American Kidney Fund Applauds Rhode Island for Expanding Medigap Access to People Under 65

ROCKVILLE, Md. (July 14, 2022) — The American Kidney Fund (AKF) applauds Rhode Island Gov. Dan McKee for signing S2194/H7244. This new law requires that Medicare supplemental policies, or Medigap, be made available to people with disabilities that qualify for Medicare, including people with end-stage renal disease (ESRD), who are under age 65.

AKF is grateful to Sen. Dennis L. Algiere for introducing the bill in the Rhode Island Senate and to the bill's cosponsors in the House: Rep. Mia Ackerman (D), Rep. Samuel Azzinaro (D), Rep. David Bennett (D), Rep. Julie Casimiro (D), Rep. Grace Diaz (D), Rep. John Edwards (D), Rep. Brian Kennedy (D), Rep. Mary Messier (D), Rep. David Morales (D) and Rep. Brandon Potter (D).

Medigap is private insurance available to Medicare beneficiaries to cover costs that Medicare does not cover. Federal law stipulates that Medigap insurers must offer plans to all beneficiaries age 65 and over, but state law dictates Medigap policy for Medicare beneficiaries under the age of 65. With the passage of S2194/H7244, Rhode Island is the 31st state to require Medigap insurers to offer plans to people with ESRD who have Medicare as their insurance.

"This legislation is a huge victory for people with ESRD in Rhode Island," said LaVarne A. Burton, AKF President and CEO. "Nearly half of dialysis patients in the state are under 65 years old. Without a Medicare Supplement plan, the high out-of-pocket costs for their life-saving treatment can drive patients to bankruptcy."

Medicare covers dialysis treatments as an outpatient procedure, which means that it covers only 80 percent of the cost of treatment. The patient must pay the other 20 percent with no annual out-of-pocket limit. Dialysis, which usually occurs three times a week, can cost approximately $10,000 per year or more for a patient without secondary insurance. Access to a Medigap plan can ease the burden of these high costs, making it easier for patients to cope with the serious financial challenges that patients often experience after being diagnosed with a chronic disease.

Medigap coverage also allows patients with ESRD to get on the transplant waiting list.

"Most transplant centers will not accept Medicare beneficiaries onto their transplant list without secondary insurance such as Medigap," said Burton. "Since a kidney transplant is the best treatment for those with ESRD, it is not an understatement to say that this legislation will be a lifesaver."

There are more than 106,000 Americans on the organ transplant waiting list and 92,000 of them, or 87%, are waiting for a kidney. In Rhode Island, all 290 people currently on the transplant waiting list are waiting for a kidney.

AKF provides long-term financial assistance that makes transplants and post-transplant care possible for low-income dialysis patients. In 2021, AKF grants helped 1,889 people nationwide receive kidney transplants — 7% of all kidney transplants performed in the United States last year. AKF's program helps post-transplant patients for their full insurance plan year, ensuring continuity of care.