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Trends In Medigap Enrollment And Coverage Options, 2014

by Center for Policy and Research

October 2, 2015

 Key Takeaways

11.2 million peopleBetween December 2013 and December 2014, enrollment in Medigap increased to 11.2 million, up from approximately 10.6 million in December 2013.

 

27% to 30%The percent of Medicare fee-for- service (FFS) beneficiaries with Medigap plans has been stable since 2010, ranging from 27 percent to 30 percent each year.

 

newer standardized Medigap plansOver the last several years, the fastest-growing Medigap plans have included newer standardized Medigap plans that contain enrollee cost-sharing requirements (copayments, coinsurance, and deductibles). For example, the highest rate of growth in enrollment was in Plan N, which includes cost sharing of up to $20 for physician office visits and up to $50 for certain emergency room visits (waived in some circumstances); enrollment in Plan N grew by 33 percent between December 2013 and December 2014.

Background

Medigap is a key source of supplemental coverage for Medicare beneficiaries. Seniors purchase Medigap coverage to protect themselves from high out-of-pocket costs not covered by Medicare, to budget for medical expenses, and to avoid the confusion and inconvenience of handling complex bills from health care providers.

In 2014, the Medicare Part A program had a $1,216 deductible per benefit period for inpatient hospital care (Part A) and coinsurance beginning with day 61 of hospitalization.2 Part B required a 20 percent coinsurance for outpatient and physician care after an annual deductible of $147.3 In addition, the Medicare program does not have a limit on beneficiaries’ potential out-of-pocket costs.

Appendix A, found at the end of this report, provides detailed information on the benefits and cost- sharing features of 2014 standardized Medigap plans.