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Medigap: Spotlight on Enrollment, Premiums and Recent Trends

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…

Traditional Medicare…Disadvantaged?

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.

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.

Policy Insight Examines How Current Rules May Deter Seniors From Switching from Medicare Advantage to Traditional Medicare and Implications for Medicare’s Future

In this new policy insight, the Kaiser Family Foundation’s Tricia Neuman examines current rules that may discourage seniors from switching from Medicare Advantage to traditional Medicare.Traditional Medicare…Disadvantaged? explores this issue through the lens of a 67-year old Boomer who faced difficult financial and health coverage choices in the aftermath of…

In All But Four States, Seniors on Medicare Can Be Denied a Medigap Policy Due to Pre-existing Conditions, Except During Specified Windows of Opportunity

In all but four states, insurance companies can deny private Medigap insurance policies to seniors after their initial enrollment in Medicare because of a pre-existing medical condition, such as diabetes or heart disease, except under limited, qualifying circumstances, a Kaiser Family Foundation analysis finds. Medigap policies provide supplemental health insurance…

Medigap Enrollment and Consumer Protections Vary Across States

A quarter of people in traditional Medicare had private, supplemental health insurance in 2015—also known as Medigap—to help cover their Medicare deductibles and cost-sharing requirements, as well as protect themselves against catastrophic expenses for Medicare-covered services. This issue brief examines implications for older adults with pre-existing medical conditions who may be unable to purchase a Medigap policy or change their supplemental coverage after their initial open enrollment period.

Medigap Reform: Setting the Context for Understanding Recent Proposals

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.

Modifying Medicare’s Benefit Design: What’s the Impact on Beneficiaries and Spending?

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.