A Medicare Buy In for the Near Elderly: Design Issues and Potential Effects on Coverage

A Medicare buy-in allowing persons below the age of full eligibility to purchase Medicare
coverage has been discussed as one way to help uninsured near-elderly persons obtain health
insurance coverage. This report describes estimates of participation rates in Medicare buy-ins
and measures the potential impact of buy-in plans on uninsurance. The report also examines
some key issues that arise in designing buy-in plans. The results suggest that many near-elderly
Americans would purchase Medicare coverage, but the introduction of a buy-in would
substantially reduce uninsurance rates only if premiums were related to income.