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 that many retirees supported; unfortunately, it was removed 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 are 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 gets passed. Other entities are currently paying that $1.8 trillion cost. It’s being paid for by the private sector, where employers have to take on the cost of providing 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 was used as the basis for expanding 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 would qualify for this cost assistance program if it were to be passed into 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 between the ages of 60-64.
Will beneficiaries under the age of 65 be eligible for Medigap?
As the law stands now, Medigap providers aren’t required to offer Medigap plans to beneficiaries under the age of 65, even if they are allowed to enroll early for other reasons (like having a serious illness such as ESRD).
It’s unclear whether the law would need to be changed to prompt Medigap providers to include younger beneficiaries or whether the cost reduction measures would make 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.
This right is the right to sign up for Medicare Supplement insurance without fear of being rejected or undergoing health screenings, which may cost their plan more due to pre-existing conditions.
But changing the age of eligibility would significantly disrupt that timeline. Legislators would have to make changes to the law to ensure that enrollees who get Medicare before age 65 are still protected from being charged more for pre-existing conditions or being rejected for 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.
The more knowledge you have, the easier it will be to sort out your Medicare need 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.