Exhibit 1 Nearly one in four Medicare beneficiaries
Exhibit 1 Nearly one in four Medicare beneficiaries had a Medigap policy as a supplemental source of coverage in 2010 No Supplemental Coverage Multiple Sources of Coverage Other Public/Private Coverage only (without Medigap) 9% 14% 1% 15% Employer. Sponsored only Medigap 23% 26% Medicaid only 14% Medigap only Medicare Advantage only 13% 4% Medigap + Employer 2% Medigap + Medicare Advantage 2% Other coverage combinations (including Medigap) Total Medicare Beneficiaries, 2010 = 48. 4 Million SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2010.
Exhibit 2 Percent of Medicare Beneficiaries with Medigap by State, All Plans, 2010 National Average = 23% 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.
Exhibit 3 Distribution of Income of Medicare Beneficiaries, by Source of Supplemental Coverage, 2010 15% 32% 14% 11% 5% 31% 41% 25% 39% 1% 14% 30% 43% $40, 000 or more $20, 000 -$40, 000 42% 37% 39% 44% 53% 27% 17% All Medicare Beneficiaries 7% 5% Medigap Policyholders Employer 17% Medicare Advantage 12% 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. $10, 000 -$20, 000 Less than $10, 000
EXHIBIT 4 Exhibit 4 Share of Medicare Beneficiaries with Medigap Plans C and F, 2010 National Average = 12% 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.
Exhibit 5 Share of Medigap Policyholders by All Plan Types, 2010 Plan A Plan B 2% 3% MA, MN, and WI 4% SELECT 9% Pre. Standardization 8% Plan C 13% Plans H, I, K, L, M Each 1% or less Plan D 3% Plan E 1% Plan J 8% Plan N 2% Plan G 3% Plan F 40% 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 (Pre. Standardization), 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.
Exhibit 6 Distribution of Monthly Medigap Premiums, Plans A – J, 2010 90 th percentile National average premium $ 169 $ 177 $ 187 $ 175 $ 181 $ 186 $ 195 I J $ 169 $ 140 10 th percentile A B C D E F G H 10 th percentile $89 $130 $161 $149 $145 $155 $140 $149 $151 $157 90 th percentile $168 $198 $213 $205 $206 $197 $195 $208 $215 $211 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.
Exhibit 7 Average Monthly Medigap Premiums for Plan F, by State, 2010 National Average = $181 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.
Exhibit. A 2 Table 8 Standard Medigap Plan Benefits, 2013 BENEFITS MEDIGAP POLICY A B C D E 1 F G 2 H 1 I 1 J 1 K 3 L 3 Medicare Part A Coinsurance and all costs after hospital benefits are exhausted Medicare Part B Coinsurance or Copayment for other than preventive services Blood (first 3 pints) Hospice Care Coinsurance or Copayment (added to Plans A, B, C, D, F, and G in June 2010) Skilled Nursing Facility Care Coinsurance Medicare Part A Deductible Medicare Part B Deductible Medicare Part B Excess Charges Foreign Travel Emergency (Up to Plan Limits)* Out-of-Pocket Limit M 4 N 4 50% 75% * 50% 75% 50% $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. 1 After 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. 2 Benefits for Plan G reflect the standard benefit after June 1, 2010 (Part B excess charges changed from 80% to 100%). 3 Medigap Plans K and L available for purchase in 2005. 4 Medigap 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.
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