Exciting news for kidney disease patients in Idaho to be thankful for this holiday season!

Idaho released its final reforms on Medigap insurance, which will make large strides towards helping give end stage renal disease patients (ESRD) under age 65 new options to get medical insurance coverage.  This new policy by the Idaho Department of Insurance, titled the “Rule to Implement the Medicare Supplement Insurance Minimum Standards Model Act,” will prevent Medigap issuers from denying or limiting Medicare supplemental policies, due to health status, conditions, or claims experience.   It will cap the price for these policies at no-more-than 150% of policies for those over age 65, until the policyholder becomes 65.  The rule would also allow those who successfully appeal their denial of Medicare Part B benefits to receive the full six-month grace period to enroll in Medigap.

Deen Vetterli, the National Kidney Foundation’s (NKF) CEO for Utah and Idaho, spearheaded NKF’s outreach on this important rule.  Reaching out to Idaho’s civic leaders, such as Health and Welfare Committee Chairman Heider and Dean Cameron, the Director of the Department of Insurance, she explained current insurance practices and changes needed to improve the lives of the more than 2,000 ESRD patients in Idaho.

Significant costs can be incurred by Medicare patients that make Medigap coverage necessary. For instance, the inpatient hospital deductible for Medicare under Part A is $1288. Dialysis treatments, which are typically needed at least three times weekly, are covered under Part B at 80%, and the cumulative out-of-pocket expenses can well exceed $7,000 annually. When kidney patients cannot afford the deductibles and co-payments associated with Medicare, it can have a detrimental effect on their health and access to healthcare.

This rule will be approved by the Idaho legislature in 2017.  After this time, policies will become available to those under age 65.