Pamela Stearns Devito Explains the Difficulty of Obtaining Health Care Prior to Medicare Age 65

Pamela Stearns Devito is a retired Human Resource and Benefits Administrator, currently living on Florida’s gulf coast. In the following article, Pamela Stearns Devito discusses healthcare in the United States, obtaining coverage as a retiree prior to age 65, and the options available to those not Medicare eligible.

Medicare is the federal health insurance program for millions of people in the United States. However, the general eligibility rule for Medicare is that a person must be sixty-five years of age or older, which means that many early retirees are not eligible for health care through this program. While there are a few situations in which people under the age of 65 may qualify for Medicare coverage, it’s important to note that these exceptions are very rare. For example, Pamela Stearns Devito says that those with certain disabilities or health conditions, such as end-stage renal disease or Lou Gehrig’s disease, may be able to enroll in Medicare before 65.

So, how can one get healthcare before turning 65?

Pamela Stearns Devito explains below some ways a person can obtain healthcare before turning 65.

COBRA

COBRA gets its name from the Consolidated Omnibus Budget Reconciliation Act. It was introduced in 1985 and allows people to keep employer-sponsored health insurance after certain circumstances like a change in their own job status, such as retirement.

HEALTH PLAN MARKETPLACE (Obamacare)

You may be able to afford health insurance through the marketplace (www.HealthCare.gov) and health insurance exchanges and taking advantage of advance premium tax credits. Advance premium tax credits are available to anyone based on income. You may qualify for a premium subsidy as the American Rescue Plan Act (ARPA) eliminated the subsidy cliff through 2025. What this means is that the government has relaxed the income limits and so many more people will get the cost of their premium reduced through the premium tax credit.

Individual private health insurance

Individual private health insurance is a plan you purchase from a non-government exchange, such as an insurance agent or broker. Shopping on a private exchange allows you to have more variety in your coverage options, although a person may be required to provide medical history to qualify.

Short-term health insurance

Short-term health insurance is a type of limited health insurance coverage that lasts for a brief time; you can get a short-term health insurance policy that lasts for as long as you need, as long as it’s under a year in length. The most common use of this type of plan is to bridge a gap in coverage until you are eligible somewhere else.

Joining a family member’s plan

You may be eligible to join a family member’s plan provided you qualify for inclusion. A family member can add his/her spouse (and children under the age of 26) to their existing plan. Dependents can be added provided you claim them as dependent on your taxes.

Medicaid

Medicaid is a federal program that’s administered at the state level. You have to have income and assets that are lower than your state’s maximum income limit to qualify. Check with your state’s Medicaid program to find out more about qualifying.

Final Thoughts

Overall, Pamela Stearns Devito says that it’s clear that the Medicare age requirement of 65 years is an important factor when it comes to accessing quality health care. While there are some exceptions, most people will need to meet this minimum age in order to qualify for Medicare coverage and access essential medical services.

However, there are different options available for those who are unable to meet this age requirement, as outlined above. So, whether you’re getting close to Medicare age or are still a few years away, it’s important to explore all of your options for obtaining affordable and quality health care.