Most Americans know that they can qualify for Medicare at age 65, although there are a few exceptions that allow younger individuals to qualify as well. However, Democrats in the Biden administration have introduced legislation that could lower the Medicare eligibility age to 60. Many people wonder what Medicare at 60 would look like, including how much it would cost and what the eligibility criteria would be. While this proposed change has not taken effect yet, it could affect your health insurance coverage if it does. Keep reading as we give you all the details on what Medicare at age 60 might look like.
Medicare At Age 60: What Does It Look Like?
Today Medicare eligibility starts at age 65. There are exceptions for those who have received Social Security disability benefits for 24 months or those diagnosed with ALS or End-Stage Renal Disease (ESRD). During his presidential campaign, President Joe Biden expressed his desire to lower the eligibility age to 60. This would provide additional health care options to those who retire early or are unemployed. The job market is often tougher for older individuals, so those people are often left without group health insurance if they are unable to find a job. Even though the Affordable Care Act (ACA) greatly expanded access to health care coverage, many think that more can be done. Congress has now introduced legislation that could make President Biden’s desire a reality. This Medicare For All bill was introduced by Representative Pramila Jayapal.
So, just what would Medicare coverage for 60 year-olds look like? Many aspects would likely look the same as they do today — simply with a lower eligibility age. Those with sufficient work credits would likely still receive Medicare Part A with no premium. This premium-free coverage does raise some concerns, though. The hospital insurance trust fund is already projected to become insolvent in a few years. Enrolling millions of uninsured Americans in the 60 to 65 age group would cause the fund to run out of money even faster.
Medicare Part B would still include a premium, even for enrollees with sufficient work credits. Remember that Part B includes a late enrollment penalty today for anyone who does not sign up during their initial enrollment period. There is still some question as to whether that penalty would apply under the new legislation. If it does, no one knows for sure when the penalty would take effect. Would you then be required to sign up for Medicare at age 60, or would the penalty still apply only if you waited past age 65? The answer to that question is not known at this point in time.
Eligibility For Medicare At Age 60
To understand what eligibility for Medicare might look like at age 60, it helps to understand what eligibility looks like today. Today, you become eligible for Medicare at age 65 as long as you have been a U.S. citizen for at least five years. If you are already receiving Social Security benefits, then you will be automatically enrolled in coverage. Those who are not yet receiving retirement benefits will need to apply for coverage. If the proposed Medicare legislation passes the House and Senate, then here is what you can expect.
You would become eligible for Medicare at age 60 instead of age 65. The five-year U.S. citizenship rule would likely still apply. Since most people are not receiving Social Security benefits at age 60, they would need to apply for Medicare coverage at that age manually. The provisions that allow younger individuals to qualify for Medicare likely would not change.
Younger individuals would still be able to receive Medicare after having been on Social Security disability benefits for at least 24 months. Similarly, younger people who are diagnosed with ALS or ESRD could still sign up for Medicare as well. Remember that Medicare and Medicaid are two completely separate insurance programs. Medicare is administered by the Federal government, and it mostly provides coverage for older individuals. Medicaid, on the other hand, is primarily administered by state governments. It is meant to provide health coverage for low-income individuals and families.
Medicare Costs At Age 60
Medicare costs at age 60 may not be much different than they are today at age 65. For those people who have at least 40 work credits, Part A coverage would probably still be provided with no premium. If you do not qualify for premium-free Part A coverage, the monthly premium is currently either $274 or $499 per month, depending on how much work history you have. When it comes to Part B coverage, everyone pays a premium for it.
The premium for Part B coverage is currently $170.10 per month. This premium is adjusted on a sliding scale depending on your income. The more income you have, the higher your premium will be. You could pay as much as $578.30 each month for your Part B premium. Part C plans, or Medicare Advantage plans, vary in cost. Each of these plans is administered by a private insurance company, so the details of each plan vary according to the coverage details, copay amounts, and deductibles. This is also true of Medicare Part D prescription drug plans.
One difference between the new Improving Medicare Coverage Act and the existing cost structure is that the act expands subsidies for low-income beneficiaries. Those who have an income that is below 200% of the Federal poverty level would be eligible for a Medicare Cost Assistance Program that would eliminate premiums for those people. This applies to both the Part A and Part B premium, and it does not matter how many work credits you have.
Remember that premiums are not the only costs associated with Medicare coverage. Just like with most insurance plans, beneficiaries will also have many out-of-pocket expenses. You might be required to pay copayments and deductibles when you receive treatment from your provider. Just because Congress decides to implement a lower Medicare eligibility age does not mean that the affordability of health coverage will improve. Health care costs have continued to rise in recent years, and this applies to Medicare recipients as well. Since its inception, Medicare has traditionally had low reimbursement rates for providers, so many health care providers do not support the lowering of the eligibility age.
