Medicare Beneficiaries Supplemental Coverage Insights

Explore data on the distribution of Medicare beneficiaries with Medigap policies as supplemental coverage, state-wise Medigap prevalence, income levels across coverage sources, and share of beneficiaries with Medigap Plans C and F in 2010.

• Medicare
• Beneficiaries
• Medigap
• Coverage
• Analysis

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1. Exhibit 1 Nearly one in four Medicare beneficiaries had a Medigap policy as a supplemental source of coverage in 2010 Multiple Sources of Coverage (without Medigap) 9% No Supplemental Coverage 14% Other Public/Private Coverage only 1% 15% Medigap only Employer- Sponsored only 26% Medigap 23% 4% Medigap + Employer 2%Medigap + Medicare Advantage Medicare Advantage only 13% Medicaid only 14% Other coverage combinations (including Medigap) 2% Total Medicare Beneficiaries, 2010 = 48.4 Million SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2010.

2. Exhibit 2 Percent of Medicare Beneficiaries with Medigap by State, All Plans, 2010 National Average = 23% 21% 28% 35% 51% 30% 30% 21% 20% 19% 12% 16% 26% 50% 24% 22% 27% 26% 38% 27% 49% 47% 22% 21% 19% 13% 33%29% 17% 15% 24% DC 9% 17% 22% 46% 27% N/A 25% 16% 22% 24% 29% 13% 19% 25% 20% 25% 17% 12% 19% 2% 19% 0%-15% (6 states, DC) 16%-20% (12 states) 21%-25% (13 states) 26%-30% (10 states) 31%-40% (3 states) More than 40% (5 states) NOTE: Analysis excludes California, as the majority of health insurers do not report their data to the NAIC. Analysis includes standardized plans A-N, policies existing prior to federal standardization, plans in Massachusetts, Minnesota, and Wisconsin that are not part of the federal standardization program, and plans that identified as Medicare Select; excludes plans where number of covered lives was less than 20. Number of Medigap policyholders as of December 31, 2010, as reported in the NAIC data. SOURCE: K. Desmond, T. Rice, and Kaiser Family Foundation analysis of 2010 National Association of Insurance Commissioners (NAIC) Medicare Supplement data. Kaiser Family foundation and Mathematica Policy Research analysis of CMS State/County Market Penetration Files.

3. Exhibit 3 Distribution of Income of Medicare Beneficiaries, by Source of Supplemental Coverage, 2010 1% 5% 11% 14% 14% 15% 25% 31% 41% 30% 32% 39% 43% $40,000 or more $20,000-$40,000 $10,000-$20,000 42% 37% 44% Less than $10,000 39% 53% 27% 17% 17% 12% 7% 5% All Medicare Beneficiaries Medigap Policyholders Employer Medicare Advantage Medicaid No supp Cov NOTE: Numbers do not sum due to rounding. SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2010.

4. EXHIBIT 4 Exhibit 4 Share of Medicare Beneficiaries with Medigap Plans C and F, 2010 National Average = 12% 12% 13% 20% 46% 21% 8% <1% <1% 17% 12% <1% 6% 36% 18% 16% 12% 13% 29% 15% 37% 34% 8% 13% 11% 19% 18% 9% 10% 9% 15% DC 12% 5% 39% 18% N/A 10% 10% 11% 13% 15% 6% 14% 8% 13% 18% 3% 8% 10% 11% 1% 8% 0%-5% (5 states, DC) 6%-10% (13 states) 11%-15% (16 states) 16%-20% (8 states) 21%-30% (2 states) More than 30% (5 states) SOURCE: K. Desmond, T. Rice, and Kaiser Family Foundation analysis of 2010 National Association of Insurance Commissioners (NAIC) Medicare Supplement data.

5. Exhibit 5 Share of Medigap Policyholders by All Plan Types, 2010 Plan A 2% MA, MN, and WI 4% Plan B 3% SELECT 9% PreStandardization 8% Plan C 13% Plan D 3% Plans H, I, K, L, M Each 1% or less Plan E 1% Plan J 8% Plan N 2% Plan F 40% Plan G 3% Total Number of Medigap Policyholders, 2010= 9.3 million NOTE: Analysis excludes California, as the majority of health insurers do not report their data to the NAIC. Analysis includes standardized plans A-N, policies existing prior to federal standardization (PreStandardization), and plans in Massachusetts, Minnesota, and Wisconsin that are not part of the federal standardization program; includes plans that identified as Medicare Select; excludes plans where number of covered lives was less than 20. Number of Medigap policyholders as of December 31, 2010, as reported in the NAIC data. SOURCE: K. Desmond, T. Rice, and Kaiser Family Foundation analysis of 2010 National Association of Insurance Commissioners (NAIC) Medicare Supplement data.

