TDCI: Consumers should be aware of Medigap facts andfalsehoods

Posted By | December 2, 2019 2:12 pm

As Tennesseans consider their health plans ahead of the Dec. 15, 2019 deadline to enroll for coverage on the Federally Facilitated Marketplace, the Tennessee Department of Commerce & Insurance (TDCI) reminds consumers of next year’s changes to Medigap plans and clarifies who is and who is not affected by the changes.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) makes changes to the sale of Medigap Plans C, F, and F High Deductible after January 1, 2020. These changes do not affect anyone who turns 65 before January 1, 2020, nor anyone else who is eligible for Medicare due to disability or end-stage renal disease before that date. Those eligible for Medicare before Jan. 1, 2020 can still purchase Plans C, F and F High Deductible even after the changes for newly eligible consumers take effect.

What to do if you will be newly eligible after January 1, 2020: If you turn 65 on or after January 1, 2020, or otherwise become eligible for Medicare due to disability or end-stage renal disease after that date, then you are considered “newly eligible.” Newly eligible enrollees cannot purchase Plans C, F or F High Deductible after January 1, 2020.

Medigap Plans D, G and G High Deductible will be replacing Plans C, F, and F High Deductible for newly eligible beneficiaries. All other Medigap plans will remain unchanged.

False information about MACRA is being spread. TDCI has learned that policyholders in Tennessee and elsewhere have been erroneously told that premiums for Plans C and F and F High Deductible will be so expensive that eligible Tennesseans should switch coverage. Such statements are false and misleading and violate Medigap insurance laws. Consumers should remember: If you have a Plan C or F or F High Deductible, as long as you pay the premium, the Medigap coverage cannot be cancelled.

It is not true that Plans C and F and F High Deductible will no longer be available after 2019. The plans will still be available to those who were eligible for Medicare before Jan. 1, 2020.

For more information, visit cms.gov, tn.gov/commerce, or call 615-741-2218.

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