the tale of two people.
One is on Medicare and healthcare companies are knocking at the door to sell them an advantage plan or Medicare supplement. The cost is 108/month if you have little income. The premium gets higher the more money a person makes. Which, as unfair as that sounds, this person pays 136/ month. A very reasonable advantage plan has no premium above the Medicare premium.
The spouse is too young for Medicare so they have to buy their own. The premium is 435/ month with high co-pays and high out of pocket......both have the same company. Why such a difference?
The person under 65 is in a risk pool which is not universal enrollment, and therefore, adverse selection exists.
The Medicare person is in a risk pool with universal enrollment, in which adverse selection does not exist.