Wall Street Journal Looks at Obstacles for ‘Near Elderly’ to Obtaining Insurance
The Wall Street Journal on Tuesday examined the "difficulty" for "near elderly" people -- those between ages 50 and 64 -- in obtaining health insurance through individual coverage plans "at the very time they are developing health problems that scare insurers." According to the Journal, the near elderly, who are too young for Medicare but old enough to be "vulnerable to layoffs or pushed into early retirement," have a "particularly tough" time trying to find affordable health coverage from insurers, which often say the age group carries too high a risk for serious health complications.
A 2002 study by the Urban Institute found that 18.4% of near elderly U.S. residents who said they were in "good health" were uninsured, compared with 9.2% who said they were in "excellent health" -- suggesting that "the near elderly with some health issues may have difficulty getting affordable insurance at a time in life when ... they need it," the Journal reports.
United HealthCare, in conjunction with AARP, is expanding a one-year pilot program offering lower-priced plans with looser standards for people ages 50 to 64. In the program, United only examines the past five years of consumers' medical histories and uses more lenient standards in accepting patients with certain conditions and establishing premiums for them.
The program, which has been available to consumers in Colorado, Illinois, Missouri, Nebraska and Ohio, also will now be offered to residents of Texas and Okalahoma. Jim Pogue, president of Ovations Insurance Solutions, the United unit that is running the pilot program, said the program has been profitable, in part because of the company's efforts in managing the care of consumers through "health-risk assessment" questionnaires and educational materials. The insurer also provides a nurse or clinician for consumers with serious conditions. According to Pogue, the plan helps the insurer prevent minor health conditions in customers from turning into bigger, more expensive problems (Rubenstein, Wall Street Journal, 11/16).