Medigap Plan C and Plan F are going away

The following is an expansion of an excerpt from the book A Medicare Owner’s Manual. This book was published in January, 2019 and is available on Amazon.

With the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Medigap Plan C and Plan F will no longer be available beginning in the year 2020. This is due to the fact that these plans pay for the Medicare Part B deductible, and the MACRA law eliminates Medigap plans that provide this coverage.

If you have enrolled in a Medigap Plan C or Plan F prior to 2020 you may be able to keep the plan, but you will not be able to change to a new policy of Plan C or Plan F with a starting date of January 1, 2020 or later.

Plus, if you were eligible for Medicare, either by virtue of your age (65 before 2020) or by disability or end-stage renal disease (ESRD) before 2020, you can still purchase a Medigap Plan C or Plan F, even if you had another plan previous to 2020.

MACRA

The Medicare Access and CHIP Reauthorization Act had many facets. The primary provisions are:

• changes to the way providers are reimbursed by Medicare
• changes to funding provisions
• an extension of the Children’s Health Insurance Program (CHIP)

So the provision we’re interested in was actually just an add-on, put in place to eliminate a class of benefit that Congress deemed was inappropriate to the way the Medicare system should work. Specifically, under Medigap Plan C and Plan F, even the first dollar of cost (of Medicare Part B) to the enrollee is covered. Plan C and Plan F both have complete coverage of the deductible for Medicare Part B. For 2019, the Medicare Part B deductible is $185.

If you request a Medigap Plan C or Plan F from your insurer and you first became eligible for Medicare in 2020 or later, you will instead get a Medigap Plan D or Plan G, respectively. Plan D is identical to Plan C, except for the Medicare Part B deductible coverage. The same applies for Plan G – it’s identical to Plan F except for the Medicare Part B deductible coverage.

In addition, since there is a high-deductible Medigap Plan F, there will be a new option, a high-deductible Medigap Plan G available in 2020 for new enrollees.