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DOI Issues Clarification on Medigap

August 14, 2019
1:55 PM

Agents and brokers selling Medigap policies take note: The Delaware Department of Insurance (DOI) this week issued a clarification on the requirements of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) with regards to how MACRA will change the availability of certain Medicare Supplement insurance plans, more commonly known as Medigap. The communication stems from inquiries to the DOI from Medicare eligible citizens.

Commissioner Navarro in his release specifically mentions agents and brokers, noting that:

As this act is rather complex, it has not been determined if consumers have been misinformed, or if they did not fully understand what was relayed to them by agents and brokers. The lack of complete understanding can have a damaging effect relative to decision making for Medicare beneficiaries or their caretakers.

In April 2015, U.S. Congress passed MACRA. Section 401 of MACRA prohibits the sale of Medigap policies that cover Part B deductibles to “newly eligible” Medicare beneficiaries. “Newly eligible” is defined as those individuals who: (a) have attained age 65 on or after Jan. 1, 2020; or (b) first become eligible for Medicare due to age, disability or end-stage renal disease, on or after Jan. 1, 2020.

This most recent clarification from the DOI follows a bulletin released this spring, which also was intended to explain the upcoming MACRA changes.

Read DOI press release