Near-Elderly Adults, Ages 55-64: Health Insurance Coverage, Cost and Access

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Coverage

Insurance Status by Age

Table 1. Insurance status by age

Insurance status/ Population	Ages 25-34	Ages 35-44	Ages 45-54	Ages 55-64	Ages 55-59	Ages 60-64
Population (millions)	39.0	43.1	42.4	31.8	17.9	13.9
	Proportion with:
Any private	0.642^*	0.718	0.743	0.743	0.759^#	0.722
Any employment-related	0.615^*	0.693	0.708	0.69	0.708^#	0.667
Policyholder of employment-related	0.469^*	0.496	0.504	0.5	0.511	0.486
Any individual coverage	0.029^*	0.03^*	0.038^*	0.061	0.06	0.061
Any Medicaid	0.078^*	0.06	0.055	0.056	0.05	0.063
Any Medicare	0.008^*	0.021^*	0.037^*	0.076	0.063^#	0.093
Any other public	0.013^*	0.019^*	0.029^*	0.05	0.044	0.059
Uninsured	0.277^*	0.207^*	0.172	0.153	0.147	0.16

Source: 2006 Medical Expenditure Panel Survey—Household Component
* indicates that the estimates are statistically different from those for individuals ages 55-64 at the 5% level.
# indicates that the estimates for individuals ages 55-59 and ages 60-64 are statistically different at the 5% level. The percentages may not sum to 100% since individuals can be covered by more than one source of insurance. Individuals are classified as having a particular source of insurance if they have that source at some point in the first half of 2006. They are classified as uninsured if they are uninsured throughout the first half of 2006. Individuals are classified as working if they were working at the time of their first interview in 2006.

Near-elderly adults, ages 55-64, were less likely to be uninsured than individuals ages 25-34 and 35-44 (Table 1).
Individuals ages 45-54 and 55-64 had similar rates of private health insurance, employment-related coverage, and being uninsured.
Near-elderly individuals were more likely than those of all other age groups to have individual coverage, Medicare, and other public coverage.
Individuals ages 55-59 were more likely to have employment-related coverage than those ages 60-64. Individuals ages 60-64 were more likely to have Medicare coverage than those ages 55-59.

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Full-Year Insurance Status by Age

Table 2. Health insurance status throughout 2006

Insurance status/ Population	25-54	25-34	35-44	45-54	55-64
	Individuals insured in January
Population total (millions)	96.3	27.7	33.8	34.8	26.6
Percentage that were:
Insured all year	93.0^*	90.4^*	93.4^*	94.8	95.9
	Individuals uninsured in January
Population total (millions)	27.5	11.1	9.1	7.3	4.7
Percentage that obtained:^a
Any insurance	23.2	23.8	24.3	20.7	20.2
Individual coverage	1.7	2.0^~	2.4^~	0.6^~	2.0^~
Public coverage	5.5	5.9	5.9	4.6	6.9
Employment-related coverage	16.7^*	17.1^*	17.0^*	15.6	12.2
			All
Insured all year	71.70^*	63.64^*	72.91^*	77.86^*	81.57
Insured part year	10.89^*	14.33^*	10.69^*	7.94	6.67
Uninsured all year	17.41^*	22.03^*	16.40^*	14.20^*	11.76

Uninsured all year and have at least one chronic condition	6.50	5.60	6.22	7.6	6.75

Source: 2006 Medical Expenditure Panel Survey—Household Component
* indicates that the estimates are statistically different from those for individuals ages 55-64
~ indicates that the standard error for the estimate exceeds 30% of the estimate.
a The percentages may not sum to those for any insurance since individuals can obtain more than one source of insurance.

Near-elderly adults who were insured in January 2006 were more likely than adults ages 25-44 to have stable coverage throughout the rest of the calendar year (Table 2).
Near-elderly adults who were uninsured in January 2006 were less likely to obtain employment-related coverage than adults ages 25-44.
Near-elderly adults were more likely to be insured all year and less likely to be insured part year or uninsured for the full year than adults ages 25-44. They were also more likely than 45-54 year olds to be insured all year and less likely to be uninsured all year.

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Access to Employer Coverage

Table 3. Individuals offered employment-related health insurance through own current job or spouse's current job

Individuals	Workers				Non-workers
Individuals	Single women	Single men	Married women	Married men	Married women	Married men
	Proportion with offers
	Ages 25-54
Population total (millions)	18.1	19.8	28.1	33.8	10.9	2.6
Offer from current main job	0.731	0.705^*	0.701	0.749^*⁺	NA	NA
Any offer from self or spouse	--	--	0.895^*	0.853⁺	0.648^*	0.47^*⁺
	Ages 55-64
Population total (millions)	3.9	2.1	5.8	8.1	4.2	3.1
Offer from current main job	0.75	0.593⁺	0.666	0.703	NA	NA
Any offer from self or spouse	--	--	0.802	0.838	0.382	0.385

Single and married working men ages 55-64 were less likely to be offered coverage from their current main job than those ages 25-54 (Table 3).
Near-elderly working married women were less likely to have access to coverage through themselves or a spouse than working married women ages 25-54 (80.2 percent vs. 89.5 percent).
Younger married men were less likely than younger married women to have access to employer-sponsored coverage. However, near-elderly married men and women had similar access to such coverage.
Non-working younger married men and women were more likely to have access to employer-sponsored coverage through a working spouse than near-elderly non-working married men and women.

