Empowering Individuals Through Improved Access & Choice
KCP continues to support policies that protect access for individuals with kidney disease to all types of health insurance that best meet their healthcare needs and the needs of their families. Unfortunately, some insurance plans in recent years have changed their policies by refusing to allow individuals to access nonprofit charitable assistance programs for help cover their monthly premiums – thereby reducing choice and complicating individuals’ care decisions.
Similarly, some insurance plans have implemented policies to incentivize or mislead individuals in their marketing materials into enrolling early into Medicare. They’ve done this by implementing higher cost sharing requirements after a individual is diagnosed with kidney failure or misleading individuals about their right to retain private health insurance coverage. KCP supports change that ensure insurance plans do not discriminate against individuals on dialysis and that individuals can continue to make their own decisions about their coverage based on the intricacies of their individualized care
Further, KCP supports policies that would allow ESRD beneficiaries to have access to Medigap plans that assist with costs that aren’t covered by Medicare, such as co-payments, deductibles, and healthcare outside of the U.S. Currently, Medigap coverage is only guaranteed for Medicare beneficiaries age 65 and over, and is not available in every state to people 64 and younger, leaving many ESRD Medicare beneficiaries under the age of 65 to face the serious financial strain imposed by Medicare Part B’s 20 percent cost sharing on their own. Safeguarding access to high-quality care for younger individuals with kidney diseases requires that these individuals be able to afford the high cost of care and guaranteeing Medigap eligibility to individuals under the age of 65 is an important step towards that goal.
As part of our goal to further access and choice in insurance, KCP believes that individuals who have commercial insurance through an employer should be able to retain that insurance for an additional 12 months, granting these individuals the ability to decide whether or not to keep their insurance for up to 42 months after becoming eligible for Medicare, since many private plans have more robust healthcare offerings an lower co-pays and out of pocket expenses. Expanding the 30-month coordination period of ESRD beneficiaries to 42 months would allow these individuals to make more informed decisions about their healthcare, relieving unnecessary pressure on individuals with a life-threatening disease.
In summary, Congress should protect the rights of individuals with kidney failure of all ages, including those under 65, by allowing individuals with ESRD to access charitable assistance programs, outlawing policies that incentivize and mislead individuals to switch to Medicare, allowing access to Medigap plans for all individuals with ESRD and by lengthening the coordination period that these individuals have to make informed decisions about their health insurance. Enacting these reforms will alleviate the increasing strain on individuals on dialysis in the United States and will defend the right of individuals on dialysis to select their own insurance.