Supporting Medigap reform

Most people with ESRD are eligible for Medicare even if they are under 65. But 20 states do not require health insurers to offer private supplemental Medigap plans to these younger Medicare beneficiaries. Without Medigap, ESRD Medicare beneficiaries face daunting out-of-pocket expenses for the 20% of medical care not covered by Medicare Part B and that is not subject to an out-of-pocket cap. Additionally, ESRD Medicare beneficiaries are required to have supplemental insurance in order to be added to the kidney transplant waiting list, as Medicare alone is not considered full coverage by transplant centers across the nation. Without access to Medigap plans, many ESRD Medicare beneficiaries under 65 cannot access kidney transplantation.

To protect people living with ESRD who do not have access to Medigap, AKF supports:

• Federal legislation that would ensure guaranteed availability of Medigap supplemental insurance to all Medicare ESRD beneficiaries, regardless of age.

• State legislation that would require insurance companies that offer Medigap coverage to make it available to Medicare ESRD beneficiaries under 65 and that would place limits on the premiums charged to Medicare ESRD beneficiaries so that Medigap is affordable.