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Uninsured and Under 65: A Look at Your Options

If you’re an older American but don’t yet qualify for Medicare, you may face special difficulties in finding health insurance again. Older Americans who lose their health insurance due to job loss often have a harder time finding employment again than their younger counterparts—and it may take much longer for them to get a new job with benefits.

There are options for older Americans who don’t qualify for Medicare. But none of them are great options—many are expensive, and some those that aren’t often have strict qualification rules. Here’s a look at your options if you are too young for Medicare and find yourself without insurance.

Find a new job

Health Insurance

Millions of Americans fall into a difficult gap when it comes to insurance—too young for Medicare, too old to easily and quickly find a new job.

If you lost your health insurance benefits because you lost your job, often the best route back to full coverage is through a new job. If your employer covers your health care, chances are it won’t be prohibitively expensive, and you can’t be denied coverage. There are problems with this approach, however. The reality is that it’s often more difficult for older Americans to land new jobs than their younger counterparts, and you may need health insurance now—not in the few months it will take to find a new job.

Find out if you qualify for Medicare early

There are very limited times when Medicare is available for those under 65. Those who receive Social Security disability benefits and are afflicted with Lou Gehrig’s disease are eligible, as are those who have received Social Security disability benefits for other reasons for at least 24 months. In addition, if you have worked long enough to qualify in a federal, state, or local government position and meet the requirements of Social Security disability, you may qualify—even if you don’t currently receive disability benefits. If you receive disability benefits from the Railroad Retirement Board, you may be eligible for hospital insurance through the government after a certain waiting period.

Private health insurance

If you don’t meet the requirements for Medicare, your best option may be to buy private health insurance. This is easier said than done, however, especially if you are in an older age bracket. Certain health conditions may be excluded from coverage—either for a period of time or indefinitely. You may be able to buy coverage for pre-existing conditions for an additional cost, however—each health insurance company handles these conditions differently.

COBRA

If you lost your health insurance when you lost your job, your employer is required by law to allow you to keep your group insurance coverage for up to 18 months—while paying the same cost the employer paid. COBRA can sometimes be more expensive than general private insurance; however, it ensures you keep coverage, even for pre-existing conditions, while you search for a new plan or a new job.

HIPAA

If you exhaust your COBRA benefits before you can find a new job or a new plan, you may be able to get coverage through your state. HIPAA plans are often only available if you haven’t had a significant break in coverage—usually 63 days or more will disqualify you, although different states have different rules. HIPAA tends to be much more expensive than a general private plan—sometimes two or three times the cost. You can find out more about HIPAA options in your state by visiting your state insurance department website.

State-run high-risk insurance pools

You may struggle to find coverage because of a serious health problem. If that’s the case, you may be eligible through your state’s high-risk insurance pool—if there is one. Currently, only 33 states run high-risk pools that offer coverage for those who are medically uninsurable to traditional health insurance companies. The cost of these plans is often capped at around 125%-150% of the price you’d pay for a standard policy. And even if you qualify, you may not get coverage right away; some states have long waiting lists.

Medicaid

Medicaid is health insurance coverage for the financially destitute. If you have little or no financial assets, you may qualify for Medicaid—but each state’s income and eligibility requirements vary. Check with your state’s Department of Health or Department of Insurance office online to see if you qualify.

Millions of Americans fall into a difficult gap when it comes to insurance—too young for Medicare, too old to easily and quickly find a new job; with too much money to qualify for Medicaid, but not enough to afford expensive private options. If that sounds like you, your options may be few. Hopefully health care reform will bring better options for people who fall into these categories—and not too late for those who need it.