Health insurance from your last shift to Medicare at 65
Retire at 52 and Medicare is 13 years away. For most Florida firefighters that gap gets covered one of four ways: staying on your employer's retiree group plan, COBRA for up to 18 months, a spouse's plan, or an individual Marketplace policy.
Which one costs least depends on your department, your family, and, starting in 2026, your income in a way it did not before. One of these doors closes permanently if you miss a short deadline, and it is usually the one people assume will always be there.
Option 1: Your employer's retiree group plan
Florida law gives you the right to stay. Under Florida Statute 112.0801, a state agency, county, municipality, special district or district school board that offers group health coverage must give retirees and their eligible dependents the option of continuing in it, at a premium of
“no more than the premium cost applicable to active employees.”
Fla. Stat. 112.0801
Read the rest of that sentence too. The statute says the cost may be paid by the employer or by the retiree. In practice most retirees pay the whole premium themselves, which is why the number is such a shock. The law protects your access and caps the rate. It does not promise anyone else pays it.
This is the door that closes for good
Every department sets its own election rules, and they are short and unforgiving. Miami-Dade requires your retiree coverage election within 30 days of your retirement date, and once coverage is gone it cannot be reinstated. At Broward Sheriff's Fire Rescue, taking the stipend means you can never re enroll in BSO medical. In Palm Beach County you must already be enrolled in the Fire Fighters Employee Benefits Fund to keep it in retirement. Get your department's deadline in writing before your last day.
The specifics for each department, including who to call, are on the department retirement steps pages.
Option 2: COBRA
COBRA lets you keep the same employer coverage after you leave. For state and local government plans, the federal Centers for Medicare & Medicaid Services has jurisdiction over it. Two numbers matter:
- How long: in most cases a maximum of 18 months for the covered employee.
- How much: up to 102 percent of what the plan costs, meaning the full premium, both your share and the share your employer used to pay, plus a small administrative charge.
COBRA is a bridge, not a plan. It can carry you to a spouse's open enrollment or the start of a new job's coverage. It cannot carry a 52 year old to 65.
Option 3: A spouse's employer plan
If your spouse is still working and has coverage through work, this is often the cheapest option on the table. Losing your own coverage generally lets you join a spouse's employer plan outside open enrollment, but the window is short, commonly 30 days. Have your spouse ask their HR department how it works, and what the deadline is, before your last day.
Option 4: The Marketplace, and what changed in 2026
Losing job based coverage lets you buy an individual plan through HealthCare.gov outside open enrollment. Whether it is affordable depends almost entirely on the premium tax credit, and that changed.
The subsidy cliff is back
The enhanced premium tax credits that had removed the income cap expired on December 31, 2025. The House passed an extension in January 2026, but as of October 2026 the Senate has not acted and nothing has been enacted. Under the original rules now in effect, a household with income above 400 percent of the federal poverty level gets no premium tax credit at all. Not a smaller one. None.
Here is why that matters more for firefighters than almost anyone. The Marketplace looks at your income for the year, and a pension alone can put a couple close to that line. Then the extras land on top:
- A DROP payout taken as cash counts as income in the year you take it. A direct rollover to another retirement account generally does not.
- 457(b) withdrawals count in the year you take them.
- A leave payout on your final check counts as wages.
- A Roth conversion counts in the year you convert.
One badly timed withdrawal can push a household over the line and cost the entire year's subsidy. How you take your DROP and when you draw from your 457(b) are now health insurance decisions too. Run the numbers on HealthCare.gov for your actual expected income, and have a tax professional look at the timing, before you move any money.
Money that helps pay the premium
- The FRS Health Insurance Subsidy. $7.50 a month per year of service, from $45 to $225 a month, for life. It is not automatic, and the six month filing window is strict. How to claim it.
- The $3,000 HELPS Act exclusion. Eligible retired public safety officers can exclude up to $3,000 a year of health insurance premiums from taxable income. Who qualifies.
- Department benefits. The BSO retiree stipend and the Palm Beach County Firefighters' Retirement Insurance Fund are covered on those departments' pages.
