Medicare at 60 and Health Insurance Reform

Christian Worstell
In this article...
  • 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 affordable healthcare to nearly 64 million Americans every year. As of 2022, 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.

The Biden administration's Medicare at age 60 proposal of 2021 would involve 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 proposes lowering the Medicare eligibility age to 60 as a way to expand access to health insurance for older adults.

That's not all — the bill also creates a special enrollment period for Medicare and establishes a new program to provide financial assistance to low-income participants.

The changes that are proposed in H.R. 5165 would not be permanent; they're designed to last for 5 years. At this point, Congress would need to re-evaluate and take further action.

The Improving Medicare Coverage Act was referred to the Subcommittee on Health on September 6, 2021. For the Medicare eligibility age to change, the bill would need to pass the House and Senate before going to the President to sign into law. If that happened, the bill would come into effect 6 months later.

Eligibility for Medicare at 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 proposes changes to eligibility requirements for Medicare assistance. It recommends increasing the income limit to 200% of the federal poverty line. This would allow more people to participate in Medicare Savings Programs. Plus, it would allow participants to access joint eligibility decisions if they also want to get the low-income subsidy to help with prescription drug costs.

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). To qualify, your kidneys must not function; you must also be in dialysis or have gotten a kidney transplant. In addition, you must meet one of the following criteria:

  • Eligible for or receiving Social Security or Railroad Retirement benefits
  • Met the work requirements for the Railroad Retirement Board, Social Security or a government agency
  • Are the spouse or dependent of someone who fulfills one of the first two criteria

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?

Until the Improving Medicare Coverage Act makes it out of committee, 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. Program costs are still in question, as the Congressional Budget Office has not released a cost estimate as of May 2022.

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.

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@MyHelpAdvisor.com.

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