Health care coverage and use of preventive services among the near elderlyin the United States

Objectives. It has been proposed that individuals aged 55 to 64 years be al lowed to buy into Medicare. This group is more likely than younger adults t o have marginal health status, to be separating from the workforce, to face high premiums, and to risk financial hardship from major medical illness. The present study examined prevalence of health insurance coverage by demog raphic characteristics and examined bow lack of insurance may affect use of preventive health services. Methods. Data were obtained from the Behavioral Risk Factor Surveillance Sy stem, an ongoing telephone survey of adults conducted by the 50 states and the District of Columbia. Results. Many near-elderly adults least likely to have health care coverage were Black or Hispanic, had less than a high school education and incomes less than $15 000 per year, and were unemployed or self-employed. Health in surance coverage was associated with increased use of clinical preventive s ervices even when sex, face/ethnicity, marital status, and educational leve l were controlled. Conclusions. Many near-elderly individuals without insurance will probably not be able to participate in a Medicare buy-in unless it is subsidized in some way.