social Security benefits counts toward the Marketplace income figure — including for people who claim early at 62.
- Deductible contributions, including HSA contributions if you are eligible to make them (see below).
Get a CPA in the room. Every item on that list is a tax decision with consequences well beyond your health premium — Roth conversion strategy, future required minimum distributions, Medicare's income-related premium adjustment at 65, and estate considerations all interact. We can tell you precisely where the cliff sits and what a plan costs on either side of it. We cannot tell you whether to convert, and any agent who offers to is out of their lane. Bring both people to the table.
One practical mechanic worth knowing: the credit you take during the year is an advance based on your estimate. It is reconciled against your actual income when you file. Estimate too low and you repay the difference; estimate too high and you get the balance back as a refundable credit. Report income changes to the Marketplace during the year rather than discovering the gap at tax time. Our federal poverty level calculator will show you where a given income lands as a percentage of the poverty level for your household size.
How long do you have to enroll after you retire?
Sixty days from the day your job-based coverage ends — and you can start up to 60 days before it ends, which is the half most people miss. Enrolling in advance is how you get a new plan to start the day after the old one stops, with no gap.
Losing job-based coverage is a qualifying life event whether you were laid off, resigned, or retired on your own schedule. What does not qualify is voluntarily dropping coverage while you are still employed and eligible for it. The full list of qualifying events and their deadlines is in ACA Special Enrollment Period in Wisconsin: 2026 Rules, and the Special Enrollment Period qualifier will check your situation in about a minute.
If you miss the window and have no other qualifying event, you generally wait for Open Enrollment, which runs November 1 through January 15 for the following plan year. For someone who retires in February, that is a long and uninsured spring. Do not let the 60 days run out while you are deciding between COBRA and the Marketplace — you can enroll in a Marketplace plan and keep deciding, but you cannot decide and then enroll after day 61.
What happens to your HSA when you retire early?
The money you have already saved is yours permanently and can be spent on qualified medical expenses regardless of what plan you are on — including, once you get there, on Medicare premiums. The question is whether you can keep contributing.
You can, if two things are true at once: you are covered by a qualifying high deductible health plan, and you are not enrolled in Medicare. IRS Publication 969 sets the 2026 figures:
| Figure | Self-only | Family |
|---|---|---|
| Maximum HSA contribution | $4,400 | $8,750 |
| Catch-up contribution, age 55+ | $1,000 additional per eligible person | |
| HDHP minimum deductible | $1,700 | $3,400 |
| HDHP maximum out-of-pocket | $8,500 | $17,000 |
That last row is the one that trips up early retirees shopping bronze plans. A high deductible does not by itself make a plan HSA-qualified — the out-of-pocket maximum also has to come in at or under the federal ceiling. Several bronze plans in this market carry out-of-pocket maximums above $8,500 for self-only coverage, which puts them outside the 2026 HDHP definition no matter how large the deductible is. Check the plan's Summary of Benefits and Coverage, or ask us to check it, before you plan a year of contributions around it.
Two further timing points, both of which cost real money when missed:
- Medicare ends contributions. Once you are enrolled, your contribution limit is zero from that month forward. Publication 969's eligibility test is explicit: you must not be enrolled in Medicare.
- Part A can be backdated. If you claim Social Security after 65, Part A entitlement can be granted retroactively — which can retroactively disqualify contributions you already made. If you are still contributing to an HSA as you approach 65, this is a conversation to have with your tax advisor before you file for benefits, not after.
How do you hand the bridge off to Medicare at 65?
Deliberately, and on a schedule — because two separate things go wrong here, and both are permanent.
First: the financial help stops at Part A eligibility, not at your birthday party
HealthCare.gov is unambiguous: "you can't get savings on your Marketplace plan premiums or out-of-pocket costs once you're eligible for Medicare Part A." And if you keep taking the advance credit past that point, you have to pay it back when you file your federal taxes. A household taking a $931 monthly credit that runs four months too long is looking at roughly $3,700 owed at filing.
Your Marketplace coverage also does not shut itself off. "Marketplace coverage doesn't end automatically when Medicare starts" — you end it. You can report your Medicare start date on your application up to three months in advance, and your Marketplace coverage will end the day before Medicare begins. If Medicare starts May 1, update the application as early as February 1 and Marketplace coverage ends April 30. Clean handoff, no overlap, no repayment.
Second: a Marketplace plan earns you no Medicare Special Enrollment Period
This is the expensive misunderstanding. People who delay Medicare while covered by an employer group plan get a Special Enrollment Period later and no penalty. A Marketplace plan is not employer coverage. It buys you nothing on that front. Your Initial Enrollment Period is the one you get: seven months long, starting three months before the month you turn 65 and ending three months after it.
Miss it, and Medicare.gov sets out what follows:
- Part B: an extra 10% of the standard premium for each full 12-month period you could have had Part B and did not — for as long as you have Part B. The standard premium is $202.90 in 2026, so a two-year delay means 20%, or about $243.50 a month, permanently.
- Part D: 1% per month without creditable drug coverage, applied to the national base beneficiary premium of $38.99 in 2026 — and it follows you even if you switch plans.
