Medicare Buy-In for Boomers 55+

It seems that the Boomer generation is in a no man’s land when it comes to many things. Too old for this, too young for that. And Medical coverage is at the top of the list. Especially if you are ready to retire.

The issue is that if you retire early and try to keep your health insurance, it costs a fortune that most people cannot afford. On the other hand, finding your own individual plan can also cost an arm and a leg and provides less coverage than your medical coverage from work.

There may be a solution coming soon. Medicare may shortly have a buy-in for individuals between 55 and 64 years of age. This could solve a great many problems. The doctors and hospitals would get paid. The insured would be able to continue with their services and with their personal physician in most cases and the Medicare system would have money coming in to offset the expense of treating this group of people.

In addition, statistics show that people age 55 to 65 usually have less medical issues and less medical treatment than most people 65 and older. As a group, they have taken care of themselves better, they are healthier – or at least, the onset of serious health issues that come with age haven’t set in yet – and they tend to see the doctor less, using prevention rather than a cure.

The Medicare Buy-In may take a little time to put into place. Lawmakers are working out the details that would help cover the over 5 million boomers between age 55 and 64 who are uninsured. There would be premiums on a monthly basis to the tune of a few hundred dollars, but the premiums should be less than keeping up with payments for the insurance from the old job and COBRA.

Though the idea has been discussed for years, conditions right now are just right for a program like this to start. For questions, contact the Medicare office nearest you.

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What is the Medicare Buy-In Program?

Medicare benefits are usually thought of as being only for those people age 65 and over.  However, there are exceptions to this.  There are individuals with disabilities and others who are eligible for Medicare.

There is a program called the Medicare Buy-In Program which includes QMB (Qualified Medicare Beneficiary) and also SLMB (Specified Low-Income Medicare Beneficiary).  The program is designed to help keep low-income Medicare recipients from having to pay the increasing Medicare costs that are continuing to rise, so that these particular Medicaid beneficiaries do not lose their benefits.  This includes helping beneficiaries with co-pays and deductibles. 

In an effort to make this happen and help keep coverage in tact for individuals who need it most QMB and SLIMB combine Medicare and Medicaid.  Medicaid pays part or all the premiums and deductibles for the individual or family’s Medicare coverage for individuals who qualify financially.

QMB (Qualified Medicare Beneficiary) Program serves individuals or families of little means who need assistance the most. Their assets must be under $4,000 per individual and $6,000 per couple, and their combined income must not exceed 100% of the federal poverty level.  In addition, the state Medicaid plan pays the Medicare part B premium and other costs that they would normally share. SLIMB only pays only the Part B premiums for people whose income is between 100 and 130% of the poverty limit, with assets of $4,000 per person or $6,000 per couple. 

There are various states that have this program available. If you need assistance and think you might qualify, contact your local health department, your doctor or your local hospital.  You can also find information at www.medicare.gov or www.medicaid.gov.

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