Medigap is Medicare supplemental insurance to cover the costs that Medicare does not pay, such as copayments, coinsurance and deductibles. Dialysis patients who have Medicare as their primary insurance have different levels of access to Medigap plans depending on age and state. Medicare Part B pays 80 percent of dialysis costs. Without a good Medigap plan, the patient must pay 20 percent. Hence, if a dialysis patient covered by Medicare does not have secondary coverage or a Medigap plan, medical bills could easily cause bankruptcy. In twenty states, dialysis patients under the age of 65 on Medicare are not guaranteed a Medigap plan. In the other states, they may only have access to the Medigap plans that do not fully cover their expenses. Individuals with ESRD on dialysis, regardless of age, need access to affordable and comprehensive Medigap plans. The Medigap Consumer Protection Act of 2019 (H.R. 1394/S.2428) would require Medigap insurers to offer all Medigap plans to Medicare beneficiaries under the age of 65. Additionally, it would ensure that patients of all ages have access to these plans even when they face certain situations. These circumstances include switching from Medicare Advantage to traditional Medicare, losing Medicaid eligibility, or losing COBRA as a secondary plan. The Medigap Consumer Protection Act of 2019 is especially important for ESRD patients under the age of 65. Medicare alone is not considered fully insured by most transplant centers. In fact, dialysis patients are routinely denied a place on the transplant waiting list if they only have Medicare, without a Medigap or supplemental plan. Additionally, consumer protections for Medigap are strongest when Medicare beneficiaries enroll between ages 65 and 65 ½. During this time, Medigap insurers cannot take pre-existing conditions into account and premiums are usually at their lowest. Since ESRD patients can enroll in Medigap prior to age 65, they need these protections when they enroll in Medicare. The legislation would better ensure that ESRD patients on dialysis have access to the full Medigap insurance they need.Please contact your U.S. Senators and Representative and ask them to cosponsor the Medigap Consumer Protection Act of 2019.
Once you submit the form, your personalized message will be sent directly to your State Senator.
Please Cosponsor the Medigap Consumer Protection Act of 2019 (H.R. 1394/S.2428)
Dear [Decision Maker],
As your constituent and as someone who has been touched by kidney disease, I'm requesting that you cosponsor the Medigap Consumer Protection Act of 2019 (H.R. 1394/S.2428).As you know, having a diagnosis of kidney failure (end-stage renal disease-ESRD) and being treated with dialysis is the only medical condition that allows almost all Americans Medicare eligibility regardless of age. Hence, many dialysis patients under the age of 65 are on Medicare. However, twenty states do not require Medigap insurers to offer those plans to ESRD patients under the of 65.Medigap is crucial for ESRD patients who have Medicare as their primary health insurance. Dialysis is paid for through Medicare Part B, which pays 80 percent of the cost for the service. The patient must pay 20 percent. The out-of-pocket costs to the patient without a Medigap plan--upwards of $9,000 per year-- is simply unaffordable. Indeed, many dialysis patients must file for bankruptcy due to medical bills. Additionally, Medicare beneficiaries without a supplemental plan are not considered "fully insured." Dialysis patients are routinely denied a place on the kidney transplant waiting list because they do not have a supplemental plan. Access to Medigap can mean the difference between getting a kidney transplant and staying on dialysis for the rest of one's life. The Medigap Consumer Protection Act 2019 takes a number of steps to ensure that all Medicare beneficiaries, many of whom are now limited in their access to affordable Medigap plans, get the health coverage that they need. The bill would require Medigap insurers in all states to offer the full range of Medigap plans to people under the age of 65. It would also ensure that all Medicare beneficiaries who find themselves in circumstances such as losing Medicaid eligibility, switching from a Medicare Advantage plan to traditional Medicare; or having their COBRA plan expire have access to affordable Medigap plans. ESRD patients can find themselves in any of those circumstances.
Sincerely,[Your Name] [Your Address] [City, State ZIP]