medicare changes 2020

Medicare Supplement Changes Will Introduce Two New Eligibility Groups

Published by Lauren Hayden Digital Insurance, January 29, 2019

Insurance agents will begin to see the effects of Medicare Supplement changes quite soon! These modifications will go into operation on January 1, 2020. They could drastically change the way you do business and impact your clients who are looking to purchase a Medicare Supplement plan!

While 2020 might seem like a long way away, a smart agent always stays in the know and is prepared for what’s ahead. When determining which plans are the best fit for your clients, you’ll first need to figure out which group they fall into — newly eligible or non-newly eligible. We’re here to give you the rundown on both groups so you can feel confident you’re properly advising consumers.

As an insurance agent, you may or may not be familiar with the Medicare Access and CHIP Reauthorization Act of 2015, more commonly known as MACRA. MACRA is landmark legislation that introduced changes to how Medicare pays providers for seeing and treating traditional Medicare beneficiaries. But, what’s of most interest to agents and consumers is how these changes affect available Medicare Supplement plan options.

What You Need to Know About Med Supps in 2020

Which plan is right for your client will partly be determined by the category that best describes them. This new legislation changes who is considered newly eligible for Medicare Supplements and who is considered non-newly eligible for Medicare Supplements.

Who Is Newly Eligible?

MACRA defines “newly eligible” as anyone who attains age 65 on or after January 1, 2020, OR who first becomes eligible for Medicare benefits due to age, disability, or end-stage renal disease (ESRD) on or after January 1, 2020.

Who Is Non-Newly Eligible?

Those who are “non-newly eligible” for Medicare Supplements are beneficiaries who qualify for Medicare benefits due to age, disability, or ESRD before January 1, 2020.

A New Change Means a New Plan

The MACRA Medicare Supplement changes affect the plans your clients will be able to choose and which plans you’ll want to recommend for certain clients.

Starting January 1, 2020, there are a few items you’ll want to remember:

  • MACRA prohibits first-dollar coverage with Medicare Supplement plans for “newly eligible” Medicare beneficiaries — so Plans C, F, and high-deductible F cannot be sold to those “newly eligible” for Medicare.
  • MACRA makes Plans D and G guaranteed issue plans for “newly eligible” Medicare beneficiaries for the specified periods under current law that names Plans C and F as guaranteed issue for “non-newly eligible” Medicare beneficiaries.
  • A high-deductible Plan G will be available. “Newly eligible” Medicare beneficiaries and “non-newly eligible” beneficiaries can buy the new high-deductible Plan G.

Other Things to Keep in Mind

Along with who is “newly eligible” under these changes, there are some other important tidbits about Medicare Supplements to remember for 2020 and beyond!

For Your Clients Who Are Already Eligible for Medicare

If you have clients who are already eligible for Medicare, you might be wondering how these plans will affect them. Those who are eligible for Medicare prior to January 1, 2020, can continue with their Plan C or Plan F (if they’re enrolled in one) and may continue to buy Plans C and F beyond January 1, 2020. Also, once 2020 begins, they will be able to buy the new high-deductible Plan G. For people who qualify for Medicare because of a disability or ESRD on or after January 1, 2020, the restrictions under MACRA apply.

Make It Simple

Be sure to communicate with your clients effectively and clearly so they understand what’s going on and that you’re making plan suggestions with their best interests at heart.

It’s helpful to recognize that Plan D offers the same protection as Plan C, minus coverage for the Part B deducible. Likewise, Plan G is very close to Plan F, except Plan G doesn’t cover the Part B deductible. Plans C and F will no longer be available to “newly eligible” consumers, making Plans D and G the plans that can provide the most comprehensive coverage for your consumers who fall into this category. Also, note that the only difference between Plans D and G is that Plan G covers Part B excess charges and Plan D does not.

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