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Insurers Target the Elderly: Making the Push into Pre-Medicare Population

 

By Tom Murphy, The Enquirer

 

November 10, 2007

 

Celeste McAllister, 52, dropped her health insurance because it didn't cover her medication. She can't find a replacement.
Celeste McAllister, 52, dropped her health insurance because it didn't cover her medication. She can't find a replacement.

 

Health insurers trying to boost individual policy sales are making a new push into an older market - the roughly 7 million uninsured Americans between the ages of 50 and 64.

Financially stable baby boomers who retire young or need coverage after a corporate downsizing are driving this push, experts say. Insurers also want to build ties to customers who may need Medicare-related insurance after they turn 65.

Humana Inc. launched a new individual policy last spring that targets early retirees. WellPoint Inc., the nation's largest health insurer, is testing a similar plan. Aetna Inc. announced in April a seven-year agreement with AARP to sell individual insurance to its members between the ages of 50 and 64.

But this coverage push draws skepticism from consumer watchdogs who say insurers have a history of avoiding this age range and the expensive claims for illnesses that often hit that group.

"That is a market that needs to be served, partly because traditionally WellPoint won't serve them," said Jamie Court of the California-based Foundation for Taxpayer and Consumer Rights.

That is not the case, according to Jude Thompson, WellPoint's president of individual markets.

"We don't have tougher underwriting or a different set of standards for 50- to 64-year-olds than anyone else," he said.

Federal Medicare coverage starts at age 65. Insurers find the age group in front of that marker attractive for many reasons.

One is sheer volume. The U.S. Census Bureau estimates the baby boomer population, ages 43 to 61, at 78 million people. That's about a quarter of the U.S. population.

The market "represents a big chunk of potential," said Steve DeRaleau, chief operating officer of HumanaOne, Humana's individual policy business.

Additionally, employers are dropping retiree benefits. The percentage of large companies that offer health benefits to employees and retirees has dropped from 66 percent in 1988 to 33 percent this year, according to a survey from the Kaiser Family Foundation.

Big companies also are cutting jobs, and their former workers are less likely these days to land with another large employer that provides benefits, said John Wider, vice president of health products and services for AARP Services Inc.

Many boomers also have money to spend. Their median household income of $60,000 was nearly $20,000 higher than the total for all adults, according to a Pew Research Center report released in late 2005. But a lack of insurance can quickly whittle away that wealth; according to some estimates, medical bills trigger about half of all personal bankruptcies.

Humana launched its Portrait individual insurance in April and has introduced it in 15 states so far. It plans to add it in 11 more over the next few months.

The monthly premium paid, like any insurance plan, depends on the customer's age, gender, medical history and location, and the coverage desired. For example, a 50-year-old male nonsmoker living in Kentucky can find Portrait monthly rates starting at $133.

The push doesn't mean everyone will find coverage. Celeste McAllister, 52, dropped her student health coverage last year because it didn't cover her blood pressure medication. She can't find a replacement.

The fitness instructor, who returned to school to become a nurse, found coverage was too expensive or not comprehensive. One policy she found online charged a $400 monthly premium, which is too steep for her part-time salary. Another wouldn't provide enough annual prescription coverage.

McAllister said she has no pre-existing conditions that scare away insurers. She thinks her best bet for finding decent coverage lies in landing a full-time job that offers it.

"As I get older it's not going to get any easier," she said.


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