Over 65 but not eligible for Medicare. Can I get insurance?

Q. I recently immigrated from the United Kingdom to the U.S. and will soon receive a green card. But at the age of 84 I can't find anybody who will sell me health insurance even though I'm in good health. Any advice?

A With Medicare covering the huge majority of people 65 and older in the U.S., there hasn't been a true market for private individual insurance for seniors in many decades. This is a big problem for elderly immigrants because they aren't eligible for Medicare until they have been in permanent residence in this country for five years.

This woeful situation will change completely come Jan. 1, 2014, when the full provisions of the new health care law take effect. As of that date, insurers won't be allowed to turn people away based on pre-existing conditions or age, so you'll be able to buy health insurance with no questions asked. And a good thing, too: The law says that everyone who lives here legally, whether a citizen or not, must either have health insurance or pay a fine in the form of a tax penalty. This includes you.

More good news: There will be new and stricter limits on how much more insurance companies can charge older clients than younger clients. Right now in some states an older person might pay as much as five times more than a younger person for the identical health plan. The health law says there can't be more than a three-to-one difference.

The best way to buy health insurance will be via the new Marketplaces that are opening in every state on Oct. 1. The Marketplaces will offer a selection of comprehensive private health insurance plans at various price points, and you can buy whichever one you want. Coverage will begin Jan. 1. If your income is within specified limits, you may also qualify for a new kind of tax credit that you can use right away to help pay for your insurance.

We've prepared a couple of publications that explain all this in more detail: a guide to health reform and a guide to how the tax credits will work.

—Nancy Metcalf