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The State of Medicare Supplement Coverage: Trends in Enrollment and Demographics


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Published on May 3, 2021

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For Medicare enrollees, purchasing Medicare Supplement (Medigap) coverage helps fill gaps in their Medicare Fee-For-Service (FFS) benefits. This report describes Medicare Supplement coverage options, demographics of enrollees with Medicare Supplement policies, and the most recent enrollment trends by using the latest available data sources: 2019 National Association of Insurance Commissioners (NAIC) data, 2019 California Department of Managed Health Care data, and 2018 Medicare Current Beneficiary Survey (MCBS) results.

Key takeaways include:

  • Only 4% of enrollees with Medicare Supplement coverage reported having difficulty paying medical bills in the last 12 months, compared to 12% of fee-for-service (FFS) Medicare enrollees without Medicare Supplement coverage.
  • Between December 2018 and December 2019, the national Medicare Supplement enrollment increased from 14 million to 14.5 million enrollees.
  • Among fee-for-service (FFS) Medicare enrollees without additional insurance coverage (such as Medicaid, employer-provided insurance, etc.), 50% had Medicare Supplement coverage in 2019.
  • Medicare enrollees with Medicare Supplement insurance were older than the general Medicare population: 43% of Medicare Supplement policyholders were 75 years old or older compared with 35% for all Medicare enrollees.