Summary

In 2006, near-elderly adults were less likely to be uninsured than younger adults and they were also more likely to have coverage for the full calendar year. However near-elderly individuals lacking coverage were also more vulnerable to the high health care costs associated with serious and chronic illnesses that emerge at older ages. For example, roughly 60% of near-elderly adults who were uninsured throughout 2006 had at least one chronic condition compared to 35% of uninsured younger adults. Those conditions can be expensive, with full-year insured near-elderly adults with at least one chronic condition spending $7,377 in 2006 compared to $4,951 for their younger counterparts.

These higher health care costs can lead to higher burdens for near-elderly individuals than for younger adults. Even those near-elderly adults with private health insurance had the highest burdens of all privately insured age groups in 2006. Close to 30% of the near-elderly had out-of-pocket costs for premiums and medical care that exceeded 10% of their families' after-tax income compared to 12% of those ages 25-34. Those with individual coverage had even higher burdens: 69% exceeded the 10% threshold.

Uninsured adults of all ages with health problems also had difficulty accessing needed health care. For example, there were large differences between the full-year insured and the full-year uninsured in the likelihood that an individual with a chronic condition did not visit a health care provider, the number of visits for those who did, and the likelihood that the individuals reported delays in obtaining medical visits and prescription drugs. While the full-year uninsured of all ages experienced these problems more than the full-year insured, as mentioned above, the uninsured near-elderly were more likely to have a chronic condition and therefore be in greater need of medical attention.

One source of coverage for near-elderly individuals is retiree health insurance. In 2006, roughly 16% of near-elderly adults had such coverage, with men more likely to be policyholders of such coverage than women. Estimates from the 2006 Medical Expenditure Panel Survey—Insurance Component indicate that only 18.6% of active employees worked for employers that offered retiree health insurance to individuals under age 65.

Access to employer-sponsored health insurance through an individual's current job or that of a spouse is lower for certain near-elderly adults than their younger counterparts. For example, working married women and non-working married men and women had lower offer rates, as did single working men. Coverage from previous jobs helped to shelter the insurance status of near-elderly workers without access to such coverage. Coverage from a previous job could also have led individuals to seek those jobs that did not have offers of private coverage or, alternatively, to retire. Near-elderly adults without access to coverage through a current employer had a higher rate of uninsurance than near-elderly adults overall, but they were much less likely to be uninsured than younger workers without such access.

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