By Susan Jaffe | February 3, 2016 | Kaiser Health News in collaboration with Money magazine
Danny Thompson’s kidneys have failed and he needs a transplant but in some ways, he’s lucky: Both of his sons want to give him one of theirs, and his Medicare coverage will take care of most his expenses.
Danny Thompson (Heidi de Marco/KHN)
Yet the 53-year-old Californian is facing another daunting obstacle: He doesn’t
have the money for his share of the medical bills and follow-up drugs, and he can’t buy supplemental insurance to help cover his costs.
“It’s frustrating to be in the shape I’m in,” said Thompson, who depends on dialysis instead of his kidneys to cleanse his blood. “My plan is to get a transplant so I can go back to work.”
Almost one in four Medicare beneficiaries has such a policy, known as Medigap, which is sold by private insurance companies. It can help pay for costs Medicare doesn’t cover, including the 20 percent coinsurance required for medical expenses, including certain drugs, plus deductibles and co-payments. Those expenses have no out-of-pocket limit for beneficiaries.
This KHN story also ran on Money.
Federal law requires companies to sell Medigap plans to any Medicare beneficiary aged 65 or older within six months of signing up for Part B, which covers doctor visits and other outpatient services. If they sign up during this guaranteed open enrollment, they cannot be charged higher premiums due to their medical conditions.
But Congress left it to states to determine whether Medigap plans are sold to the more than 9 million people younger than 65 years old who qualify for Medicare because of a disability. [Continued in Kaiser Health News or Money magazine.]…