Can I Keep My Medigap Plan C or F?

Can I Keep My Medigap Plan C or F?

You not only can keep a Medigap Plan C or F if you have one, there is no legitimate reason for you to replace it.

Rumors have been flying around about Medigap Plans C and F and whether people can keep them or have to give them up. The rumors are a result of Congressional changes in the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. That Act prohibits the sale of Medigap Plans C and F beginning in 2020, but only to newly eligible Medicare beneficiaries. This prohibition applies to anyone who becomes 65 in 2020 or later, or anyone who becomes eligible for Medicare in 2020 or later because of disability or ESRD.

Congress did not prohibit the sale of these policies to people who were already eligible or enrolled in Medicare before 2020. Medicare beneficiaries eligible or enrolled in Medicare before 2020 can continue to purchase these two Medigap plans even beyond 2020.

In addition, if someone is enrolled in a Medicare Advantage (MA) plan before 2020 and that MA plan leaves their service area in 2020 or later, they will still be able to buy a Medigap Plan F under guaranteed issue rules. Similarly, an individual who becomes eligible for Medicare before 2020, continues to work and delays enrollment in Part B, may buy Medigap Plan C or F if they leave that employment and enroll in Part B in 2020 or later. This assumes, of course, that Congress doesn’t make any additional changes to further restrict beneficiaries’ choices.

The National Association of Insurance Commissioners (NAIC) has reconvened their Medigap subgroup. This subgroup is required by federal law to incorporate Congressional changes into the NAIC Model Act and Regulation that becomes part of the law in each state. This subgroup will explore the changes that need to be made, and clarify the requirements companies must comply with under federal law. When the NAIC Medigap subgroup has completed their work, legislation will be introduced in California to make sure our state law mirrors the federal requirements by 2020.

Stayed tuned to this space for more information on this topic.

Karen Fletcher
Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.

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