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As of January 1, 2020 individuals who are newly eligible for Medicare will no longer be able to purchase Medigap Plan C or Plan F (this includes the high deductible Plan F option as well). This is a result of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) that prevents individuals new to Medicare from purchasing Medigap plans that pay for the Part B deductible, which is currently $185 for 2019. Both Plans C and F cover the Part B deductible. This law also applies to the 3 states- Massachusetts, Wisconsin and Minnesota- who operate their own Medigap systems.
Medicare Eligibility Before January 1, 2020
If you are eligible for Medicare before January 1, 2020, you will still be able to purchase Plan C or Plan F. If you were eligible for Medicare before this time but did not enroll, you will be able to purchase Plan C or Plan F as long as you are within your Medigap Open Enrollment Period or have a Guaranteed Issue Right once you enroll in Original Medicare. Only those with Original Medicare can purchase a Medigap plan.
*Medigap plans do not work with Medicare Advantage.
If you are presently enrolled in Medigap Plan C or Plan F, you can continue to renew it from insurers in your state.
Premiums for Medigap plans can change from year to year, and Medigap issuers may choose to discontinue plan offerings. Your right to switch plans if your premiums increase depends on your state’s laws. If your Medigap is terminated, you will have a guaranteed issue period. Guaranteed issue rights are rights you have in certain situations when insurance companies must offer you certain Medigap policies. In these situations, an insurance company:
- Must sell you a Medigap policy
- Must cover all your pre-existing health conditions
- Can’t charge you more for a Medigap policy because of past or present health problems
In most cases, you have a guaranteed issue right when you have other health coverage that changes in some way, like when you lose the other health care coverage. In other cases, you have a “trial right” to try a Medicare Advantage Plan (Part C) and still buy a Medigap policy if you change your mind.
If you are newly eligible for Medicare on or after January 1, 2020, you will not be able to purchase Plan C or Plan F. However, Plan D and Plan G currently provide coverage for all the same out-of-pocket costs, except for the Part B deductible coverage. If you have questions about Medicare Supplements, we have your answers. Give one of our Trusted Agents a call and it would be our pleasure to serve you!
