2010 Medigap Plan Changes

Effective June 1, 2010 there are planned changes to the current standardized Medigap policy offerings. These changes will impact all companies offering Medicare Supplement insurance.

History:
The Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) included language to encourage the National Association of Insurance Commissioners (NAIC) to modernize the Medigap market. The NAIC decided to review the Medigap plans to determine if there were changes that could be made to the benefit packages in response to changes in the marketplace since the standardization of the product in 1990.

Summary of 2010 Changes:

Eliminates 4 Medigap Plans:

• Plan E, H, I, and J are eliminated

Modernizes Benefits:

• Eliminates the At-Home Recovery Benefit (Affects Plan D, G, I and J)
• Eliminates Preventive Care Benefit (Affects Plans E and J)
• Replaces the 80% Part B Excess Charges Benefit with a 100% benefit (Affects Plan G)
• Creates a new Hospice Benefit as part of Basic (Core) benefits (Affects all plans, starting 6/1/2010) :

1. Medicare offers a hospice benefit with a drug co-pay and inpatient respite care coinsurance. The 2010 modernized plans will now cover the expenses below as a core benefit
2. * $5 co-pay for outpatient prescription drugs for pain and symptom management* 5% of the Medicare-approved amount for inpatient respite care (short-term care given by another caregiver so the usual caregiver can rest). Does not include room and board

Creates New Plan Options:

• Plan M - with increased cost-sharing (including 50% coverage of Part A Deductible)
• Plan N - with new co-pay structure (will offer similar benefits to Plan F, but there will be a $20 co-payment for doctor visits and a $50 co-pay for emergency room visits - waived upon admission to the hospital).
• Both Plans M &N have all the core benefits plus the foreign Travel Emergency Benefit. And the cost of these plans will be approximately 75% of the cost of Plan F.

Summary:

• * Overall = Reduces number of plans from 14 to 11.
• * Plans E, H, I, and J are no longer offered due to duplicity as a result of benefit changes
• * Eliminates outdated and underutilized benefits
• * Adds new plans that feature higher cost sharing and lower anticipated premiums for policyholders.