Under 65 Health Insurance

Under 65 Health Insurance

Over the age of 50, it can be difficult to pay for healthcare. Only around 65% of adults between the ages of 50 and 65 are covered by employer insurance. After losing employer group health coverage, it can be expensive for Americans age 50 to 65 to hold health insurance. In this age category, almost one in three adults spends 10% of their income on healthcare. Out-of-pocket costs can also be two-and-a-half times higher with private marketplace insurance compared to employer-sponsored insurance. This is often because insurance companies charge you higher premiums due to your relatively advanced age and therefore higher risk for health conditions.

Early retirement before you are eligible for Medicare can be challenging, but you can find coverage to bridge the gap with the Health Insurance Marketplace. The Department of Health and Human Services runs the Health Insurance Marketplace.

Individual and Family Health Insurance

The annual open enrollment period to buy health insurance is from November 15 to December 15. When you retire, you will have a special enrollment period lasting 60 days during which you can first sign up for a plan. These policies will likely cost more in out-of-pocket expenses than your employer coverage did.

COBRA

If you are within 18 months of qualifying for Medicare (at age 65), this can be a good option for you. The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows employees to stay with the same group health coverage they had under their employer for 18 months after you leave the company. With the same insurance, you do not have to worry about changing doctors or joining a new network. Only employers with more than 20 people can offer their former employees COBRA coverage.

Short Term Health Insurance

These less expensive policies give you less comprehensive coverage but may make sense in the short term versus buying an individual or family health insurance plan.

Medicaid

Medicaid is jointly administered by the federal and state governments. You can qualify for Medicaid based on your income and assets. You also have to be a U.S. national, a citizen or have an immigration status to be accepted into the program. Not all healthcare providers will accept Medicaid, so you may have to switch doctors.

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Medicare Under 65

Even if you are under age 65, you can qualify for Medicare if you fall under one of the following groups of people:

  • You have End Stage Renal Disease (kidney failure)
  • You have Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease)
  • You have been receiving disability benefits from Social Security or the Railroad Retirement Board for at least 24 months

Those with ALS will be automatically enrolled in Medicare once they begin receiving disability benefits. Those receiving disability benefits will be automatically enrolled in Medicare in the 25th month of receiving benefits. People with End Stage Renal Disease can choose to enroll in Medicare, in which case they need to enroll with Social Security online or in person at their local Social Security office. They can enroll during the annual election period from October 15 to December 7.

If you are under 65 and looking for a health insurance plan, Texas Medicare Advisors has you covered. We can help you find the plan you’re looking for, so just give us a call today at 512-900-3008.