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2020 Changes to the Medicare Supplement Landscape - Medigap Plan F, Plan N, and High-Deductible Plan N no longer available.

Category: Medicare Supplements - Medigap
Published on 2019-07-15 16:42:31

In 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was passed eliminating Medicare Supplements that cover the cost of the Medicare Part B deductible - and this includes Plan F, Plan N, and high-deductible Plan N (some of the most popular Medicare Supplements).

So starting January 1st, 2020, the Medicare Supplement landscape will change and Medigap Plan F, Plan N, and High-Deductible Plan N will no longer be available to people newly eligible for Medicare benefits.

People who are already enrolled in a a Plan F, Plan N, or high-deductible Plan N before 2020 can keep their existing polices (although current Plan members might expect that their monthly premiums may increase over time due to the as the plan's shrinking risk pool of new, healthier plan members that usually act to keep monthly premiums lower).

A Medicare Supplement (also called a Medigap policy) works together with your original Medicare coverage, filling the “gaps” (deductibles, coinsurance, and co-payments) in your Medicare Part A (in-patient or hospital insurance) and Medicare Part B (out-patient or physician insurance) coverage.

Medicare Supplements are offered by private insurance company (such as United HealthCare)  and provide additional coverage to your original Medicare Part A and Part B coverage.

Reminder: A Medicare Supplement is not the same as a Medicare Advantage plan.  If you are searching for a Medigap plan in your area please call a Medicare representative at 1-800-633-4227 or visit (https://www.medicare.gov/find-a-plan/questions/medigap-home.aspx)

Here is the actual language from the Medicare Access and CHIP Reauthorization Act of 2015 (04/16/2015 Public Law No: 114-10):

Subtitle A--Medicare Beneficiary Reforms
Sec. 401. Limitation on certain medigap policies for newly eligible Medicare beneficiaries.

Section 1882 of the Social Security Act (42 U.S.C. 1395ss) is amended by adding at the end the following new subsection:
"(z) Limitation on Certain Medigap Policies for Newly Eligible Medicare Beneficiaries.--
    "(1) In general.-- Notwithstanding any other provision of this section, on or after January 1, 2020, a medicare supplemental policy that provides coverage of the part B deductible, including any such policy (or rider to such a policy) issued under a waiver granted under subsection (p)(6), may not be sold or issued to a newly eligible Medicare beneficiary.
   "(2) Newly eligible medicare beneficiary defined.--
In this subsection, the term `newly eligible Medicare beneficiary' means an individual who is neither of the following:
        "(A) An individual who has attained age 65 before January 1, 2020.
        "(B) An individual who was entitled to benefits under part A pursuant to section 226(b) or 226A, or
deemed to be eligible for benefits under section 226(a), before January 1, 2020.
   ‘‘(3) TREATMENT OF WAIVERED STATES.—In the case of a State described in subsection (p)(6), nothing in this section shall be construed as preventing the State from modifying its alternative simplification program under such subsection so as to eliminate the coverage of the part B deductible [$185 in 2019, up from the - compare to the 2015 Medicare Part B deductible of $147] for any medical supplemental policy sold or issued under such program to a newly eligible Medicare beneficiary on or after January 1, 2020.
In the case of a newly eligible Medicare beneficiary, except as the Secretary may otherwise provide, any reference in this section to a medicare supplemental policy which has a benefit package classified as ‘C’ or ‘F’ shall be deemed, as of January 1, 2020, to be a reference to a medicare supplemental policy which has a benefit package classified as ‘D’ or ‘G’, respectively.
   ‘‘(5) ENFORCEMENT.—The penalties described in clause (ii) of subsection (d)(3)(A) shall apply with respect to a violation of paragraph (1) in the same manner as it applies to a violation of clause (i) of such subsection.’’.

[emphasis added]

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