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CRS – Medigap: A Primer

Medigap: A Primer. Carol Rapaport, Analyst in Health Care Financing. September 19, 2012

  • “Medicare is a nationwide health insurance program for individuals aged 65 and over and certain disabled individuals. The basic Medicare benefit package (termed “Original Medicare” in this report) provides broad protection against the costs of many, primarily acute, health care services. However, Medicare beneficiaries may still have significant additional costs, including copayments, coinsurance, deductibles, and the full cost of services that are not covered by Medicare. In 2008, about 17% of Medicare beneficiaries purchased the private supplemental insurance known as Medigap to fill some of the cost gaps left by Original Medicare…This report provides a broad overview of Medigap insurance. The report covers the history of Medigap legislation, the various types of Medigap plans, consumer protections awarded to Medigap beneficiaries, and the requirements facing the insurance providers and the NAIC. Following an empirical description of Medigap markets, the report discusses proposals related to the percentages of a Medigap insurer’s revenue that is returned as benefits to the policy holders and Medigap cost-sharing requirements.”
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