Unlocking Affordable Health Insurance for Seniors Over 65

The Affordable Care Act  introduced new ways to help with health insurance costs for people ages 50 to 64, and the number of Americans age 65 or older enrolled in nongroup (individual) health coverage has increased. However, affordability remains a challenge for many of these seniors.

Roughly 1 in 4 American adults ages 50 to 64 say health care costs are a major financial burden, according to a recent West Health-Gallup survey. The high cost of health insurance, combined with the fact that many retirees no longer have employer-sponsored or other group health insurance, can make it difficult for older adults to afford the coverage they need.

Most older adults are eligible for Medicare, a national health insurance program for people over 65 and those with disabilities. If you are already a retiree or a beneficiary of Social Security, you can sign up for Medicare Part A and Part B during your initial enrollment period, which lasts three months before the month you turn 65, and ends three months after. If you decide to enroll in Medicare, you Go to the article may also choose a stand-alone prescription drug plan, called Medicare Part D. Most people who choose Medicare Advantage plans do not need to sign up for a stand-alone prescription drug plan, because their plan includes prescription drug benefits.

Those without retiree coverage or who lose their job-based coverage may be able to buy health insurance through the Marketplace. The Marketplace provides a simplified way to shop for health plans and compare prices, and you can get help paying for the monthly premium if you have income-based assistance. Your household size and income determine what you pay for your plan, as well as whether or not you qualify for free or low-cost coverage through Medicaid.

Many New York City residents have access to free, confidential and in-person help with Medicare questions and concerns through NYC’s Health Insurance Information Counseling and Assistance Program (HIICAP), available by calling 311. You can also learn more about the ACCESS NYC website to see which City, State and Federal health and human service benefit programs might be right for you. Depending on your household size and income, you might be eligible for an Advanced Premium Tax Credit or other savings to help pay for the health plan of your choice. The ACA makes it easier for people who want to buy an individual market health plan or Medicare to find out if they qualify for financial help. This helps ensure more people have access to affordable, quality health insurance. The ACA also made it easier for people with employer-sponsored or other group coverage to keep their health insurance when they leave or change jobs, or when their current plan is discontinued. Previously, this could only happen during an open enrollment period. Starting in 2021, the ACA will allow more frequent enrollment periods, making it easier to switch plans and providers. This will especially help people who are transitioning from employer-based or other group coverage to Medicare.