Medigap (or Medicare Supplement) is private insurance available to Medicare beneficiaries to cover costs that Medicare does not cover. Federal law stipulates that Medigap insurers must offer plans to all beneficiaries age 65 and over, but state law dictates Medigap policy for Medicare beneficiaries under the age of 65. For individuals with end-stage renal disease (ESRD) under the age of 65 who are enrolled in Medicare, they can find themselves without a Medigap plan.
Medigap is vital for people with ESRD because Medicare covers dialysis as an outpatient procedure, which means that it pays for 80 percent. The patient must pay the other 20 percent with no annual out-of-pocket limit. Dialysis is usually three times a week, and hence, very expensive—approximately $10,000 per year or more -- for a patient without secondary insurance. In fact, it can drive patients to bankruptcy. Even more dire, however, is that most transplant centers will not accept Medicare beneficiaries onto their transplant list of they do not have secondary insurance, such as Medigap. It means that without a Medigap plan, ESRD patients can be denied the life-saving procedure of a kidney transplant.
Currently, twenty states do not require Medigap insurers to offer plans to people with ESRD who have Medicare as their insurance.
On September 8, 2020, Iowa Representative Cindy Axne introduced, H.R.8181, the Jack Reynolds Memorial Medigap Expansion Act. The bill would require insurers nationwide to offer the same Medigap plans to Medicare ESRD beneficiaries under age 65 that all Medicare beneficiaries over age 65 have. The bill would provide a much-needed insurance option, and it would offer a lifeline to Medicare ESRD patients under age 65 who want to be added to the kidney transplant list.
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Please cosponsor H.R.8181, the Jack Reynolds Memorial Medigap Expansion Act
Dear [Decision Maker],
Sincerely,[Your Name] [Your Address] [City, State ZIP]