Medicare Supplement insurance

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Medicare Supplement insurance (also referred to as MedSupp or Medigap) provides coverage for a beneficiary’s various obligations under traditional Medicare, such as the Part B deductible and coinsurance. MedSupp allows seniors to see any Medicare provider in the country and its products are subject to different regulatory requirements than those of Medicare Advantage (MA). MedSupp is regulated at the state level (subject to federal provisions) rather than by the Centers for Medicare and Medicaid Services (CMS).

While the MedSupp market as a percentage of total Medicare enrollment (including MA members) decreased from 24% in 2005 to 21% in 2014, the actual membership has grown approximately 9% in the same period. The growth of the senior market together with regulatory challenges to the MA industry will likely keep the MedSupp industry viable and relevant—although it is not without its own regulatory changes and challenges. The Medicare Access and CHIP Reauthorization Act of 2015 will affect the MedSupp industry in calendar year 2020 due to the introduction of new benefit coverage restrictions affecting what can and cannot be covered. At Milliman, we have the experience, resources, and industry knowledge to help carriers evaluate the ramifications of the new legislation.

We have extensive experience in the MedSupp industry, providing assistance with:

  • Pricing and experience benchmark analysis
  • Rate filing
  • Financial reporting
  • Application/underwriting analysis
  • Actuarial appraisals
  • Market research and competitive intelligence