Nevada Enacts Medigap Expansion Legislation Supported by the American Kidney Fund

ROCKVILLE, Md. (June 10, 2025) - The American Kidney Fund (AKF) commends Nevada for passing legislation (SB 292) that requires Medicare supplement policies — known as Medigap — be made available to people under age 65 with disabilities who qualify for Medicare, including those with end-stage renal disease (ESRD). The bill was signed into law by Gov. Joe Lombardo on June 7.  

Medigap (private Medicare supplement insurance) plays a vital role for people living with ESRD on Medicare who rely on it to cover costs that Medicare does not. Importantly, the new law also helps make Medigap more affordable by including premium protection, preventing ESRD patients under 65 from having to pay a higher premium than Medigap Plans A, B, and D subscribers over 65 for most plans, and not more than twice the standard rate for other plans.   

While federal law requires Medigap insurers to offer plans to all Medicare beneficiaries who are 65 and over, the states control Medigap policy for Medicare beneficiaries under 65. 

By passing SB 292, Nevada has become the 34th state to require Medigap insurers to offer plans to people under 65 with ESRD who have Medicare as their health insurance.  

AKF played a leading role in the advancement of SB 292, including securing the sponsorship of the bill's primary sponsor, state Sen. Roberta Lange. AKF worked closely with Lange throughout the legislative process and testified in support of the bill in Carson City.  

"Kidney failure affects people both young and old and it can cause immense financial stress to individuals and their families," said LaVarne A. Burton, AKF President and CEO. "We are thankful to state Sen. Lange for her work and dedication to passing this legislation so that all Nevadans who need Medigap policies can access them and take care of their kidney health."  

Medicare is federal health insurance for people 65 and older and for younger people with disabilities, ESRD or ALS. But because Medicare covers only 80% of the cost of most services, beneficiaries have a 20% out-of-pocket responsibility with no annual limit. Having a secondary insurance such as Medigap is critical to ESRD patients because it protects them from that 20% cost burden. Health care for kidney failure, including dialysis, can cost $16,000 per year or more for a patient without secondary insurance like Medigap.  

Medigap coverage also plays an important role in helping people with ESRD get on the transplant waiting list. A kidney transplant is considered the best treatment for kidney failure. There are currently over 105,000 Americans on the organ transplant waiting list and more than 93,000 of them, or about 89%, are waiting for a kidney. In Nevada, 346 people are currently waiting for a kidney transplant. 

AKF's Health Insurance Premium Program helps ESRD patients with the premiums for all types of insurance, including Medigap. This long-term financial assistance from AKF makes transplants and post-transplant care possible for low-income dialysis patients. In 2024, AKF grants helped 1,601 people nationwide receive kidney transplants. AKF's program helps post-transplant patients for their full insurance plan year, ensuring continuity of care.