Connecticut Expands Medigap Options for Medicare Beneficiaries Under Age 65

Effective July 1, 2021, Connecticut Medicare beneficiaries who qualify for Medicare by reason of disability will be able to select standardized Medicare Supplement (“Medigap”) plan D, in addition to plans A and B. (Medigap plan C remains available only for those beneficiaries whose Medicare eligibility began before January 1, 2020). The Center for Medicare Advocacy worked with the state legislature to achieve passage of the amended statute to expand Medigap rights.[1]

Connecticut law has strong Medigap protections for all Medicare-eligible residents. Plans are community-rated and have continuous guarantee issue[2] – meaning rates are the same regardless of age and issuance of a policy cannot be denied based on age, pre-existing condition, or how long someone has been on Medicare.[3]

Until 2020, companies selling Medigap plans in Connecticut had been required to offer Medigap plans A, B and C to individuals eligible for Medicare by reason of disability. However, the federal Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) restricted the sale of Medigap plan C (and F, and F high deductible) only to people eligible for Medicare before January 1, 2020. Therefore, anyone who became eligible for Medicare on or after January 1, 2020 may not buy or be sold Medigap plan C.

Both MACRA, and corresponding changes to Connecticut Insurance Regulations[4], indicate that Medigap plan C was to be re-designated as plan D. However, a corresponding change in the Connecticut General Statutes was needed to ensure that under Connecticut law, companies are required to offer Medigap plan D to individuals who qualify for Medicare by reason of disability.

Adding Medigap plan D for people who are Medicare-qualified by reason of disability allows for Medigap options as similar as possible to beneficiaries who became eligible for Medicare before January 1, 2020. These options in plan D include skilled nursing facility coinsurance and foreign travel emergency coverage.

The Center for Medicare Advocacy applauds the Connecticut state legislature for maintaining one of the United States’ most robust Medigap programs. Having continuous, community-rated Medigap options allows Connecticut Medicare beneficiaries more opportunities to move freely, as needed, between traditional Medicare and a Medicare Advantage plan. We encourage other states to follow suit with their own state laws.

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[1] Connecticut General Statutes Title 38a, Chapter 700c, Section 38a-495c (d)
[2] https://portal.ct.gov/-/media/CID/1_LifeHealth/Medicare_Supplement_Insurance_Rates.pdf
[3] Those age 65 or older without prior employer health insurance, MA-PD, or Medigap coverage within 63 days of Medigap enrollment may have a waiting period before pre-existing health conditions are covered by the Medigap policy. All beneficiaries under age 65 may be subject to applicable pre-existing condition waiting periods, regardless of prior coverage. Waiting periods are as long as 6 months for a pre-existing condition.
[4] Connecticut Insurance Regulations Section 38a -495a-6b (a)(1)