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Sources of Employment-Related Coverage—Current Job or Retiree Coverage

In December 2006, 69.5 percent of near-elderly adults had employment-related coverage (Figure 1). About one-half (50.1 percent) had coverage from a current job, 16.2 percent had coverage from a retirement job, and 5.7 percent had some other form of employment-related health insurance.
Near-elderly adults' source of employment-related coverage differed from that for younger adults. For example, retiree coverage played a larger role in providing employment-related coverage to 55-64 year olds than to 45-54 year olds (16.2 vs. 1.4 percent) and coverage from a current job played a correspondingly smaller role (50.1 percent vs. 65.6 percent).

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Policyholder/Dependent Status for Retiree Coverage

Near-elderly men were more likely than near-elderly women to be a policyholder of coverage from a retirement job (14.0 percent vs. 7.9 percent), as shown in Figure 2. Near-elderly women were more likely than near-elderly men to be a dependent on such a plan (9.4 percent vs. 2.2 percent).
While almost no men are covered as dependents on a retiree health insurance policy with a policyholder age 65 or older, 3.2 percent of women are covered by such a plan. This represents about one-third of all women dependents of retiree coverage.

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Retiree Coverage—Employer Data

In 2006, only 20 percent of employees worked for an establishment that offered health insurance to retirees.
Employees at the largest firms were much more likely to work at an establishment that offered health insurance to retirees (Figures 3 and 4).
Employees in the next largest firm size category (100-999 employees) were also more likely than workers in smaller firms to work at an establishment that offered health insurance to retirees.

Table 4. Health insurance status of individuals who have access to employer-sponsored health insurance

Individuals	Workers				Non-workers
Individuals	Single women	Single men	Married women	Married men	Married women	Married men
Population (millions)
Age 25-54	13.2	14.0	25.2	28.8	7.1	1.2
Age 55-64	2.9	1.2	4.7	6.8	1.6	1.2
	Proportion with: Any private coverage
Age 25-54	0.903	0.872⁺	0.929^*	0.912^*⁺	0.832	0.668^*⁺
Age 55-64	0.931	0.909	0.962	0.942⁺	0.877	0.871
	Any employment-related coverage
Age 25-54	0.897	0.863⁺	0.922	0.907^*⁺	0.826	0.646^*⁺
Age 55-64	0.93	0.909	0.943	0.931	0.855	0.848
	Policyholder of employment-related
Age 25-54	0.883	0.857	0.532^*	0.727^*⁺	0.014^*	0.156^*⁺
Age 55-64	0.926	0.909	0.604	0.77⁺	0.168	0.338⁺
	Any individual coverage
Age 25-54	0.01^~	0.013^*^~	0.011^*	0.009	0.008^~	0.034^~
Age 55-64	0.003^~	0	0.029^~	0.024	0.039^~	0.022^~
	Any Medicaid
Age 25-54	0.034	0.01⁺^~	0.009^*	0.007	0.025	0.054^~
Age 55-64	0.017^~	0.037^~	0	0.003^~	0.021^~	0.024^~
	Any Medicare
Age 25-54	0.002^~	0.003^~	0.001^~	0.001^~	0.029^*	0.109⁺
Age 55-64	0	0	0	0.001^~	0.118	0.154
	Any other public
Age 25-54	0.006^~	0.018^*⁺	0.022^*	0.019^*	0.036	0.057^~
Age 55-64	0.008^~	0	0.05	0.048	0.066^~	0.039^~
	Uninsured
Age 25-54	0.07	0.117⁺	0.054^*	0.072^*⁺	0.122	0.248^*⁺
Age 55-64	0.064	0.086^~	0.03	0.049⁺	0.079^~	0.077^~

Source: 2006 Medical Expenditure Panel Survey—Household Component
* indicates that the estimates for ages 25-54 and 55-64 are statistically different at the 5% level.
+ indicates that the estimates for men and women are statistically different at the 5% level within each age/marital status category.
~ indicates that the standard error for the estimate exceeds 30% of the estimate. The percentages may not sum to 100% since individuals can be covered by more than one source of insurance. Individuals are classified as having a particular source of insurance if they have that source at some point in the first half of 2006. They are classified as uninsured if they are uninsured throughout the first half of 2006. Individuals are classified as working if they were working at the time of their first interview in 2006. Individuals are considered to have access to employer-sponsored health insurance if either they or their spouse (if married) have an offer of coverage through a current job. Some observations were excluded in the sample for this table due to data requirements.

