Medicare supplemental insurance, also known as “Medigap,” is an important source of supplemental coverage for nearly one in four people on Medicare. Traditional Medicare has cost-sharing requirements and significant gaps in coverage; Medigap helps make health care costs more predictable and stable for beneficiaries by covering some or all Medicare…
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Medigap Reforms: Potential Effects of Benefit Restrictions on Medicare Spending and Beneficiary Costs
As part of several debt-reduction and Medicare-reform proposals, some policymakers propose to prohibit Medicare supplemental insurance policies (known as Medigap) from covering all of enrollees’ out-of-pocket Medicare costs, which some believe leads to higher use of services and higher Medicare spending. Such changes would expose Medigap enrollees – currently about…
This brief presents the most current data available on the Medicare supplemental insurance (Medigap) market, including enrollment and premiums by state and plan type, analyzes how many beneficiaries have first dollar coverage (particularly Plans C and F), and describes recent Medigap proposals that have emerged as part of efforts to reduce Medicare spending and the national debt.
Medigap Enrollment Among New Medicare Beneficiaries: How Many 65-Year Olds Enroll In Plans With First-Dollar Coverage?
On March 26, 2015, the House of Representatives passed H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015, which would replace the Sustainable Growth Rate (SGR) formula, among other changes; the bill is currently pending in the U.S. Senate. H.R. 2 includes a provision that would prohibit Medicare supplemental insurance (Medigap) policies from covering the Part B deductible for people who become eligible for Medicare on or after January 1, 2020. This data note looks at the number and share of “new” Medicare beneficiaries who would be affected by the Medigap provision in H.R. 2, if it had been implemented in 2010, using the most current data sources available, and examines trends in Medigap enrollment among new beneficiaries since 2000.
The House-passed legislation to repeal the Medicare Sustainable Growth Rate (SGR) includes a provision that would prohibit Medicare supplemental insurance (Medigap) policies from covering the Part B deductible for people who become eligible for Medicare beginning in 2020. A new Kaiser Family Foundation Data Note explores the implications of this…
This policy insight examines the low rate of Medigap coverage among people under age 65 with disabilities on Medicare and the federal law that governs consumer rights and protections related to Medigap open enrollment.
Policy Insight Examines a Key Barrier That Younger Medicare Beneficiaries with Disabilities Face in Getting Supplemental Insurance Coverage
In a new policy insight, the Kaiser Family Foundation’s Tricia Neuman and Juliette Cubanski examine a 1990 federal law that ensures that people age 65 and older are able to buy a Medigap policy when they sign up for Medicare, but denies younger Medicare beneficiaries with disabilities the same right…
This report examines an approach to reforming Medicare that has been a focus of Congressional hearings and featured in several broader debt reduction and entitlement reform proposals, and was included in the June 2016 House Republican health plan. The analysis models four different options for modifying Medicare’s benefit design, all of which include a single deductible, modified cost-sharing requirements, a new cost-sharing limit, and a prohibition on first-dollar Medigap coverage. The analysis models the expected effects on out-of-pocket spending by beneficiaries in traditional Medicare, and assesses how each option is expected to affect spending by the federal government, state Medicaid programs, employers, and other payers, assuming full implementation in 2018.
Modifying Traditional Medicare’s Benefit Design Could Reduce Federal Spending But With Cost Tradeoffs Between Beneficiaries and The Federal Government
Revamping traditional Medicare’s benefit design and restricting “first-dollar” supplemental coverage could reduce federal spending, simplify cost sharing, protect against high medical costs, decrease out-of-pocket spending for many beneficiaries, and provide more help to those with low incomes — but would be unlikely to achieve all of these goals simultaneously.
In this new policy insight, Tricia Neuman examines current rules that may discourage seniors from switching from Medicare Advantage to traditional Medicare. The issue is explored through the lens of a 67-year-old beneficiary who faced difficult financial and health coverage choices in the aftermath of a serious biking accident.