Medigap At Age 60
Another big question about this new legislation is how Medicare Supplement plans will be handled. Today, Medigap plans exist to help Medicare beneficiaries with out-of-pocket expenses not covered by Medicare. Medicare coverage provides payment for 80% of the cost of most services and procedures. Medigap plans can help pay for the 20% of the cost that is not covered. Eligible individuals can enroll in a Medigap plan today during the Open Enrollment period. They can choose to have their plan begin at the same time as their Part B coverage. If they enroll during this period, their health will not affect whether they are accepted into a plan.
Medigap rules vary today from state to state. Lawmakers have not made it entirely clear how the Medicare expansion would affect the existing Medigap rules. Today, the state laws govern whether Medigap plans must be available for those under 65. There seems to be no consensus on whether that would change going forward. It might mean that even though you are eligible for Medicare at age 60, you might not have access to a Medigap plan until you turn 65. Similarly, it is unknown whether guaranteed issue rights would apply to those in the 60 to 65 age group. This means that you cannot be denied coverage due to an existing health condition. The proposed new law is unclear on how that rule would apply to the new eligibility group.
The Bottom Line
Medicare has traditionally been available for those age 65 and older or younger individuals receiving Social Security disability benefits. However, a recent proposal in Congress could lower the eligibility age to 60. Many aspects of Medicare might still look very similar, like the requirement of work credits for premium-free Part A coverage. However, many questions still exist about Medigap and supplemental coverage for those in the new age group. However, unless the Democrats can gain support from conservative party members like Joe Manchin, the new proposal might never become law anyway.
Frequently Asked Questions
Will the Medicare age be lowered to 60?
It is impossible to say whether the Medicare age will be lowered to 60. However, legislation has been introduced in Congress that would do that. This lowering of the eligibility age is something that Joe Biden pushed during his presidential campaign. Now that he is president, Congress is attempting to get the age lowered through new legislation. Even though Democrats currently control the House of Representatives, they will have a more difficult time getting the legislation through the Senate. Many people do not support the legislation, and lowering the eligibility to 60 could present real problems for the solvency of the Medicare program. Medicare is funded through payroll taxes and premiums, so lowering the age of eligibility could put a financial strain on the program. There are also questions about how Medigap and the guaranteed issue rules would be affected by this new bill. On the other side of the coin, there have also been talks in the past about raising the Medicare eligibility age to 67 to help Medicare remain solvent.
What is the earliest age you can get Medicare?
The earliest age that most people can get Medicare is 65. However, there are a few exceptions. If you have been receiving Social Security disability benefits for 24 months, you will be enrolled in Medicare coverage regardless of your age. Similarly, younger individuals who have been diagnosed with Lou Gehrig’s Disease (ALS) or End-Stage Renal Disease (ESRD) can apply for Medicare benefits. If the proposed Medicare expansion takes place, the general eligibility age would be lowered to 60. This means that you would become eligible for Medicare at age 60 instead of 65. Since most people are not receiving Social Security retirement benefits at age 60, the people in that age group would need to manually apply for Medicare upon becoming eligible.
What is the difference between Medicare Part A and Part B?
There are a few differences between Medicare Part A and Part B. The biggest difference is in the coverage provided by each part. Medicare Part A is considered hospital insurance. It covers hospital stays and inpatient care. Part B, on the other hand, is medical insurance. Part B covers doctor’s office visits, outpatient care, and many preventive services. This includes things like the flu vaccine, pneumonia vaccine, hepatitis B vaccine, lab tests, and preventive screenings.
The other difference is in the amount of the premium. If you have enough work credits, then you will not have to pay a premium for Part A coverage. Those without enough work credits can still receive Part A, but they will need to pay a monthly premium. Part B always includes a monthly premium. The amount that you pay for Part B coverage depends on your income. The more money you make, the more you will be required to pay. Part B coverage is also optional. You can choose whether or not to enroll in Part B, while enrollment in Part A is mandatory.
Is Medicare available to people who are under 60?
Medicare is available to people under 60, but only in a couple of circumstances. The most common way that you can receive Medicare under 60 is if you have been receiving Social Security disability benefits for at least 24 months. You can also receive Medicare before age 60 if you have been diagnosed with ALS or End-Stage Renal Disease. The proposed legislation that could lower the eligibility age to 60 would not affect these exceptions. Even though the legislation could lower the general eligibility age to 60, the ways to get Medicare before age 60 would remain the same. It is still yet to be determined whether the legislation will pass and take effect.