Note that a Marketplace plan's drug coverage may or may not be creditable for Part D purposes. Do not assume; confirm it in writing before you rely on it.
When you get there, the next decision is Medicare Advantage versus a Medicare Supplement — and in Wisconsin, supplements do not use the lettered plans you will read about on national websites. Wisconsin uses a standardized Basic Plan with riders. We cover that in Wisconsin Medicare Supplement: Basic Plan & Riders Explained and compare the two paths in Medicare Advantage vs. Medicare Supplement in Wisconsin. If your 65th birthday is inside the next year, start at our turning 65 guide.
Do your Gundersen or Mayo doctors stay in network?
Not automatically, and this is worth checking before price. Individual-market networks in western Wisconsin are narrower than most employer PPOs. The plan that wins on premium may not be the plan that keeps the cardiologist you have seen for a decade.
Most individual plans available in La Crosse County are HMOs or EPOs, which means out-of-network care is generally not covered at all except in an emergency. That is a meaningfully different risk profile from a typical employer PPO, and it matters most for exactly the people reading this: early retirees are the age group most likely to be mid-treatment, on specialty medications, or managing a chronic condition with an established care team.
Three things to verify on any plan before you enroll, in this order:
- Your physicians, by name, in that specific plan's directory — not the carrier's general directory. Carriers frequently sell several networks under one brand.
- Your hospital system, including where you would actually be admitted, and whether the ancillary providers there (anesthesia, pathology, radiology) participate.
- Your prescriptions, on that plan's formulary, at your tier, with any prior-authorization or step-therapy requirement noted.
We do this verification for every client before they enroll, for both Gundersen Health System and Mayo Clinic Health System providers. It takes an afternoon and it is the single most common reason someone regrets a plan choice.
A timeline, from 12 months out to month one of Medicare
The whole bridge, in order. Most of the expensive mistakes here are timing mistakes, not judgment mistakes.
| When | What to do |
|---|---|
| 12 months before you retire | Estimate your MAGI for each year between retirement and 65. Find out which side of $62,600 (one person) or $84,600 (two) each year lands on. Bring your CPA in now, while the drawdown plan is still a draft. |
| 3–6 months before | Get the exact end date of your employer coverage in writing. Ask whether retiree coverage exists. Check a working spouse's plan and its 30-day special enrollment window. |
| 60 days before coverage ends | Your Marketplace Special Enrollment Period opens. Price plans with and without the credit; verify doctors, hospital and drugs on each finalist. |
| Coverage end date | New plan starts the next day. Do not let the 60-day window expire while comparing — the clock does not stop for deliberation. |
| Each November 1 – January 15 | Open Enrollment. Re-run the income estimate for the new year and re-check the plan — networks, formularies and benchmark premiums all move annually. |
| Any time your income changes | Report it to the Marketplace so the advance credit tracks reality and you are not reconciling a surprise at tax time. |
| 4 months before you turn 65 | Start the Medicare decision. Your Initial Enrollment Period opens three months before your birthday month. |
| Up to 3 months before Medicare starts | Report your Medicare start date on the Marketplace application so coverage ends the day before Medicare begins — and the advance credit stops with it. |
| Month one of Medicare | Confirm the Marketplace plan actually terminated, and that no premium was drafted for it. Confirm Part D or Advantage drug coverage is active before your first refill. |
Retiring before 65 in the La Crosse area, the Coulee Region, or Winona County? We will price the bridge for your actual situation — every year of it, on both sides of the subsidy cliff — and verify your doctors and prescriptions before you enroll. Call (608) 799-8434 or request a review. By calling or texting, you consent to be contacted about your coverage at the number you provide; message and data rates may apply, and you can opt out at any time.
Frequently asked questions
What happens to my health insurance if I retire at 62 in Wisconsin?
Losing job-based coverage because you retired is a qualifying life event, so it opens a 60-day Special Enrollment Period to buy an individual plan through the Health Insurance Marketplace at HealthCare.gov — Wisconsin uses the federal Marketplace, so there is no separate state exchange. You can enroll starting 60 days before your coverage ends and up to 60 days after, so timed right there is no gap. Your other options are COBRA if your former employer had 20 or more employees, a spouse's employer plan (your loss of coverage opens a special enrollment window there too), or retiree coverage if your employer offers it. Which one costs less depends almost entirely on whether you qualify for a premium tax credit, and that depends on the income you expect for the year — not on what you earned while working.
How much does a Marketplace plan cost at age 62 in La Crosse County?
For the 2026 plan year, a 62-year-old non-tobacco user in La Crosse County had 36 individual-market plans to choose from, and the lowest-premium plan in the county — a Quartz Gundersen Performance bronze plan with a $10,150 deductible — carried a full monthly premium of $1,027.01 before any subsidy. The benchmark plan used to calculate subsidies, the second-lowest-cost silver, was $1,435.19 a month at that age. Those are live figures pulled from the CMS Marketplace API on September 21, 2026 for ZIP 54650, and they are what the plan costs before a premium tax credit — most early retirees who qualify for a credit pay a small fraction of it. Your own premium depends on your age, your county, tobacco use, the plan you pick, and your income, so ask for a quote rather than budgeting from these numbers.
