In 2015, Congress passed, and the President signed into law, a measure that makes
changes to the sale of Medigap Plans C, F and F High Deductible after January 1, 2020. The
law is the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
There is a lot of misinformation being circulated about these MACRA changes. The purpose
of this bulletin is to make clear what MACRA does and does not do and clarify and correct
the false and misleading information provided by some groups, entities and individuals.
DOES THIS CHANGE AFFECT EVERYONE?
*If an individual is currently age 65 or will be age 65 before January 1, 2020, MACRA DOES NOT
affect them.
*If an individual first becomes eligible for Medicare due to age, disability or end-stage renal
disease before January 1, 2020, MACRA DOES NOT affect them.
WHO IS CONSIDERED “NEWLY ELIGIBLE”?
*“Newly eligible” means those persons who a) attain the age of 65 on or after January 1, 2020
or b) first become eligible for Medicare due to age, disability or end-stage renal disease, on or
after January 1, 2020.
*A person who reaches the age of 65 or is eligible for Medicare BEFORE January 1, 2020 IS NOT a “newly eligible” individual.
HOW ARE MEDICARE SUPPLEMENT PLANS AFFECTED?
*MACRA states that, as of January 1, 2020, those who are “newly eligible” CANNOT buy or be sold Plans C, F or F High Deductible after January 1, 2020.
*All other Medigap plans will remain unchanged EXCEPT for Medigap Plans D, G and G High
Deductible replacing Plans C, F, and F High Deductible for “newly eligible” beneficiaries.
*For the “newly eligible,” Plans D, G, and G High Deductible substitute for Plans C, F and F High
deductible.
ADDITIONAL INFORMATION
*Plans C, F or High F will not be discontinued for those individuals who became eligible for Medicare before January 1, 2020. Those individuals who were Medicare eligible before January 1, 2020 will still be able to keep their policies or can purchase and can still be sold Plans C or F on or after January 1, 2020.
*Medigap coverage is guaranteed renewable and, so long as the policyholder pays the premium, the coverage cannot be canceled. Some policyholders are being told that Plans C and F will no longer be available after December 31, 2019 and must therefore purchase new coverage in order to not lose their Medigap coverage – THAT IS NOT TRUE.
*Some policyholders are being told that premiums for coverage under Plans C or F will be increasing to such an extent that they should purchase other coverage. These would be considered FALSE or MISLEADING statements to induce policyholders to improperly switch coverage and are in clear violation of Medigap insurance laws. If a state finds such activity, the state can take appropriate administrative action.
We are not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area, and any information we provide is limited to those plans we do offer in your area. Please get in touch with Medicare.gov or 1-800-MEDICARE to get information on all your options.