Medicare at 60 and Health Insurance Reform
- Learn about the proposal to offer Medicare at 60 by lowering the standard eligibility age from 65. Find out about the current status of the initiative to see if it could affect your healthcare options.
The Medicare system provides healthcare to nearly 66 million Americans every year. Most people become eligible for Medicare at age 65, though some beneficiaries may qualify before age 65 due to a qualifying disability or health condition. So what age is Medicare for?
The Biden administration's Medicare at age 60 proposal of 2021 would have involved changing the eligibility criteria for Medicare, lowering the eligibility age from 65 to 60.
About the Proposal To Provide Medicare at 60
On September 3, 2021, Representative Pramila Jayapal introduced H.R.5165, otherwise known as the Improving Medicare Coverage Act. The bill proposed lowering the Medicare eligibility age to 60 as a way to expand access to health insurance for older adults.
The bill also created a special enrollment period for Medicare and established a new program to provide financial assistance to low-income participants.
The changes that were proposed in H.R. 5165 would not have been permanent; they were designed to last for 5 years. Congress would most likely continue to renew the changes after 5 years, making the "impermanent" policy effectively permanent.
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Eligibility for Medicare at Age 60
If the Improving Medicare Coverage Act were to become law in its original form, it would make just one change to the current eligibility rules: lowering the minimum age. That means you could start getting Medicare at age 60, regardless of income.
In addition, the bill proposed changes to eligibility requirements for Medicare assistance, increasing the income limit to 200% of the federal poverty line.
This was intended to allow more people to participate in Medicare Savings Programs.
Who Is Currently Eligible for Medicare at 60?
Some people are eligible for Medicare, even if they have not reached the age of 65. This includes certain people with disabilities. If you're eligible for Social Security Disability Insurance, you can get Medicare after a waiting period of 24 months.
You may also be able to receive Medicare at or before age 60 if you have end-stage renal disease (ESRD) or Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's Disease.
Can You Be Eligible for Medigap Plans at Age 60?
Even if you qualify for Medicare at age 60, you may not be eligible for Medicare Supplement Insurance (Medigap). It depends on the insurance provider and your state's laws.
Federal law doesn't require insurance providers to sell Medigap policies to anyone under age 65. However, the individual company may decide to do so. Some states have laws that compel companies to offer Medigap plans to anyone who's eligible for Medicare, regardless of age. Others have guaranteed issue rights, which means that insurance companies can't increase prices or deny coverage for Medigap insurance based on your pre-existing health conditions.
Keep in mind that some states offer Medigap plans to people under 65, but with restrictions. In California, Massachusetts and Vermont, for example, insurance companies aren't obligated to offer these plans to people with ESRD.
If Medigap policies are available to younger Medicare beneficiaries, they may be more expensive than traditional plans.
The Improving Medicare Coverage Act may or may not affect eligibility for Medigap; in its current state, the bill does not address this issue. This may change as the bill moves through the legislative process.
Is Medicare at 60 Likely To Happen?
It's not clear if Medicare at 60 has enough bipartisan support to pass. Democrats introduced the bill; there were more than 100 Democratic cosponsors. Some Republicans have also voiced their support for lowering the eligibility age.
Opponents of the bill often express reservations about the cost. Reducing the Medicare age to 60 would open up the program to more people, increasing expenditures.
Given that the Congressional Research Service is already predicting trouble funding Medicare as it is, it's unclear how the government would pay for the expanded version.
If the Improving Medicare Coverage Act makes it through Congress in the future, it's almost certain to undergo changes. If you're starting to think about Medicare, it's worth paying attention to the progress of the bill — or any similar bills that arise — in the coming years.