What is the 400% federal poverty level subsidy cliff, and where is it for 2026?
For 2026 coverage, the premium tax credit phases out entirely above 400% of the federal poverty level — the applicable percentage table in Rev. Proc. 2025-25 simply stops at 400%, so a dollar of income above the line takes the whole credit away rather than shrinking it. The Marketplace uses the 2025 poverty guidelines for 2026 coverage: $15,650 for a household of one and $21,150 for a household of two, which puts the line at $62,600 and $84,600. We tested both edges live: a 62-year-old in La Crosse County with $62,600 of income was quoted a $909 monthly credit, and the same person at $62,601 was quoted nothing. For a couple aged 62 and 61, the drop at $84,600 was $2,123 a month — $25,476 for the year — over one dollar of income.
Can I stay on my Marketplace plan after I turn 65?
You can keep the plan itself, but you cannot keep the financial help. HealthCare.gov states plainly that you can't get savings on your Marketplace plan premiums or out-of-pocket costs once you're eligible for Medicare Part A, and that any advance premium tax credit you use after that point has to be paid back when you file your federal taxes. Marketplace coverage also does not end automatically when Medicare starts — you have to end it yourself. You can report your Medicare start date on your Marketplace application up to three months in advance, and your Marketplace coverage will end the day before Medicare begins.
Will I owe a Medicare penalty if I had a Marketplace plan before 65?
Yes, if you let the Initial Enrollment Period pass. A Marketplace plan is not employer coverage, so it does not give you a Special Enrollment Period for Medicare later and it does not protect you from the late enrollment penalty. Your Initial Enrollment Period is seven months long — it starts three months before the month you turn 65 and ends three months after it. Miss it and the Part B penalty is an extra 10% of the standard premium for each full 12-month period you could have had Part B and didn't, for as long as you have Part B; the standard Part B premium is $202.90 in 2026. The Part D penalty is 1% of the national base beneficiary premium ($38.99 in 2026) for each month you went without creditable drug coverage, and it is also permanent.
Can I keep contributing to my HSA after I retire early?
You can, as long as you are covered by a qualifying high deductible health plan and are not enrolled in Medicare. IRS Publication 969 sets the 2026 contribution limits at $4,400 for self-only coverage and $8,750 for family coverage, plus a $1,000 catch-up contribution once you are 55 or older. The plan has to actually meet the 2026 HDHP test — at least a $1,700 self-only or $3,400 family deductible, with an out-of-pocket maximum no higher than $8,500 self-only or $17,000 family — and not every bronze Marketplace plan does, so check the Summary of Benefits before you assume yours qualifies. Once you enroll in Medicare, your contribution limit for that month and afterward is zero, though you can still spend what is already in the account.
Sources
- Centers for Medicare & Medicaid Services. Health Insurance Marketplace API — 2026 individual-market plans, premiums and advance premium tax credit determinations for La Crosse County, Wisconsin (ZIP 54650, FIPS 55063, rating area 6), retrieved September 21, 2026. developer.cms.gov
- HealthCare.gov. Federal Poverty Level (FPL) — glossary — the poverty guideline amounts used for 2026 Marketplace savings. healthcare.gov
- Internal Revenue Service. Rev. Proc. 2025-25, Internal Revenue Bulletin 2025-32 — applicable percentage table under § 36B(b)(3)(A)(i) for taxable years beginning in 2026, and the 2026 Required Contribution Percentage of 9.96%. irs.gov
- Office of the Law Revision Counsel. 42 U.S.C. § 300gg — Fair health insurance premiums — the 3-to-1 limit on age rating and the 1.5-to-1 limit on tobacco rating. uscode.house.gov
- HealthCare.gov. Changing from the Marketplace to Medicare — loss of savings at Part A eligibility, repayment of advance credits, and ending Marketplace coverage. healthcare.gov
- Medicare.gov. When does Medicare coverage start? — the seven-month Initial Enrollment Period and resulting coverage start dates. medicare.gov
- Medicare.gov. Avoid late enrollment penalties — Part B and Part D late enrollment penalty calculations, the 2026 standard Part B premium ($202.90) and the 2026 national base beneficiary premium ($38.99). medicare.gov
- Internal Revenue Service. Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans — HSA eligibility and Medicare, 2026 contribution limits, and 2026 HDHP deductible and out-of-pocket thresholds. irs.gov
For general information only — not insurance, tax, or legal advice. Eligibility, premiums, premium tax credits and cost-sharing reductions depend on your income, household size, location, and plan year; every premium and credit figure in this article is a dated quote for one county, one plan year and one set of ages, and is not a quote for any individual. Confirm eligibility and enroll at HealthCare.gov. Consult a licensed agent or a certified Marketplace navigator, and a qualified tax advisor for anything touching modified adjusted gross income. Hougom Insurance Agency is not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area; any information we provide is limited to the plans we do offer. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program for help with all of your options.