By James Schulze
This article discusses rising healthcare costs and how they are creating more demand for U65 health insurance aged leads, real-time leads, and inbound calls. It also helps agents better understand the different lead types available and how important it is to consider their sales approach and operations in determining the optimal mix of leads to fuel their U65 health insurance sales growth.
Healthcare continues to get more expensive in the United States. Insurance premiums are rising, employers are facing higher benefit costs, and consumers are paying more attention to what they spend on healthcare. For insurance agents, that creates an opportunity.
Consumers under age 65 who aren’t covered by Medicare may have several options for health insurance, including employer-sponsored coverage, ACA Marketplace plans, short-term medical plans, private health insurance, and other alternatives. As costs increase, more consumers have a reason to shop, compare plans, and reconsider whether their current coverage still makes sense.
This is creating a greater demand for U65 health insurance. Specifically, the expiration of enhanced federal subsidies on December 31, 2025, brought back the strict “subsidy cliff,” stripping millions of higher earners and specific low-income groups of ACA financial help. With enrollment rules tightening and total marketplace participation dropping by nearly 3 million people for the 2026 plan year, many individuals now find themselves completely ineligible for premium tax credits. To avoid paying 100% of these soaring marketplace premiums out of pocket starting in January 2026, individuals are increasingly turning to private, non-marketplace Under-65 (U65) insurance plans. These private U65 options offer a cheaper, year-round alternative for healthy adults, contractors, and families who are locked out of ACA discounts or missed the formal open enrollment window.
For insurance agents, U65 health insurance leads are more important than ever. At The Leads Warehouse, we are seeing demand for U65 health insurance leads continue to increase. Agents who traditionally concentrated heavily on Medicare are also paying more attention to the under-65 market, creating opportunities for aged U65 health insurance leads, real-time U65 health insurance leads, and U65 health insurance calls.
Healthcare costs continue to rise
The cost of healthcare is hardly a new issue, but the numbers continue moving higher. From 2021 to 2025, health insurance costs experienced a two-phase trend, starting with modest annual premium increases of 3.5% to 4.5% before spiking to 6% to 8% per year due to post-pandemic medical utilization and inflation. By the current 2026 plan year, employer healthcare costs jumped up an average of 8.3%, while unsubsidized consumers on the ACA marketplace faced an average full-price premium increase of 26% following the expiration of enhanced federal subsidies on December 31, 2025. Over the next five years from 2026 through 2030, underlying commercial medical trends are projected to hit historic highs of 8.5% to 9.5% annually, driven primarily by the soaring demand for costly specialty drugs like GLP-1 weight-loss medications.
For consumers, rising healthcare costs can show up in several places, including:
- Monthly insurance premiums
- Deductibles
- Copays
- Prescription drugs
- Out-of-pocket expenses.
Employers face the same pressure. Providing health insurance is an increasingly significant employee-benefit expense, and higher employer costs can eventually affect the plans and contributions available to workers.
That creates a large population of consumers asking a simple question: “Is there a better health insurance option available to me?” For an insurance agent, that question creates opportunity. Someone doesn’t necessarily need to lose coverage to become a health insurance prospect. A higher premium, larger deductible, change in employment, new family situation, or dissatisfaction with existing coverage can all cause a consumer to shop.
The market is much bigger than the uninsured population
It can be tempting to think about U65 health insurance leads primarily as consumers without insurance, but that misses a much larger opportunity. The potential U65 private health insurance marketplace excluding the ACA is vast, consisting of roughly 40 million Americans who are either uninsured (~26.7 million) or buy their coverage completely off-exchange through private brokers (~10 to 15 million).
A consumer can already have health insurance and still be a strong prospect. Someone paying an increasing amount for employer-sponsored coverage may want to understand alternatives. A self-employed consumer may be reviewing individual coverage. A family facing higher premiums or deductibles may want to compare available plans. Someone approaching an enrollment period may simply want to know whether better options exist.
Rising healthcare costs give insured consumers a reason to shop just as they give uninsured consumers a reason to seek coverage. That means the potential U65 market extends well beyond people who currently have no health insurance.
Shopping creates demand for U65 health insurance leads
Insurance agents need consumers to talk to. As more people evaluate their health insurance options, demand for U65 health insurance leads can increase because agents and agencies want to reach consumers during that decision-making process.
But consumers don’t all shop the same way. Some are actively searching for coverage today. Others may have expressed interest weeks or months ago and haven’t made a final decision. Some prefer to speak directly with an agent. That creates opportunities across multiple lead products. At The Leads Warehouse, U65 health insurance campaigns can include aged U65 health insurance leads, real-time U65 health insurance leads, and U65 health insurance calls (read our blog, “What Are U65 Health Insurance Leads? A Complete Guide For Insurance Agents”).
The right lead product depends heavily on the agent’s sales operation.
Real-time U65 health insurance leads capture fresh intent
Real-time U65 health insurance leads give agents the opportunity to reach consumers shortly after they have expressed interest in health insurance. Real-time U65 health insurance leads are best utilized on an API posting directly to an agency’s dialer. U65 leads should post to an immediate dialing list, as at The Leads Warehouse, client-reported stats show exponentially better contact rates if the leads are contacted within 8 seconds after creation.
That fresh intent is valuable, but it also makes speed critical. A consumer looking for health insurance may continue researching after completing a form. They may visit additional websites, request other information, or speak with another agent.
An agency buying real-time U65 health insurance leads should therefore have the technology and staffing necessary to respond quickly. The TCPA language for a real-time U65 health insurance lead allows for more than just phone calls – SMS and email must be part of lead activation to maximize consumer touches.