Highlights for individuals with access to coverage through a current job include the following:

Near-elderly working married adults and non-working married men were less likely to be uninsured than their younger counterparts (Table 4).
Near-elderly married men and women were more likely to be policyholders than younger married men and women.
Married men, regardless of age, were more likely to be policyholders of employer-sponsored coverage than married women.
A higher percentage of non-working near-elderly married men than women were the policyholder of coverage from a previous employer (33.8 percent vs. 16.8 percent), although both were equally likely to have employment-related coverage.

Table 5. Health insurance status of individuals who do not have access to employer-sponsored health insurance from a current job

Individuals	Workers				Non-workers
Individuals	Single women	Single men	Married women	Married men	Single women	Single men	Married women	Married men
Population (millions)
Age 25-54	4.9	5.8	3.0	5.0	5.0	4.4	3.8	1.4
Age 55-64	1.0	0.9	1.1	1.3	2.0	1.9	2.6	1.9
	Proportion with: Any private coverage
Age 25-54	0.183^*	--	0.251^*	0.213^*	.107^*	.153^*	0.219^*	0.241^*
Age 55-64	0.352	--	0.612	0.536	.311	.350	0.64	0.579
	Any employment-related coverage
Age 25-54	0.083^*	--	0.086^*	0.07^*	.074^*	.099^*	0.112^*	0.168^*
Age 55-64	0.193	--	0.398	0.264⁺	.247	.277	0.537	0.543
	Policyholder of employment-related
Age 25-54	0.056^*	--	0.032^~	0.053^*	.046^*	.081^*	0.048^*	0.119^*⁺
Age 55-64	0.139^~	--	0.058^~	0.175⁺	.239	.268	0.22	0.489⁺
	Any individual coverage
Age 25-54	0.1	--	0.171	0.147^*	0.033	.057	0.108	0.073^~
Age 55-64	0.185	--	0.229	0.272	.071	.073^~	0.106	0.036⁺^~
	Any Medicaid
Age 25-54	0.181^*	--	0.117^*	0.099^*	.494^*⁺	.263	0.201^*	0.209^*
Age 55-64	0.058^~	--	0.008^~	0.026^~	.284	.248	0.076	0.083
	Any Medicare
Age 25-54	0.023^~	--	0.006^~	0.003^~	.159^*	.172^*	0.072	0.147^*⁺
Age 55-64	0.051^~	--	0.01^~	0.005^~	.280	.297	0.116	0.26⁺
	Any other public
Age 25-54	0.021^~	--	0.027^~	0.024^~	.021^~	.038	0.02^*^~	0.042^~
Age 55-64	0.044^~	--	0.077^~	0.042^~	.054^~	.043^~	0.09	0.064^~
	Uninsured
Age 25-54	0.619^~	--	0.611^*	0.665^*	.340^*	.503^*⁺	0.518^*	0.443^*
Age 55-64	0.502	--	0.324	0.421	.236	.221	0.188	0.18

Source: 2006 Medical Expenditure Panel Survey—Household Component
* indicates that the estimates for ages 25-54 and 55-64 are statistically different at the 5% level.
+ indicates that the estimates for men and women are statistically different at the 5% level within each age/marital status category.
~ indicates that the standard error for the estimate exceeds 30% of the estimate. The percentages may not sum to 100% since individuals can be covered by more than one source of insurance. Individuals are classified as having a particular source of insurance if they have that source at some point in the first half of 2006. They are classified as uninsured if they are uninsured throughout the first half of 2006. Individuals are classified as working if they were working at the time of their first interview in 2006. Individuals are considered to not have access to employer-sponsored health insurance if neither they nor their spouse (if married) have an offer of coverage through a current job. Some observations were excluded in the sample for this table due to data requirements. Estimates for single male workers were suppressed since there were fewer than 100 observations in the 55-64 age group.

Highlights for individuals with access to coverage through a current job include the following:

Near-elderly married individuals were less likely to be uninsured than younger adults. They were less likely to have Medicaid but more likely to have employer-sponsored coverage than younger married adults (Table 5).
Non-working near-elderly adults were less likely to be uninsured than those who were working. (Significance test not shown.)

