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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.

decision Plan C Plan F

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.

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