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Medicare Eliminates First Dollar Coverage Option for New Medicare Members

September 25th, 2019

Medicare Eliminates First Dollar Coverage Option for New Medicare Members
The Medicare Access and CHIP Reauthorization Act of 2015, (MACRA) referred to as MACRA law, will change Medicare Supplement plans in all states starting January 1st, 2020 and impact newly eligible Medicare members heavily in Garfield and Eagle Counties.

Due to MACRA, on January 1, 2020:

• Medicare Supplement plans with Part B deductible coverage (Plans C, F and high deductible F) cannot be purchased by “newly eligible” Medicare recipients.
• The following guaranteed issue plans will be accessible for “newly eligible” Medicare recipients: Plans D, G, and high deductible G (which is brand new!)
• Total population over 65 in Garfield county is expected to increase by 5869 by 2030. That’s an 80.8% increase in Medicare Members in 10 years.
Starting January, 1st, 2020, Medicare Supplement Plans C and F will no longer be available to Newly Eligible Medicare Members. That means if you turn 65 or otherwise become eligible for Medicare after January 1st 2020, you won’t be able to purchase a Medicare Supplement Plan C or F.

The law states that if you are eligible for Medicare before January 1st, 2020 you are not considered “newly eligible” and the new MACRA rules do not apply. You can still purchase a plan F or Plan C and if you already have a Plan F or Plan C you will not lose your coverage.

“Most existing Medicare members won’t notice a difference with the elimination of Plan F and C since it only effects newly eligible members,” According to Justin Bever, Chief Strategy Officer and Licensed Colorado Insurance Producer for Medicare Compare. A senior insurance brokerage located in Carbondale, Colorado that helps Medicare members review their coverage and choose plan options.

“As a Baby Boomer who qualifies for Medicare after January 1st, 2020, you’ll have no option for First-dollar coverage through a Medicare Supplement plan,” Justin says. “That’s particularly concerning for The Western Slope as there’s a tidal wave of Baby Boomers who will join Medicare in the next 10 years here.”
According to the Colorado Demography Office, the population over 65 in Garfield county is expected to grow by 5869 and Eagle county is expected to grow by 3501 by year 2030. That’s an 80.8% increase in Medicare members in Garfield and a 59.3% increase in Eagle. Members who may not be able to choose first-dollar coverage when they turn 65.

First-Dollar coverage refers the Medicare Part B deductible currently covered by Plan F and C. The $185 deductible will not be covered for new Medicare members under the new Medicare Supplemental plan options.

While the loss of first-dollar coverage may seem detrimental, most Medicare members actually save money by choosing Plan G. Plan G covers everything a Plan F does except Part B deductible. The Part B deductible is $185 for 2019.

“The difference in annual premium between a Plan G and F is almost always more than the $185 deductible. That equals more money in your pocket every year when you choose Plan G,” Justin Bever explains. “There are also other Medicare Health Plan options available in a few Western Slope counties that still offer first dollar coverage and low out of pocket costs. I find that more and more members are considering other plan options every year during the Open Enrollment Period.”

The Open Enrollment Period for Medicare Advantage and Part D Prescription Drug starts October 15th and ends December 7th every year. During this time Medicare Beneficiaries in Colorado should review coverage changes for the new year and decide if they should elect a new plan to meet their needs for a January 1st effective date.

About Medicare Compare: Medicare Compare is a leading Senior Insurance Brokerage located in Carbondale, CO. They specialize in Medicare Health plans and serve Colorado Medicare Members to provide valuable information on Medicare changes, Cost comparisons of coverage and free benefit reviews. For additional questions call Justin Bever at 720-464-0125, email [email protected] or visit https://www.medicarecompare.com

Resources: Colorado Demographic Office- https://demography.dola.colorado.gov/AgeMap/
Medicare.gov – Medicare Supplement Plan F – G https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
Medicare.gov- Open Enrollment https://www.cms.gov/Outreach-and-Education/Reach-Out/Find-tools-to-help-you-help-others/Medicare-Open-Enrollment.html