American Kidney Fund Applauds Indiana for Expanding Medigap Access to People Under 65

ROCKVILLE, Md. (March 13, 2024) -- The American Kidney Fund (AKF) commends Indiana Gov. Eric Holcomb for signing S.B. 215 into law. This new law requires that Medicare supplemental policies — otherwise known as Medigap — be made available to people under 65 with disabilities who qualify for Medicare, including people under 65 with end-stage renal disease (ESRD).

Medigap is private insurance available to Medicare beneficiaries to cover the 20% in out-of-pocket costs that Medicare does not cover. Medicare covers dialysis treatments as an outpatient procedure and 20 percent of that cost (with no annual out-of-pocket limit) can cost approximately $10,000 per year or more for a patient without secondary insurance. 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 65. 

"Kidney failure can happen at any age and can be a devastating diagnosis to cope with — especially for a young person — without also worrying about financial concerns," said LaVarne A. Burton, AKF President and CEO. "We are grateful to Indiana state Sen. Kyle Walker and Rep. David Abbott for their work to pass this law to protect kidney failure patients under the age of 65 and provide them with access to essential insurance coverage."

By passing S.B. 215, Indiana also increases protections for people under 65 with ESRD who have Medicare as their health insurance. The bill includes critical premium protection, preventing ESRD patients under 65 from having to pay a higher premium than plan subscribers over 65 for plans A, B and D, and ensuring policies do not include any waiting periods or a preexisting condition limitation or exclusion.

Medigap coverage also helps patients with ESRD to get on the transplant waiting list. A kidney transplant is the best treatment for those with ESRD. There are over 103,000 Americans on the organ transplant waiting list and more than 90,000 of them, or about 88%, are waiting for a kidney. In Indiana, of the 1,244 people currently on the transplant waiting list, 1,108 are waiting for a kidney.

AKF provides long-term financial assistance that makes transplants and post-transplant care possible for low-income dialysis patients. In 2023, AKF grants helped 1,615 people nationwide receive kidney transplants. AKF's program helps post-transplant patients for their full insurance plan year, ensuring continuity of care.