Effective January 1, 2020, Medicare Supplement plans no longer cover the cost of the Medicare Part B deductible, as part of a federal change under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This law only affects people who become newly eligible for Medicare on or after January 1, 2020.
If you were enrolled in a Medicare Supplement plan before January 1, 2020, you can continue to use that plan. If you are eligible for a Medicare Supplement plan before January 1, 2020, but not yet enrolled, you’ll be able to enroll in eligible plans that continue to offer Medicare Part B deductible coverage (like our Medex®’ Bronze plan).
For 2019, the annual Part B deductible is $185, and subject to change on January 1 every year.
I currently have Medex® Bronze. How does this affect me?
If you’re a current Medex Bronze plan member, this MACRA law change doesn’t interfere with or change your eligibility or benefits in any way. You don’t need to take any action or switch plans.
You’re considered newly-eligible for Medicare if you meet one of the follow criteria:
- Will turn age 65 on or after January 1, 2020
- First become eligible for Medicare on or after January 1, 2020 due to age, disability or end-stage renal disease (ESRD)
Yes, learn more about our Medex Sapphire plan.
No, this federal mandate doesn’t affect people who are already enrolled in any of our Medex plans. If you’re already enrolled in one of these plans, your benefits won’t change because of this MACRA law.
No, if you’re already enrolled in one of our Medex plans, you don’t need to take any action or switch plans. Your benefits won’t change because of this federal mandate.
The federal mandate has no effect on your out-of-pocket costs; however, every year we’re required to file a request with the Massachusetts Division of Insurance (DOI) for benefit and premium rate changes for the following plan year. This may cause the cost of your premium to change.
Yes. Because you were eligible for Medicare before January 1, 2020, you can switch to the Medex Bronze plan for your future coverage.
This federal mandate won’t affect your benefit coverage or out-of-pocket costs in any way. However, if you’re newly eligible for Medicare as a result of a disability or end-stage renal disease (ESRD) beginning on or after January 1, 2020, you won’t be able to join the Medex Bronze plan.
Yes. If you were eligible for Medicare before January 1, 2020, you can enroll in a Medex Bronze plan after you retire, even if that happens on or after January 1, 2020. However, you must enroll in Part B to purchase a Medex plan on or after January 1, 2020.
No. All of our Medicare plans are individual plans, which means each member must be enrolled in his or her own plan with separate premiums, cost shares, and invoices.
If you were eligible for Medicare before January 1, 2020, you can enroll in any of the following Medicare Supplement plans: Medex Core, Medex Sapphire, or Medex Bronze.
People who are newly eligible for Medicare on or after January 1, 2020, can’t join the Medex Bronze plan or any other closed Medex plans.
No, the federal mandate does not affect Medicare Supplement plans offered by employer groups. If you are on a Medex retiree plan through your spouse’s or your previous employer, you aren’t affected by the law. The law only affects direct-pay Medicare Supplement plans.
MACRA is the Medicare Access and CHIP Reauthorization Act, a federal law passed in 2015 to change how Medicare reimburses health care providers. The MACRA model reimburses health care providers based on the quality of their services, rather than the quantity of services they perform. The value of care takes precedence over the volume of care.
The new MACRA law, effective January 1, 2020, will continue to help control overall health care costs, and help manage “waste” in the health care system by limiting federal reimbursements to health care providers.