Over the age of 50, it can be difficult to pay for healthcare. Only around 65% of adults between the ages of 50 and 65 are covered by employer insurance. After losing employer group health coverage, it can be expensive for Americans aged 50 to 65 to hold health insurance.

In this age category, almost one in three adults spends 10% of their income on healthcare. Out-of-pocket costs can also be two-and-a-half times higher with private marketplace insurance compared to employer-sponsored insurance.

This is often because insurance companies charge you higher premiums due to your relatively advanced age and therefore higher risk for health conditions.

Early retirement before you are eligible for Medicare can be challenging, but you can find coverage to bridge the gap with the Health Insurance Marketplace which is a resource for anyone who wants to compare plans or get their insurance questions answered.

The Health Insurance Marketplace is run by The Department of Health and Human Services and to be eligible to use the Insurance Marketplace you must live in the United States and be a lawful citizen of the country.

Once you start researching the market, you can take the time to compare different types of health insurance and available plans based on price, benefits, quality, and other features you might find important for your individual situation.

There are many health insurance options available but some research and reflection from your side are needed to find the right one.

and Family Health

Individual health insurance policies are available to individuals who currently are not enrolled in either a government program such as Medicare or Medicaid or in a job-based policy.

Medical costs you need to have in mind while purchasing a health insurance program are the deductible (the amount you must pay in full before the plan’s benefits begin), copayments (your portion of medical costs you need to pay after paying the price of your deductible), and the out-of-pocket max which is your spending cap on medical costs.

Once you reach the out-of-pocket max, your plan is responsible for paying for all your services in full.

A family policy works the same way as an individual plan, except that it will cover multiple people. Often, this will increase the deductible, out-of-pocket maximums, and monthly cost.

The annual open enrollment period to buy health insurance coverage is from November 15 to December 15. When you retire, you will have a special enrollment period lasting 60 days during which you can first sign up for a plan.

These policies will likely cost more in out-of-pocket expenses than your employer coverage did.


If you are within 18 months of qualifying for Medicare (at age 65), this can be a good option for you.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as reduction in the hours worked, voluntary or involuntary job loss, during the transition between jobs, death, divorce, and other challenging life events.

With the same insurance, you do not have to worry about changing doctors or joining a new network. Only employers with more than 20 people can offer their former employee’s COBRA coverage. COBRA can save you money on out-of-pocket costs.

Employer-sponsored health plans may provide broader networks than non-group health plans if you travel out of state or have more than one home.

Short Term
Health Insurance

Short-term health insurance is a type of health plan that can provide you with temporary medical coverage when you are between health plans, outside enrollment periods, and need some coverage in case of an emergency situation.

Also, short-term health insurance could be a good idea if you are someone who is generally healthy and don’t require regular health services or prescription medication.

Short-term medical insurance typically provides some level of coverage for preventive care, doctor visits, urgent care, and emergency care.

There may also be coverage for prescriptions or in other words a prescription drug plan of some kind. Some plans also offer cost savings for seeing in-network providers.

These less expensive policies give you less comprehensive coverage but may make sense in the short term versus buying an individual or family health insurance plan.


Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources.

The federal government has general rules that all state Medicaid programs must follow, but each state runs its own program which means that eligibility requirements and benefits can vary from state to state.

Medicaid is jointly administered by the federal and state governments.

You can qualify for Medicaid based on your income and assets. You also have to be a U.S. national, a citizen or have an immigration status to be accepted into the program. Not all healthcare providers will accept Medicaid, so you may have to switch doctors.

Medicaid offers benefits that Medicare doesn’t usually cover, such as personal care services and nursing home care.

People with Medicaid usually don’t pay anything for covered medical expenses but may owe a small co-payment for some items or healthcare services.

Five Common



and how you can avoid them

Five Common Medicare Mistakes Book Cover

Even if you are under age 65, you can qualify for Medicare if you fall under one of the following groups of people:

  • You have End Stage Renal Disease (kidney failure)
  • You have Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease)
  • You have been receiving disability benefits from Social Security or the Railroad Retirement Board for at least 24 months


Those with ALS will be automatically enrolled in Medicare once they begin receiving disability benefits. Those receiving disability benefits will be automatically enrolled in Medicare in the 25th month of receiving benefits. People with End Stage Renal Disease can choose to enroll in Medicare, in which case they need to enroll with Social Security online or in person at their local Social Security office. They can enroll during the annual election period from October 15 to December 7.

If you are under 65 and looking for a health insurance plan, Texas Medicare Advisors has you covered. We can help you find the plan you’re looking for, so just give us a call today at 512-900-3008.

Medicare Under 65​

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