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How does MACRA affect you and Your Medigap Policy for 2020
What you Need to Know


Due to some recent confusion over plan changes and eligibility from the recent Medicare Access and CHIP Re authorization Act of 2015 (MACRA), we thought we would try to provide some clarity.

Here are three changes to Medigap Insurance plans in 2020:

Medicare Supplement Insurance Plans in 2020 cannot pay your Part B deductible.

This is one of the biggest changes going into effect in 2020. Medicare Supplement Insurance Plans C and F are two of the most popular plans because they offer first-dollar coverage—they pay 100% of your Part A and Part B deductibles. Unfortunately, when Congress reauthorized the Medicare program in 2015, the legislation passed phased out Medicare Supplement Insurance Plans that covered the Part B deductible effective January 1, 2020. 

If you buy either Plan C or Plan F prior to that date, you will be allowed to keep your plan after the new rule goes into effect. In some cases, you may even be able to buy a plan after the effective date if you became eligible for Medicare prior to December 31, 2019

A new high deductible Plan G will be available

The Centers for Medicare and Medicaid Services authorized a new high-deductible Plan G option. The new plan will be available as of January 1, 2020, and anyone eligible for Medicare can apply.  Although the new high-deductible Plan G can’t pay your Part B deductible, money you spend on your Part B deductible can be applied to your Plan G deductible

Lastly, the out of pocket maximums for Plans K and L will increase

In 2019, the out-of-pocket maximum for Plan K is $5,560, and for Plan L, it is $2,780. As part of the changes to Medicare Supplement Insurance Plans in 2020, these limits will increase to $5,880 for Plan K and $2,940 for Plan L.  Plan K and Plan L cover 50% and 75% respectively of your Part B coinsurance, Part A deductible, and Part A hospice and skilled nursing facility coinsurance amounts. Once you reach the out-of-pocket maximum, however, these plans pay 100% of your qualifying Part A and Part B expenses.


If a consumer is eligible for Medicare Part A prior to January 1st 2020, they will not lose eligibility to enroll into Plans C or F and may still purchase the plans in 2020 and beyond. Effectively, nothing changes for this group of Medicare beneficiaries.

Changes to MACRA will prohibit first dollar, out of pocket coverage of all claims on Plan F, High Deductible Plan F and Plan C, requiring *newly eligible Medicare beneficiaries to pay some of the cost of their medical care that was once covered entirely by one of these plans.


If a consumer is eligible for Medicare Part A starting January 1st 2020 or beyond, then they will not be eligible to enroll or purchase Plans C, F or HDF as an option for Medicare supplement plans. They will continue to have access to all other Medicare supplement plans.

For *newly eligible Medicare beneficiaries who can no longer purchase Plans C or Plan F in 2020, Plans D and Plan G will become the new “Guaranteed Issue” plans of choice.

The bottom line is that Medicare beneficiaries “Newly Eligible for Medicare Part A OR  B”  on January 2020 or after cannot choose a Plan C or F but instead Plan G will become the Flagship Policy.

*Note: “Newly eligible” is defined as those who turn 65 (or otherwise qualify) on, or after, the law goes into effect, or who first become eligible for Medicare Part A after January 1st, 2020.

Information not applicable for all states

Medigap Policy Review, A service we provide

With MACRA now in place, this brings about the Question:

Do I have the right Medigap policy?

At MedicareinLasVegas we encourage our clients with Medigap policies to review and compare prices and policy benefits frequently.  New Carriers are coming into the market offering lower competitive pricing along with additional ways to save money.  An example is the Household discount. Household discounts can range from 3% up to 15%.  This opportunity is available when 2 or more people live in a residence and either purchase a Medigap policy from the same carrier or make up a household.  This discount can impact the premium you pay monthly for your policy. Feel free to reach out to us for a Medigap Policy Review.  It’s easy and quick. We can search our list of Carriers and see if you may qualify to make a change and present you with a list of options.  The key benefit of the change would be the opportunity to SAVE money monthly.

Fill out our CONTACT US form , give us a call,  or Text Us.  If you have had your policy for a few years you would be surprised that you may save money for the exact same benefits.

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