The healthcare landscape can be complex for immigrants over 65. However, with the right knowledge and resources, it’s possible to navigate the health insurance system successfully. The first step is understanding the different types of coverage available to this age group, including Medicare and private/qualifying health plans. Next, determining what your options are to obtain affordable health insurance and how much you will have to pay for the coverage you choose. Finally, you’ll need to understand how Medicaid and other public and private health insurance benefits work together to help with out-of-pocket costs.

Individual Health Insurance Options

The ACA health marketplace provides Affordable health insurance for seniors over 65, customizable health plan options and cost-saving subsidies based on income. These include Cost-Sharing Reductions and Advanced Premium Tax Credits, which lower the deductibles, copays, and monthly premiums of Marketplace Silver Plans. These subsidies can be significant, allowing a senior to purchase a plan that covers most or all of their medical expenses and save them a substantial amount of money.

A recent study, Characteristics of Americans Ages 50 to 64 in the Nongroup Health Insurance Market, reports that as the number of people who are uninsured has declined since the ACA’s implementation, more and more older adults have been turning to the nongroup (individual) health insurance market to obtain coverage. However, these individuals are often facing high out-of-pocket costs and premiums.

Most of these nongroup individuals can find affordable individual health insurance through the ACA exchanges (Marketplace). If they have not yet qualified for Medicare, they can sign up for a Medicare Advantage plan, which includes all services covered by Original Medicare plus extra coverage like dental and vision care and telehealth. Additionally, if they haven’t enrolled in Medicare, they can enroll in a Medicare Supplement (Medigap) plan to cover the 20% of their medical costs that Medicare does not pay.

In addition to the ACA’s private and supplemental options, New York State helps many low-income Medicare beneficiaries with their out-of-pocket costs. You can find information about eligibility and how to apply on NY Connects or the Department for the Aging’s Health Insurance Information, Counseling and Assistance Program (HIICAP). There are also more than 500 trained HIICAP counselors located in local offices for the aging around the state who can provide free, impartial assistance with Medicare, Medicare Advantage programs (managed care), Medicare prescription drug coverage (Medicare Part D), and Medigap as well as other health and long-term care insurance issues. You can call 311 to be connected with the local office closest to you.