Exhibit 1 SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey...

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

Transcript of Exhibit 1 SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey...

Page 1: Exhibit 1 SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2010. Nearly one in four Medicare.

Exhibit 1

SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2010.

Nearly one in four Medicare beneficiaries had a Medigap policy as a supplemental source of coverage in 2010

Other Public/Private Coverage only

1%

15% Medigap only

4% Medigap + Employer

2% Medigap + Medicare Advantage

2%Other coverage combinations (including Medigap)

Total Medicare Beneficiaries, 2010 = 48.4 Million

Medicare Advantage

only13%

Medicaid only14%

Employer-Sponsored only

26%

No Supple-mental Cover-

age14%

Medigap23%

Multiple Sources of Coverage

(without Medigap)

9%

Page 2: Exhibit 1 SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2010. Nearly one in four Medicare.

Exhibit 2

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.

Percent of Medicare Beneficiaries with Medigap by State, All Plans, 2010

National Average = 23%

25%12%

19% 29%

N/A17%

27%

22%

DC 9%

19%

20%

2%

24%

33% 29%

49%

46% 22%

17%

28%

21%

20%22%

21%

25%

27%

30%

47%13%

30%

26%

13%

12%

25%

51%

19%

24%

16%

27%19%

22%

50%

16%

19%

15%

35%

24%

21%

17%

26%38%

0%-15% 16%-20% 21%-25% 26%-30% 31%-40% More than 40%(6 states, DC) (12 states) (13 states) (10 states) (3 states) (5 states)

Page 3: Exhibit 1 SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2010. Nearly one in four Medicare.

Exhibit 3

All Medicare Beneficiaries

Medigap Policyholders

Employer Medicare Advantage

Medicaid No supp Cov

17%7% 5%

17%

53%

12%

37%39%

27%

42%

41%

44%

32% 39%

43%

31%

5%

30%

15% 14%25%

11%1%

14%

$40,000 or more$20,000-$40,000$10,000-$20,000Less than $10,000

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.

Distribution of Income of Medicare Beneficiaries, by Source of Supplemental Coverage, 2010

Page 4: Exhibit 1 SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2010. Nearly one in four Medicare.

Exhibit 4

SOURCE: K. Desmond, T. Rice, and Kaiser Family Foundation analysis of 2010 National Association of Insurance Commissioners (NAIC) Medicare Supplement data.

Share of Medicare Beneficiaries withMedigap Plans C and F, 2010

National Average = 12%

EXHIBIT 4

5%DC

3%8%

14% 6%

N/A 12%

12%

8%

8%

13%

1%

18%

19% 18%37%

39% 10%

10%

20%

13%

<1%<1%

18%

18%

21%

34%9%

8%

13%

8%

6%

11%

46%

11%

15%

12%

15%17%

13%

36%

10%

11%

9%

13%

15%

12%

10%

29%

<1%16%

0%-5% 6%-10% 11%-15% 16%-20% 21%-30% More than 30%(5 states, DC) (13 states) (16 states) (8 states) (2 states) (5 states)

Page 5: Exhibit 1 SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2010. Nearly one in four Medicare.

Exhibit 5

Plan A2% Plan B

3%

Plan C13%

Plan D3%

Plan E1%

Plan F40%

Plan G3%

Plan J8%

Plan N2%

Plans H, I, K, L, MEach 1% or less

PreStandardization8%

MA, MN, and WI4%

SELECT9%

Share of Medigap Policyholders by All Plan Types, 2010

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.

Page 6: Exhibit 1 SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2010. Nearly one in four Medicare.

Exhibit 6

A B C D E F G H I J

$140

$169 $177 $187

$175 $181 $169

$186 $196 $195

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.

Distribution of Monthly Medigap Premiums, Plans A – J, 2010

90th percentile

National average premium

10th percentile

10th percentile $89 $130 $161 $149 $145 $155 $140 $149 $151 $157

90th percentile $168 $198 $213 $205 $206 $197 $195 $208 $215 $211

Page 7: Exhibit 1 SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2010. Nearly one in four Medicare.

Exhibit 7

National Average = $181

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.

Average Monthly Medigap Premiums for Plan F, by State, 2010

$174$158

$166 $163

N/A$181

$183

$184

DC $180

$209

$173

$139

$176

$193 $186

$176

$174 $177

$189

$156

$209

$201$175

$155

$177

$178

$172

$189$181

$183

$220

$165

$226

$162

$154

$178

$171

$154

$163$171

$173

$178

$168

$190

$178

$129

$158

$172

$171

$174

$162

Less than $150 $151-$160 $161-$170 $171-$180 $181-$190 More than $190(2 states) (6 states) (7 states) (19 states, DC) (9 states) (6 states)

Page 8: Exhibit 1 SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2010. Nearly one in four Medicare.

Exhibit 8

BENEFITSMEDIGAP POLICY

A B C D E1 F G2 H1 I1 J1 K3 L3 M4 N4

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.

Standard Medigap Plan Benefits, 2013Table A2