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State insurance department clarifies Medigap coverage

August 19, 2019

Delaware Department of Insurance Commissioner Trinidad Navarro issued a bulletin to agents and brokers last month clarifying the requirements of the Medicare Access and CHIP Reauthorization Act of 2015. This bulletin will help Medicare-eligible citizens better understand how MACRA will change the availability of certain Medicare Supplement insurance plans, more commonly known as Medigap.

Highlights of the bulletin include definitions and statements below:

“Newly eligible” means individuals who turn age 65 on or after Jan. 1, 2020, or first become eligible for Medicare due to age, disability or end-stage renal disease on or after Wednesday, Jan. 1. As of Jan. 1, the sale of Medigap plans C, F and F High Deductible will be discontinued and no longer available for purchase by newly eligible Medicare beneficiaries.

Newly eligible beneficiaries who turn age 65 on or after Jan. 1, or first become eligible for Medicare due to age, disability or end-stage renal disease on or after Jan. 1,  can purchase Medigap plans D, G or G High Deductible as a substitute for Medigap plans C, F and F High Deductible.

The discontinuation of plans C, F and F High Deductible will not affect a person currently age 65 or who will be 65 before Jan. 1.

The discontinuation of plans C, F and F High Deductible will not affect a person who first becomes eligible for Medicare due to age, disability or end-stage renal disease before Jan. 1.

Individuals who were Medicare-eligible before Jan. 1 will still be able to keep their C, F or F High Deductible plans and will be able to repurchase those lettered plans on or after Jan. 1.

Medigap coverage cannot be canceled and is guaranteed renewable as long as the policyholder pays the premium.

For more information about upcoming changes to Medigap, go to www.insurance.delaware.gov/divisions/dmab/ or call the Delaware Medicare Assistance Bureau at 1-800-336-9500 to speak to a Medicare counselor.

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