Laying a Solid Foundation | Lesson 7


In the last lesson, we mentioned that Medicare Supplement regulations mostly come from the state level.

Except when they don’t.

A great example of an exception to this rule is MACRA, the Medicare Access and CHIP Reauthorization Act of 2015.

Though MACRA brought many changes, the change with the greatest impact to consumers was prohibiting Medicare Supplements from covering the Part B deductible for newly eligible Medicare beneficiaries.

Newly eligible means someone who attained the age of 65 OR first became eligible for Medicare due to a disability on or after January 1, 2020.

Practically speaking, this created two new eligibility groups: Newly eligible and non-newly eligible.

Let’s compare these two groups.

Newly eligible beneficiaries were first eligible for Medicare on or after January 1, 2020.

Members of this group cannot purchase Medicare Supplement Plan C, F, or high-deductible F, since those plans cover the Part B deductible.

Since they cannot purchase Plans C and F, they can enroll in plans D and G with a guaranteed-issue right.

This group will find the most comprehensive coverage in Plan D, G, and high-deductible G.

Conversely, non-newly eligible beneficiaries were first eligible for Medicare prior to January 1, 2020.

They can still purchase Plans C, F, and high-deductible F.

Because they can still purchase Plans C and F, they are not able to enroll in Plans D and G with a guaranteed issue right.

Instead, they continue to have Plans C and F as two of their guaranteed issue options.

Although Plans C and F provide the most comprehensive coverage, this group may eventually find it more cost-effective to switch to Plans D or G.

To read more about this change, you can review our Agent Survival Guide article in the resources for this module.

To best help your clients navigate their Medicare Supplement choices, it’s crucial to understand which group they belong to.

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