# Plain Language Summary: Close the Medigap Act of 2023

This bill makes significant changes to Medigap insurance, which is supplemental coverage that helps Medicare beneficiaries pay for costs that regular Medicare doesn't cover. The core change is that starting January 1, 2024, insurance companies will no longer be allowed to deny you Medigap coverage or charge you more based on your health status, medical history, or pre-existing conditions. Currently, many states allow insurers to reject applicants or price policies higher for people with health problems. Under this bill, if you're eligible for Medicare, you'll have a guaranteed right to buy any Medigap policy that the company offers to new customers, regardless of your health.

The bill also increases the percentage of premiums that insurance companies must spend on actual medical care rather than administrative costs and profits. Starting in 2024, companies will need to spend at least 75 percent of group policy premiums and 65 percent of individual policy premiums on benefits, with the possibility of even higher requirements. Additionally, the bill restricts how insurance companies can set prices. They can't charge different rates based on your age or your eligibility status for Medicare, and they can't set different prices for different parts of the same county. These changes aim to make Medigap more affordable and accessible, especially for older adults and people with chronic conditions.

The bill also requires the government to improve the Medicare Plan Finder website so people can better compare their options for Medigap coverage, including seeing provider networks, out-of-pocket costs, and premium information all in one place. Finally, the bill adds transparency requirements for Medigap brokers and agents, requiring insurance companies to report payments they make to these middlemen so consumers can understand potential conflicts of interest. The government will conduct an outreach campaign to inform Medicare beneficiaries about these new protections starting in 2024.

Close the Medigap Act of 2023

Doggett, Lloyd

Close the Medigap Act of 2023 This bill (1) expands guaranteed issue rights with respect to Medigap policies (Medicare supplemental health insurance policies), (2) eliminates certain limitations&nbsp;on Medigap policies for newly eligible Medicare beneficiaries, and (3) modifies other provisions related to Medigap policies. (Guaranteed issue rights require that a policy be offered to any eligible applicant without regard to health status.)