Table 6. Characteristics of the insured and uninsured by age, 2006

Characteristics	Ages 25-54		Ages 55-64
Characteristics	Insured	Uninsured	Insured	Uninsured
Total (millions)	97.5	27.0	26.9	4.9
	Proportion that are:
	Sex
Male	0.474	0.56^*^{^}	0.484	0.502
Female	0.526	0.44^*^{^}	0.516	0.498
	Region
North	0.191	0.137^*^{^}	0.2	0.201
Midwest	0.238	0.166^{^}	0.232	0.165^{^}
South	0.337	0.435^{^}	0.361	0.402
West	0.233^*	0.263^{^}	0.207	0.232
	MSA
MSA	0.849^*	0.833	0.818	0.817
	Full-time/Part-time
Works	0.842^*	0.71^*^{^}	0.646	0.578^{^}
Works < 35 hrs/wk	0.105	0.174^{^}	0.112	0.183^{^}
Works ≥ 35 hrs/wk	0.736^*	0.536^*^{^}	0.534	0.395^{^}
	Race/Ethnicity
Hispanic	0.108^*	0.302^*^{^}	0.062	0.199^{^}
Non-Hispanic black	0.115^*	0.131^*^{^}	0.094	0.14^{^}
Non-Hispanic white	0.706^*	0.501^*^{^}	0.782	0.571^{^}
Non-Hispanic other	0.071	0.066	0.062	0.089
	Poverty Status
Poor	0.065	0.199^{^}	0.076	0.189^{^}
Near poor	0.024	0.069^{^}	0.025	0.066^{^}
Low income	0.087^*	0.209^{^}	0.072	0.214^{^}
Middle income	0.312^*	0.349^*^{^}	0.248	0.274
High income	0.51^*	0.174^*^{^}	0.578	0.258^{^}
	Marital Status
Married	0.66^*	0.475^*^{^}	0.71	0.551^{^}
Widowed	0.012^*	0.011^*	0.054	0.078^{^}
Divorced	0.113^*	0.161^*^{^}	0.16	0.248^{^}
Separated	0.022	0.042^{^}	0.02	0.035
Never married	0.193^*	0.311^*^{^}	0.056	0.087

Source: 2006 Medical Expenditure Panel Survey—Household Component
* indicates that the estimates are statistically different from those for individuals ages 55-64 at the 5% level.
^ indicates that the estimates are statistically different at the 5% level by insured/uninsured status within each age category. Individuals are classified as insured if they have any insurance at some point in the first half of 2006, on average. They are classified as uninsured if they are uninsured throughout the first half of 2006. MSA is metropolitan statistical area.

Compared with uninsured people ages 25-54, uninsured people ages 55-64 are:
More likely to be: Female, living in the North, white, high income, married, widowed, divorced.
Less likely to be: working full time, Hispanic, middle income, never married.
Go to Table 6.

Table 7. Chronic conditions and self-reported health status of adults by insurance status: Pooled years 2003-2006

Condition	Insured All Year	Insured Part Year	Uninsured All Year
Percentage of population in insurance category with:
	Ages 25-54
Asthma	4.33	4.05	2.41
Cancer	3.00^*	2.48^*	1.16^*
Chronic obstructive pulmonary disease	4.20^*	3.70^*	2.19^*
Depression	9.88^*	12.95	7.33^*
Diabetes	4.55^*	4.66^*	3.20^*
Heart disease	5.15^*	3.63^*	2.59^*
Hypertension	12.68^*	9.13^*	6.80^*
Any chronic condition	56.00^*	48.78^*	34.89^*
Trauma	17.83	18.52	14.88
No chronic condition	44.00^*	51.22^*	65.11^*
Self-reported health:
Excellent	27.88^*	23.66^*	23.31^*
Very good	36.30^*	33.53^*	31.53^*
Good	26.43^*	28.91	31.86
Fair	7.11^*	10.06^*	10.63^*
Poor	2.29^*	3.84^*	2.67^*
Percentage of population in insurance category with:	Ages 55-64
Asthma	4.94	5.76	2.95
Cancer	8.97	5.19	4.35
Chronic obstructive pulmonary disease	6.39	7.35	6.09
Depression	12.63	14.45	10.22
Diabetes	14.70	14.26	11.12
Heart disease	14.15	12.25	10.17
Hypertension	37.84	34.05	30.24
Any chronic condition	80.02	74.97	60.37
Trauma	17.85	17.40	14.74
No chronic condition	19.98	25.03	39.63
Self-reported health:
Excellent	20.06	14.91	15.53
Very good	33.62	28.88	26.95
Good	29.51	31.71	34.13
Fair	11.47	17.05	17.46
Poor	5.34	7.44	5.92

Source: 2006 Medical Expenditure Panel Survey—Household Component
* indicates that the estimates for ages 25-54 and 55-64 are statistically different at the 5% level.

Near-elderly individuals were more likely to have at least one chronic condition and to be in fair or poor health than younger individuals, regardless of insurance category (Table 7).
Near-elderly individuals uninsured for the entire year were less likely to have a chronic condition than those insured all year. However, they were more likely to report being in good or fair health and less likely to be report being in excellent or very good health.

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