State insurance commissioners are preparing some stern words of guidance for members of Congress attempting to decrease the federal deficit: do not touch Medicare supplemental insurance.
Subsequent week, the bipartisan National Association of Insurance Commissioners is expected to send a letter to Congress opposing modifications that would need beneficiaries to pay a greater share of the price of their supplemental Medigap insurance. Seven million Medicare beneficiaries already pay monthly premiums for these policies that cover a portion of medical costs Medicare does not.
The letter will warn Congress that such proposals -geared to saving the federal government cash - could trigger numerous issues for beneficiaries and insurers and might even be illegal, stated Mary Beth Senkewicz, Florida's deputy insurance commissioner, who heads the association's senior problems job force and is shepherding the letter via the approval procedure. She supplied a number of points from the letter, which was approved unanimously by the senior problems group on Thursday but can't be released towards the public until final approval subsequent week.
Growing cost-sharing for present Medigap policyholders could be a benefit alter that violates state and federal laws requiring guaranteed, renewable advantages, stated Senkewicz. It'll also trigger "serious confusion" for seniors with fixed incomes who rely on Medigap insurance to safeguard them from unanticipated medical expenses. Previously, Medigap modifications have applied only to new policies, she stated.
Shifting some expenses to Medigap beneficiaries has emerged as 1 of a number of proposals to decrease the federal deficit by cutting Medicare spending. Additionally, the 2010 wellness overhaul calls for some price shifting within the two most well-liked and generous Medigap plans but leaves the particulars to be ironed out by the NAIC and federal wellness officials.
The Congressional Spending budget Workplace estimates that shifting some expenses to beneficiaries could save the government as a lot as $53 billion in Medicare spending more than a decade, based on a report published last March. If beneficiaries need to reach into their very own pockets to pay for medical care, CBO predicts they'll use much less services and Medicare will have fewer claims to pay.
Medigap plans have been targeted simply because some studies have shown that beneficiaries using the plans have a tendency to use much more Medicare services. Consumer advocates counter that those seniors might be sicker than the typical Medicare patient, which is why they bought the additional coverage.
If Medigap cost-sharing rises, insurers will have "a monumental huge alter in payment systems," stated Senkewicz, requiring them to recalculate monthly premiums and their future expenses according to whether or not beneficiaries will qualify for full coverage or steer clear of filing claims. Below 1 proposal analyzed by CBO, seniors would pay $550 prior to Medigap coverage kicks in, after which half of the subsequent $4,950 expenses not covered by Medicare - for a total of $3,025 - prior to the Medigap policy would cover all remaining medical bills throughout a single year.
Insurance regulators are also worried about what occurs when a patient within the middle of a therapy regime is hit with new co-payments or other cost-sharing fees.
"If I've to begin paying for some thing that had been paid for by the insurance business, if I cannot afford it, I might need to quit therapy," stated Senkewicz.
NAIC's Medigap working group also has questioned the cost-sharing proposals, stated its chairman Guenther Ruch, an administrator at Wisconsin's insurance department. The group, comprised of consumer and insurance representatives also as state regulators, is preparing a background paper with much more particulars concerning the problem.
Ruch and Senkewicz expressed small doubt that the letter to Congress will probably be approved subsequent week.
"This is 1 of those uncommon instances exactly where everybody appears to be in agreement," stated Senkewicz.
Subsequent week, the bipartisan National Association of Insurance Commissioners is expected to send a letter to Congress opposing modifications that would need beneficiaries to pay a greater share of the price of their supplemental Medigap insurance. Seven million Medicare beneficiaries already pay monthly premiums for these policies that cover a portion of medical costs Medicare does not.
The letter will warn Congress that such proposals -geared to saving the federal government cash - could trigger numerous issues for beneficiaries and insurers and might even be illegal, stated Mary Beth Senkewicz, Florida's deputy insurance commissioner, who heads the association's senior problems job force and is shepherding the letter via the approval procedure. She supplied a number of points from the letter, which was approved unanimously by the senior problems group on Thursday but can't be released towards the public until final approval subsequent week.
Growing cost-sharing for present Medigap policyholders could be a benefit alter that violates state and federal laws requiring guaranteed, renewable advantages, stated Senkewicz. It'll also trigger "serious confusion" for seniors with fixed incomes who rely on Medigap insurance to safeguard them from unanticipated medical expenses. Previously, Medigap modifications have applied only to new policies, she stated.
Shifting some expenses to Medigap beneficiaries has emerged as 1 of a number of proposals to decrease the federal deficit by cutting Medicare spending. Additionally, the 2010 wellness overhaul calls for some price shifting within the two most well-liked and generous Medigap plans but leaves the particulars to be ironed out by the NAIC and federal wellness officials.
The Congressional Spending budget Workplace estimates that shifting some expenses to beneficiaries could save the government as a lot as $53 billion in Medicare spending more than a decade, based on a report published last March. If beneficiaries need to reach into their very own pockets to pay for medical care, CBO predicts they'll use much less services and Medicare will have fewer claims to pay.
Medigap plans have been targeted simply because some studies have shown that beneficiaries using the plans have a tendency to use much more Medicare services. Consumer advocates counter that those seniors might be sicker than the typical Medicare patient, which is why they bought the additional coverage.
If Medigap cost-sharing rises, insurers will have "a monumental huge alter in payment systems," stated Senkewicz, requiring them to recalculate monthly premiums and their future expenses according to whether or not beneficiaries will qualify for full coverage or steer clear of filing claims. Below 1 proposal analyzed by CBO, seniors would pay $550 prior to Medigap coverage kicks in, after which half of the subsequent $4,950 expenses not covered by Medicare - for a total of $3,025 - prior to the Medigap policy would cover all remaining medical bills throughout a single year.
Insurance regulators are also worried about what occurs when a patient within the middle of a therapy regime is hit with new co-payments or other cost-sharing fees.
"If I've to begin paying for some thing that had been paid for by the insurance business, if I cannot afford it, I might need to quit therapy," stated Senkewicz.
NAIC's Medigap working group also has questioned the cost-sharing proposals, stated its chairman Guenther Ruch, an administrator at Wisconsin's insurance department. The group, comprised of consumer and insurance representatives also as state regulators, is preparing a background paper with much more particulars concerning the problem.
Ruch and Senkewicz expressed small doubt that the letter to Congress will probably be approved subsequent week.
"This is 1 of those uncommon instances exactly where everybody appears to be in agreement," stated Senkewicz.
