How To Get Health Insurance If You’re 55 Or Older


WRITTEN BY: Craig Sturgill

UPDATED: DECEMBER 21, 2022 | 3 MIN READ

Health insurance is vital, especially the older you get. Many agree that age can take a toll on our bodies. Illness, injuries, or disabilities can creep up on us as we age, and we find that good health insurance can save us a bundle while saving our physical and mental health. Today we’ll discuss how to get excellent health insurance if you’re 55 or older. 

Can you get Medicare coverage at 50 years old?

Most people associate Medicare with adults who are 65 and older. However, that doesn’t mean those under 65 can’t or won’t qualify for Medicare coverage. If you’re 50 years or older, you may qualify if you meet any of the following qualifications:

  • If you’ve been diagnosed with Lou Gehrig’s disease (ALS), you immediately be eligible for Medicare.
  • If you receive disability from the Railroad Retirement Board and meet specific criteria.
  • If you receive Social Security Disability for at least 24 months.
  • If you’ve been diagnosed with ESRD (End-Stage Renal Disease) and contributed to Social Security taxes for enough time.

What is the best health insurance for those over 50?

When over 50, you’ll need to ensure you get excellent health coverage at a reasonable and fair price. Some of the most popular options and best choices for health insurance come in various forms. The most common form of health insurance among American adults is employer-sponsored health insurance. This is a form of health coverage that your employer provides employees. 

In most cases, your boss will pay for a part of your premiums with you. You’ll typically be offered a few policy options through your employer, which is the most popular form of obtaining health coverage. Another popular option for health insurance among Americans over 50 is health plans available through the health insurance Marketplace. These Marketplace plans are also known as on-exchange policies and tend to be more affordable and are based on your income. 

If you’d instead buy your policy, this is an option as well. These plans are referred to as off-exchange insurance policies, and you can buy them directly through the health insurance company of your choice or the insurance broker. You’ll typically have a much more comprehensive range of coverage options if you buy insurance this way, compared to an on-exchange policy. Medicare may be an option for people 55 and older if they meet specific health requirements that Medicare would approve for early enrollment. Medicare is generally for adults 65 and older, but certain health conditions sometimes qualify for Medicare at a much younger age, like if have End-Stage Renal Disease (ESRD). 

Medicaid is a low-cost health insurance program that helps cover insurance for low-income individuals and families. Each state has a Medicaid program, and their qualification requirements vary, depending on the state you live in. Medicaid can help cover some of your medical costs if not all. To qualify for Medicaid, you must live in the state where you’re applying, and your annual gross income must fall at or below the Federal Poverty Level (FPL). 

At What Age Do You Qualify For Medi-Cal?

Medi-Cal is a Medicaid program based in California. You have to meet income requirements to qualify, but you can also qualify if you’re 65 or older.

Benefits of getting a high-deductible health plan

A high-deductible health plan is what it sounds like it is. It’s a health plan that carries a higher deductible but, in turn, carries a lower premium each month. A lower monthly premium is a benefit all in itself. This is an excellent option for those who can afford a larger payment initially and don’t foresee too many health issues in the near future. 

Another great benefit of high-deductible health plans is your Health Savings Account (HSA) options. Your HSA account is tax-free; if you have a balance remaining at the end of the year, that money will roll over into your HSA account for the new year. Another benefit of high-deductible plans is using your HSA to pay for health care expenses with pre-tax money. So, you’re saving money because you’ll pay significantly more if you pay these medical costs with post-tax dollars. 

The Affordable Care Act and its effect on people 55 and older

The Affordable Care Act (Obamacare) carries many benefits for Americans 55 and older. The popular healthcare option helps regulate monthly premiums for older adults and limits premium costs that often increase based on age. So, older Americans will be charged up to three times what a premium would be for a younger insurance beneficiary. 

The pros and cons of Medicare

Medicare comes with both pros and cons. Some of the best perks of having Medicare coverage come from lower monthly premium costs. Most beneficiaries won’t have a premium for Medicare Part A coverage; the most common Part B premium in 2023 is $164.90. Medicare also provides a variety of providers, hospitals, doctor visits, and other facilities contracted with Medicare. This means staying within the network is much easier to do than with some other insurance companies. 

Some cons of having Medicare coverage include a lack of vision and dental health benefits. While you can always purchase additional coverage, Original Medicare won’t cover these services. And while Medicare covers 80 percent of your incurred medical expenses, you’ll still be responsible for the remaining 20 percent coinsurance (cost-sharing) amount, plus applicable copays or deductibles. Depending on your health care condition, this can add up quickly and cost you quite a bit out-of-pocket. 

The average monthly premium for a 55-year-old adult

As we age, our healthcare bills increase. Once you hit age 50, your health expenses rise steadily. The average monthly premium doubles the average premium cost once you hit age 53. Once you turn 55, the average monthly premium is around $446. Then, once you turn 60, the average premium jumps nearly $100, costing you about $543 per month. 

Most individuals that are 55 years old are too young for Medicare. They would need to look for health insurance coverage from the ACA Marketplace.

FAQs

What are the best options for health insurance for a 50-year-old?

Traditional health insurance is the best choice for adults under 65 and over 50 years old. Whether you have a health insurance plan through your employer, the ACA Marketplace, or you pay for your insurance. Some of the most popular insurance companies among older Americans include:

  • United Healthcare
  • Aetna
  • Cigna
  • Blue Cross Blue Shield
  • Mutual Of Omaha

Why would you need to get health insurance at age 55 and up?

Health insurance is essential at any age. But you’ll find the older you get; the more your health begins to decline. You become more prone to illness, injury, or disability the older you get. So, it’s no surprise that your healthcare costs increase with age. When you become more prone to illness and injury, your medical insurance risks paying out more money in medical claims. So, to offset these potential costs, your insurance company raises it’s premium amounts, making you pay more out-of-pocket expenses.

What is the lowest income to qualify for Obamacare?

To qualify for Obamacare, you must first meet specific income requirements. In 2023, for a single person, you must earn at least $13,590 to qualify for Obamacare. If you’re applying for a family of four, you must make a minimum of $27,750 to qualify for plans through the Marketplace. In addition to finding affordable health plans, you may be eligible for tax credits. 

Have questions about getting health insurance?

We are here for you if you’re unsure about your current health insurance coverage or need to start health care coverage. Our team of agents can answer all your questions, and we can compile various quotes for you in just minutes. No time to call? That’s okay; complete our online form, and we can provide you with a quote almost instantaneously.