United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2001-07-31 monographic deposited born digital 36 p. GA 1.13:GAO-01-941 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-941 P0b002ee180393f4c f:d01941 DGPO 2010-08-12 2011-03-28 GAOREPORTS-GAO-01-941 machine generated eng fdlp REPORT GAOREPORTS-GAO-01-941 GAO-01-941 Health care cost control Health insurance cost control Managed health care Health insurance Cost analysis Drugs Cost sharing (finance) Medicare Choice Program Medicare Program Medigap Other Written Product A01492 Millions of Medicare beneficiaries depend on private insurance to cover expenses not covered by Medicare, such as deductibles, copayments, coinsurance, and prescription drugs. To protect themselves against large out-of-pocket costs and help fill Medicare's coverage gaps, most beneficiaries purchase Medicare supplemental insurance (known as Medigap), contribute towards employer-sponsored retiree health benefits to supplement Medicare's coverage, or enroll in private Medicare+Choice plans as an alternative to the traditional fee-for-service Medicare plan. Since Medicare+Choice plans are not available in many parts of the country and many employers do not offer retiree health benefits, Medigap may be the only supplemental insurance option widely available to seniors. As Congress continues to examine potential changes to the Medicare program, it is important to consider the role that Medigap supplemental coverage has on beneficiaries' use of services and expenditures. Medicare beneficiaries who purchase Medigap plans have coverage for essentially all major Medicare cost-sharing requirements, including coinsurance and deductibles. But offering this ''first-dollar'' coverage may undermine incentives for prudent use of Medicare services, especially with regard to discretionary services, which could ultimately increase the costs for beneficiaries and the entire Medicare program. While the lack of coverage for outpatient prescription drugs through Medicare has led to various proposals to expand Medicare benefits, relatively few beneficiaries purchase standardized Medigap plans offering these benefits. Low enrollment in these plans may be due to fewer plans being marketed with these benefits, their relatively high cost, and the limited nature of their prescription drug benefit, which still requires beneficiaries to pay more than half of their prescription drug costs while receiving a maximum of $3,000 in benefits. As a result, Medigap beneficiaries with prescription drug coverage continue to incur substantial out-of-pocket costs for prescription drugs and other health care services. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-941/html/GAOREPORTS-GAO-01-941.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-941/pdf/GAOREPORTS-GAO-01-941.pdf GAO-01-941 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-941 Other Written Product GAO-01-941; Medigap Insurance: Plans Are Widely Available but Have Limited Benefits and May Have High Costs; Health care cost control Health insurance cost control Managed health care Health insurance Cost analysis Drugs Cost sharing (finance) Medicare Choice Program Medicare Program Medigap Volume 104 Page 1388 104 Stat. 1388 Volume 111 Page 355 111 Stat. 355 Public Law 101-508 Public Law 105-33 Public Law 106-113