Tuesday, February 25, 2014
Medigap Discriminates against PWDs under 65. Information Bulletin # 385 (022014). Did you know that the federal Supplemental Insurance for Medicare Part B (called Medigap) is required to be offered, by States, only to people 65 or older? For disabled people under 65 who receive Social Security Disability Insurance and Medicare, States are not required to offer Medigap. Even the nondiscrimination requirement in the Affordable Care Act for people with disabilities and preexisting conditions does not cover those individuals under 65 who receive Medicare only (i.e., people who do not also receive Medicaid as a “dual eligible”). It does not matter if they want to purchase a Medigap/Supplemental Insurance policy but live in a State that does not offer it. To summarize, States are allowed to discriminate if you are on Medicare only, under 65 and want to purchase a Medigap/Supplemental insurance policy. 80% of most Medicare Part B services are paid for by the federal government and the remaining 20% is paid for by the individual. People over 65 purchase a Supplemental insurance policy called Medigap to cover the 20%. Because there is no federal Medicare requirement for states to offer Medigap insurance to people under the age of 65 who are on Medicare, disabled people under 65 must pay the Part B noncovered 20% out of their own pockets. That can really be expensive and a deterrent to obtain health care. 21 states and the District of Columbia do not require and offer no Medigap insurance to people with disabilities under 65 on Medicare only. These are: Alabama, Alaska, Arizona, Arkansas, Idaho, Indiana, Iowa, Kentucky, Montana, Nebraska, Nevada, New Mexico, North Dakota, Ohio, Rhode Island, South Carolina, Utah, Virginia, Washington, Washington D.C., West Virginia, Wyoming 29 states however have decided to offer some type of Medigap insurance to people under 65. The amount they charge for this Medigap insurance may be significantly higher than the amount they charge for the same policy to people 65 or older. These States are: California*, Colorado, Connecticut, Delaware**, Florida, Georgia, Hawaii, Illinois, Kansas, Louisiana, Maine, Maryland, Massachusetts*, Michigan, Minnesota, Mississippi, Missouri, New Hampshire, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Texas, Vermont*, Wisconsin (* A Medigap policy isn’t available to people with End Stage Renal Disease (ESRD) under 65 ** A Medigap policy is only available to people with ESRD.) PEOPLE ON MEDICARE ONLY UNDER THE AGE OF 65 – WE NEED YOUR HELP! The Institute for Disability Access (1640A East 2nd St, Austin, Texas 78702, 512/442-0252) wants to find out if you have attempted to purchase a Medigap policy and have been denied or you have been charged an amount per month for insurance significantly higher than people 65 or older! If you have had to pay the 20% out of your own pocket or are in debt because of the 20% copay, they want to have that information too. The Institute is trying to ascertain the extent of the discrimination for people with disabilities under the age of 65 and on Medicare only in receiving insurance because of a PRE EXISTING CONDITION (now prohibited by the Affordable care Act). If you are willing to share your story please contact the Institute at the above address. Steve Gold, The Disability Odyssey continues Back issues of other Information Bulletins are available online at http://www.stevegoldada.com with a searchable Archive at this site divided into different subjects. Information Bulletins will also be posted on my blog located at http://stevegoldada.blogspot.com/ To contact Steve Gold directly, write to email@example.com or call 215-627-7100. Ext 227.