At 65: Medicare
Your initial Medicare enrollment period is seven months long: the three months before the month you turn 65, that month, and the three months after. Most firefighters hired after March 31, 1986 paid Medicare tax on their pay, which is what generally earns premium free Part A.
If you stay on a retiree group plan past 65, ask the plan in writing how it works with Medicare. Most retiree plans expect you to enroll in Medicare Parts A and B and pay second, and missing your enrollment window can mean a late penalty that lasts for life.
I do not sell health insurance or Medicare plans. For free, unbiased Medicare counseling in Florida, call the SHINE program through the Elder Helpline at 1-800-963-5337.
Before your last day
- Get your department's retiree coverage deadline and premium in writing, for the month after you leave and at 65.
- If your spouse has coverage at work, find out their plan's deadline for adding you.
- Price a Marketplace plan on HealthCare.gov using your real expected income, including any DROP or 457(b) money you plan to take that year.
- Decide how you will take your DROP with the health insurance math in front of you, not after.
- File for the FRS Health Insurance Subsidy as soon as you are eligible.
- Put your Medicare enrollment window on the calendar, three months before you turn 65.
Common questions
How do Florida firefighters get health insurance after retiring before 65?
Most use one of four options: continuing on the employer's retiree group plan, which Florida Statute 112.0801 requires public employers to offer at no more than the active employee premium; COBRA for up to 18 months in most cases; a spouse's employer plan; or an individual Marketplace plan through HealthCare.gov. Medicare normally begins at 65.
Can my county or city drop me from its health plan when I retire?
Florida Statute 112.0801 requires a state agency, county, municipality, special district or district school board that offers group health coverage to give retirees the option of continuing it, at no more than the premium cost applicable to active employees. The cost may be paid by the employer or by the retiree, and each employer sets its own election deadline, so confirm yours in writing before your last day.
How long does COBRA last after I retire?
In most cases COBRA coverage for the covered employee lasts a maximum of 18 months, and the premium can be up to 102 percent of the plan's cost. For state and local government plans it is administered under the Public Health Service Act, with the Centers for Medicare and Medicaid Services having jurisdiction.
Are ACA Marketplace subsidies still available in 2026?
Premium tax credits still exist, but the enhanced credits expired on December 31, 2025 and, as of October 2026, have not been restored. Under the original rules, a household with income above 400 percent of the federal poverty level receives no premium tax credit.
Does a DROP payout affect my Marketplace health insurance subsidy?
It can. A DROP balance taken as cash counts as income in the year you take it, which can push household income above the 400 percent of poverty limit and eliminate the premium tax credit for that year. A direct rollover to another retirement account generally is not counted as income. Have a tax professional review the timing before you take the money.
When should a retired firefighter sign up for Medicare?
The initial enrollment period is seven months: the three months before the month you turn 65, that month and the three months after. Most firefighters hired after March 31, 1986 paid Medicare tax, which generally earns premium free Part A. Missing the window can mean a lifelong late enrollment penalty. Free counseling is available through Florida SHINE at 1-800-963-5337.
Official resources
- Florida Statute 112.0801, Group insurance; option of former employees to participate
- CMS, COBRA Continuation Coverage fact sheet
- CMS, Losing job based coverage: your Marketplace options
- ASTHO, ACA Enhanced Premium Tax Credits: Legislative Developments in 2025 and 2026
- Medicare.gov, When to sign up for Medicare
This material is for general educational and informational purposes only. It is not individualized investment, insurance, legal or tax advice. Mark Buckley does not sell health insurance or Medicare products.
Health coverage rules, premium tax credit law, employer plan terms and deadlines change, and Congress may still act on the premium tax credits after this page was reviewed in October 2026. This page summarizes published rules and is not a determination of your eligibility for any coverage or subsidy. Confirm your options with your employer's benefits office, HealthCare.gov, Medicare or a licensed insurance professional, and consult a tax professional about the timing of any withdrawal.
Mark Buckley is not affiliated with, endorsed by, or acting on behalf of the Florida Retirement System, any employer named on this page, the Centers for Medicare & Medicaid Services, HealthCare.gov or the SHINE program.
Investing involves risk, including possible loss of principal.