Speed-to-lead doesn’t guarantee a sale, but it does give the agent an opportunity to establish a relationship while the consumer is actively thinking about health insurance. And that relationship is valuable, because health insurance isn’t always an immediate buying decision.
Aged U65 health insurance leads can benefit from changing costs
An aged U65 health insurance lead is a consumer who previously expressed interest in health insurance but whose information is being purchased later. The lower cost per lead (CPL) allows agents to purchase substantially more prospects with their marketing budget (read our blog, “U65 Health Insurance Lead Prices In 2026 – What Insurance Agents Should Expect To Pay”).
But there is another reason aged U65 health insurance leads can be interesting in a rising-cost environment: the consumer’s circumstances may have changed. The plan that seemed acceptable three months ago may have increased in price. An employer may have changed benefits. A consumer may have changed jobs. Household income may have changed. A family may have experienced a life event. Or, the consumer may simply have postponed making a decision.
In our experience reviewing client disposition data at The Leads Warehouse, many health insurance customers don’t make a decision immediately. Approximately half can take more than 90 days to choose a plan, with many sales occurring after multiple follow-up attempts (Ask for The Leads Warehouse’s matrix of the number of calls vs. connections vs. contacts to closes).
That makes aged U65 health insurance leads a timing opportunity as much as a volume opportunity. To best take advantage of the timing aspect, U65 aged leads should be used on a dialer with a consistent outreach campaign. The more calls, the more likely an agent will win the timing game. The consumer should be contacted over a 3-week period, and then paused for a week, before the next 3-week campaign. A clean caller ID is imperative as consumers rarely pick up calls with “spam likely” labels.
The consumer was interested before. The agent’s job is to determine whether now is the right time.
U65 health insurance calls put the consumer on the phone
U65 health insurance calls create a different opportunity because the agent can speak directly with an interested consumer rather than beginning with a data record.
For agencies with experienced closers, calls can be particularly valuable. But deliverability is important. An agency can purchase quality U65 health insurance calls and still underperform if calls aren’t answered, routing technology blocks them, agents aren’t available, or the sales floor doesn’t have enough capacity. The consumer can be ready to talk, but the agency still has to be ready to receive the opportunity.
That is why call campaigns should be measured using metrics beyond simply the CPL. They should also measure:
- Answer rate
- Close rate
- Revenue per call (RPC)
- Cost per customer acquisition (CPA)
With the rapid growth in the U65 insurance marketplace, U65 health insurance calls are a premium product. An agent should expect to pay top dollar for U65 calls.
Rising costs make scripting more important
Healthcare costs can also give agents a natural reason for the conversation. The message doesn’t have to be complicated, as consumers know health insurance is expensive. A good opening can determine whether the consumer is satisfied with existing coverage, concerned about premiums or out-of-pocket expenses, or interested in understanding other available options.
The objective shouldn’t be to assume the consumer’s current plan is bad. It should be to determine whether changing costs have created a reason to review it. Besides a solid opening, winning agencies have well-rehearsed rebuttals and practice daily standups with the sales team to review calls and objections and to tweak scripting. That approach can work with real-time U65 health insurance leads and with aged leads where the original inquiry occurred months earlier.
Match the U65 lead to the sales operation
There is no universally best U65 health insurance lead. Real-time leads provide fresh consumer intent but require immediate response. Aged U65 health insurance leads provide volume at a lower CPL but require persistence, CRM automation, and disciplined follow-up. U65 health insurance calls put consumers directly in front of agents but require strong closers and reliable call-delivery infrastructure.
The mistake is purchasing U65 leads based solely on price. The better approach is to match the lead product to the way the agency actually sells. If an agency uses an opener/closer model, both real-time U65 leads and aged U65 leads will work well. If an agency cannot build a proper posting, aged leads are better, as the leads are delivered via a .csv file for upload to a dialer. Real-time leads are extremely effective with the proper tech stack for immediate activation. An agency without a strong tech suite should purchase U65 inbound calls.
Conclusion
Nobody wants healthcare to become more expensive. But for insurance agents, rising costs mean more consumers have a reason to evaluate their coverage. That creates conversations. Consumers may be looking for lower premiums, different deductibles, better benefits, or simply trying to understand what alternatives are available to them. Some will be actively shopping today. Others expressed interest months ago and may finally be ready to make a decision.
For insurance agents, that can increase the value of a diversified U65 marketing strategy built around U65 health insurance leads, including aged U65 leads, real-time U65 leads, and U65 calls. The Leads Warehouse has worked with insurance agents and agencies for more than 20 years. As the U65 health insurance market continues to evolve, we help agents build sales pipelines using multiple types of U65 health insurance leads designed to match different sales strategies. Are you ready to talk about how you can grow your U65 health insurance sales pipeline?
About the author
James Schulze is the President and CEO of The Leads Warehouse, a marketing data company with over 20 years of experience in bringing lead generation solutions to companies selling into the home, automotive, financial, insurance, health and life, and legal sectors. He works directly with clients to optimize conversion strategies and ROI across multiple verticals.
Connect with James Schulze on LinkedIn:
https://www.linkedin.com/in/james-l-schulze
Read additional market analysis and commentary from James Schulze on Substack:
https://jameslschulze.substack.com
If you are serious about growing your U65 health insurance business, the right mix of leads is important. Our team works with agencies to maximize their ROI on health insurance sales leads. Call 1-800-884-8371 or visit The Leads Warehouse to get started.
