Will the bill affect Medigap? Will Medigap be still available?


Although the bill will make considerable cuts on Medicare Advantage plans, this will not happen for Medigap. The new healthcare reform bill will not make any substantial changes to Medigap and the benefits the various plans provide.

The bill will maintain Medigap plans and will provide it to eligible Medicare recipients. It will continue to bridge the gap between that the out-of-pocket expenses that are not payable through Medicare.

What will happen is that there will be changes made on Medigap's plans.

Come June 2010, some plans will no longer be offered and new plans will be made available. Medigap will remove plans E, H, I and J even as it will start offering plans M and N. These new plans will be offered at lower premiums and higher cost-sharing.

Plan M includes coverage (and copayments) for skilled nursing services and facilities. It will also cover half of the deductibles of Medicare Part A. Plan N will cover virtually the same benefits but with 100% deductibles of Medicare Part A.

Also changes will be made to plans C and F. These are two of the most common plans being availed. Come 2015, these plans will provide coverage for all deductibles and coinsurance. These changes are made to encourage recipients to avail of physician services that they really need.

Another improvement that will be mandated for Medigap plans will be increased benefits for prescription drugs.

Effective in 2010, those who reach the limit of their Medicare prescription drugs benefit of $2,700 will get a rebate of $250 to help with any additional expenses they may incur for medications.

In addition, beginning 2011, those on Medigap will also get to enjoy 50% discounts on specified prescription drugs.

These changes are aimed towards getting rid of the considerable gap produced by the doughnut hole. This doughnut hole refers to the amount that the patient has to shell in after he has exceeded the Medicare prescription benefit limit of $2,700 and before the Medicare coverage picks up again.

Was this question and its answer useful?
Not a bit
  • Currently 0/5 Stars
  • 1
  • 2
  • 3
  • 4
  • 5
Very useful
Have a question about insurance? Ask the experts