6. Exhibit 6 Distribution of Monthly Medigap Premiums, Plans A J, 2010 $196 $195 $187 $186 $181 $177 $175 90th $169 $169 percentile $140 National average premium 10th percentile A B C D E F G H I J $89 $130 $161 $149 $145 $155 $140 $149 $151 $157 10th percentile $168 $198 $213 $205 $206 $197 $195 $208 $215 $211 90th percentile NOTE: Analysis excludes California, as the majority of health insurers do not report their data to the NAIC. Analysis includes standardized plans A-J; excludes plans K-L because of the small number of policyholders enrolled in these plans; excludes policies existing prior to federal standardization; excludes plans in Massachusetts, Minnesota, and Wisconsin; excludes plans that identified as Medicare Select; excludes plans where number of covered lives was less than 20. SOURCE: K. Desmond, T. Rice, and Kaiser Family Foundation analysis of 2008-2009 National Association of Insurance Commissioners (NAIC) Medicare Supplement data.

7. Exhibit 7 Average Monthly Medigap Premiums for Plan F, by State, 2010 National Average = $181 $172 $156 $129 $154 $172 $183 $155 $201 $171 $154 $226 $174 $178 $176 $175 $183 $220 $162 $163 $176 $178 $189 $184 $209 $181 $193$186 $171 $178 $158 DC $180 $181 $177 $174 $178 N/A $162 $168 $173 $171 $163 $165 $166 $177 $173 $174 $189 $158 $190 $139 $209 Less than $150 (2 states) $151-$160 (6 states) $161-$170 (7 states) $171-$180 (19 states, DC) $181-$190 (9 states) More than $190 (6 states) NOTE: Analysis excludes California, as the majority of health insurers do not report their data to the NAIC. Analysis includes standardized plan F; excludes plans that identified as Medicare Select; excludes plans where number of covered lives was less than 20. SOURCE: K. Desmond, T. Rice, and Kaiser Family Foundation analysis of 2008-2009 National Association of Insurance Commissioners (NAIC) Medicare Supplement data.

8. Exhibit 8 Standard Medigap Plan Benefits, 2013 Table A2 MEDIGAP POLICY BENEFITS E1 G2 H1 I1 J1 K3 L3 M4 N4 A B C D F Medicare Part A Coinsurance and all costs after hospital benefits are exhausted Medicare Part B Coinsurance or Copayment for other than preventive services * 50% 75% Blood (first 3 pints) 50% 75% Hospice Care Coinsurance or Copayment (added to Plans A, B, C, D, F, and G in June 2010) 50% 75% Skilled Nursing Facility Care Coinsurance 50% 75% Medicare Part A Deductible 50% 75% 50% Medicare Part B Deductible Medicare Part B Excess Charges Foreign Travel Emergency (Up to Plan Limits)* Out-of-Pocket Limit $4,800 $2,400 NOTES: Check marks indicate 100 percent benefit coverage. Amount in table is the plan s coinsurance amount for each covered benefit after beneficiary pays deductibles or cost-sharing amounts, where applicable. The Affordable Care Act eliminated cost-sharing for preventive benefits rated A or B by the U.S. Preventive Services Task Force, effective 2011. 1After June 1, 2010, Medigap Plans E, H, I, and J are no longer available for purchase by new policyholders; existing policyholders may remain in these plans. 2Benefits for Plan G reflect the standard benefit after June 1, 2010 (Part B excess charges changed from 80% to 100%). 3Medigap Plans K and L available for purchase in 2005. 4Medigap Plans M and N available for purchase after June 1, 2010. *Plan N pays 100% of the Part B coinsurance except up to $20 copayment for office visits and up to $50 for emergency department visits. SOURCE: Centers for Medicare & Medicaid Services, 2013 Guide to Health Insurance, February 2013.