Younger Medicare Beneficiaries Face Obstacles to Medigap Coverage

A recent Washington Post article highlights the problems faced by younger Medicare beneficiaries when they want to purchase Medigap coverage, an important issue left unaddressed by the recent health care reform legislation.

The article focuses on the plight of Joe Hobson, a Virginia man who suffers from a rare disease that caused him to go suddenly and permanently blind when he was 60 years old. Because of his blindness, Mr. Hobson immediately qualified for Social Security Disability Insurance (SSDI) benefits and he now receives Medicare because of his disability. (Most SSDI beneficiaries must wait for two years after they are deemed to be "disabled" before they can qualify for Medicare coverage.)

Because Medicare does not cover all of the medical services that most people may require, many Medicare beneficiaries buy a supplemental health insurance policy, called a "Medigap" policy. This private health insurance covers services that Medicare will not pay for. Insurance companies offering Medigap plans to seniors over 65 cannot deny coverage based on pre-existing conditions and they cannot charge at-risk applicants higher premiums. However, the rules barring discrimination against applicants with pre-existing conditions do not apply to people with disabilities who are not yet 65 years old, like Mr. Hobson. This means that the cheapest Medigap policy that Mr. Hobson could purchase costs three times as much as plans available to people over 65.

Unable to afford a policy now, Mr. Hobson is going to wait until he turns 65 to purchase a cheaper Medigap policy, which leaves him at risk of paying out-of-pocket for any health care expenses not covered by Medicare until then. Mr. Hobson comments in the article, "there's something not right here."

To read the full article in the Washington Post, click here