During the last half of 2021, while legislators were trying to put together the finer parts of the Biden administration’s Build Back Better plan, there was talk of lowering the qualifying age for Medicare from 65 to 60.
It was a very popular measure many retirees support; unfortunately, legislators struck it from the bill at the last minute. But that doesn’t mean future legislation won’t change that. Keep reading for more info about what Medicare at 60 looks like and how it would affect you.
What people who oppose expansion want you to know
Some conservative think tanks have estimated that expanding Medicare to people between the ages of 60 and 64 could cost the federal government somewhere between $380 billion and $1.8 trillion over the next ten years.
The latter number might happen if employers jump on the bandwagon and stop offering health insurance for their employees aged 60 and over.
They argue that the trust fund funding Medicare Part A benefits is rapidly depleting and that the government can’t afford the extra expense of taking on nearly 4 million more Medicare beneficiaries.
But that $1.8 trillion isn’t a debt that will appear out of thin air if such legislation passes. Other entities are currently paying that $1.8 trillion cost. Currently, the private sector is paying these bills, where employers have to pay for health insurance for their employees to have happy, healthy, productive workers.
It’s coming out of the pockets of Americans between the ages of 60 and 64 who are uninsured and paying for their health care costs out of pocket, or the underinsured who are paying with the help of a confusing and expensive private health insurance plan.
On top of that, these businesses and individuals are also paying taxes that fund the Medicare program simultaneously. In many ways, providing government funding so that Americans age 60+ can have healthcare is just shifting the burden.
So, the real debate lies in whether the federal government should take on that expense and alleviate that burden from businesses and individuals or whether things should stay the way they are.
What people who support Medicare expansion want you to know
Rep. Pramila Jayapal is one of the federal government’s most dedicated proponents of Medicare expansion right now.
Her original legislation expands Medicare to individuals 60 years and older in the Biden Administration’s Build Back Better plan. Under this plan, retirees between the ages of 60-64 could be eligible for the following benefits:
- A Medicare Cost Assistance Program would eliminate premiums, coinsurance, and deductibles for recipients whose income is 200% or less of the Federal Poverty Level
- No premiums for Medicare Part D for recipients whose income is 200% or less of the FPL
- In that same income level, generic prescription drugs will have a maximum $1.30 copay, and brand name drugs will have a maximum $4.00 copay.
- A streamlined, simplified application process for Medicare/Medicaid savings programs
Nearly 12 million Medicare beneficiaries may qualify for this cost assistance program if it were to become law, alleviating crippling healthcare costs for many beneficiaries.
And because most of the funding is already available in the form of fully funded Medicare and Medicaid Savings Plans — funds which are often never claimed because the current application process is so onerous and complicated — worries about paying for the program are not necessarily as dire as some people believe.
Medigap and Medicare at 60 – Unanswered questions
It’s unsure when — or even if — Medicare at 60 years of age will be available for American retirees. The recently passed legislation was the best chance that proponents of such laws have had in a long time to get effective changes made.
And given how tumultuous the political climate has been over the past several years, the future of Medicare expansion feels very uncertain.
But if the legislation were to pass, there are still some unanswered questions about how it would work – especially regarding Medicare Supplement insurance.
While the Jayapal bill is engineered to make Medicare so affordable that beneficiaries won’t need supplement insurance, that doesn’t mean there aren’t people who could benefit from having that type of coverage.
Here are some questions about how Medigap would work if Medicare were expanded to citizens aged 60-64.
Will beneficiaries under the age of 65 be eligible for Medigap?
The current law does not mandate that Medigap providers offer Medigap plans to beneficiaries under age 65, even if those beneficiaries can enroll early for other reasons (such as serious illnesses like ESRD).
It’s unclear whether the law would require a change to prompt Medigap providers to include younger beneficiaries or whether the cost reduction measures would render Medigap plans moot for that narrow age group.
Will beneficiaries lose guaranteed issue rights?
There is a narrow window of opportunity for Medicare recipients to enroll in a Medigap plan and still be eligible for guaranteed issue rights.
Individuals have the right to sign up for Medicare Supplement insurance without fear of rejection or undergoing health screenings, which may cause their plan to incur higher costs due to pre-existing conditions.
But changing the age of eligibility would significantly disrupt that timeline. Legislators can change the law to ensure that they protect enrollees who get Medicare before age 65 from higher charges for pre-existing conditions or rejection of coverage based on their current health status.
It looks as though most retirees will have to wait until age 65 before being eligible for Medicare enrollment in the foreseeable future. But even if you’re between 60 and 64, it’s never too early to start planning ahead.
FAQs
At what age does a woman qualify for Medicare?
Both men and women qualify for Medicare at age 65. You can get Medicare before 65 if you have specific disabling conditions or circumstances.
At what age can you get Medicare?
Unless you have a qualifying chronic health condition or have been disabled for 24 months, you’ll have to wait until you’re 65 to enroll in Medicare.
Can I get medicare at 55?
You can enroll in Medicare before 65 if you have ESRD, Lou Gehrig’s disease (ALS), or another qualifying disability. Sometimes, you must wait 24 months from the start of your disability benefits before Medicare begins.
Get help reviewing your Medicare options
The more knowledge you have, the easier it will be to sort out your Medicare needs when it comes. So call us if you’re ready to start the process and find the right Medicare plan for you. You can also complete our online rate form to get rates as well.
