Under-65 Health Insurance
Health insurance for consumers not yet Medicare-eligible — primarily ACA marketplace plans, short-term medical, and indemnity products.
Full Definition
Under-65 health insurance encompasses all major medical and supplemental health coverage sold to consumers below Medicare eligibility age. The three primary sub-categories are: (1) ACA Qualified Health Plans sold on or off the Marketplace, (2) Short-Term Limited Duration Medical (STLDI), and (3) Hospital Indemnity and fixed-benefit products used to supplement high-deductible major medical or to substitute for it in states where STLDI is available. Lead generation in under-65 is heavily subsidy-driven — "free" or "$0 health insurance" headlines dominate consumer paid-search intent. Agents must be Federally Facilitated Marketplace (FFM)-certified to sell on HealthCare.gov.
Example
A 48-year-old self-employed consumer at 180% FPL receives a $1,100/month APTC, bringing a $1,260 Silver plan to a $160/month out-of-pocket premium. The agent enrolls them on HealthCare.gov.
Related Terms
- ACA (Affordable Care Act) / Marketplace — U.S. federal law (2010) that created the individual health insurance marketplace, premium subsidies, and the open enrollment framework for under-65 major medical.
- Short-Term Medical (STLDI) — Limited-duration health insurance — often non-ACA-compliant — used as a gap-filler between jobs, missed OEP, or when consumers want lower premiums than ACA plans.
- Ancillary (Dental/Vision/Hospital Indemnity) — Supplemental insurance products — dental, vision, hearing, hospital indemnity, accident, critical illness — sold alongside or in place of major medical.