H.R.1282

Title: To amend title XVIII of the Social Security Act to provide for guaranteed issue of Medicare supplemental policies for disabled and renal disease beneficiaries upon first enrolling under part B of the Medicare Program.

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One issue critical to planned Medicare reform is the difference between states in the provision and availability of Medigap insurance policies (or Medicare supplements) for people under 65, such as those who benefit from the ESRD program. 

Currently, there are efforts in several states to gather support for legislation mandating the issuance of Medigap policies to all Medicare beneficiaries, regardless of age.

In addition to the District of Columbia, the following states do not offer Medigap policies for Medicare beneficiaries under 65: Alabama, Alaska, Arizona, Arkansas, Delaware, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Montana, Nebraska, Nevada, New Mexico, North Dakota, Ohio, Rhode Island, South Carolina, Tennessee, Utah, Vermont, Virginia, West Virginia, and Wyoming.

Choosing a Medigap Polcy

Individuals who are entitled to Medicare solely on the basis of having ESRD may have problems if they drop their health insurance during the MSP period. If they live in one of the 21 states that do not sell Medigap plans to ALL Medicare beneficiaries, they will have no secondary insurance coverage if they drop their private health insurance and switch to Medicare. This loophole in healthcare coverage needs to be addressed in federal legislation, and has been in Rep. English’s bill, HR1282.