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A Medicare buy-in allowing persons below the age of full eligibility to purchase Medicare coverage has been discussed as one way to help uninsured near elderly persons obtain insurance coverage. This brief summarizes findings from an Urban Institute report that examined potential participation rates in alternative buy-in plans and measured their potential impact on rates of uninsurance. Many individuals younger than 65 would purchase Medicare coverage, but without subsidies participation would be limited to those who could afford substantial premiums. Buy-ins would reduce uninsurance rates only if they provided subsidies to make the plans affordable to those with limited incomes.