Medicare Advantage Act Closes Medigap Plan F to New Enrollees
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 closed Medigap Plans C and F to new enrollees who became eligible for Medicare on or after January 1, 2020. However, existing holders can retain their plans, while some pre-2020-eligible individuals may still purchase Plan F today. This restriction has led to a decline in enrollment from approximately 4.9 million in 2023 to around 4.5 million by 2024. The shrinking pool of younger and healthier members is causing upward pressure on premiums, as the remaining enrollees tend to be older or sicker. This adverse selection increases claims per member faster than average, prompting carriers to request larger premium hikes. Switching from Plan F to Plan G could save money if its monthly cost remains within $24 of Plan F’s; however, many existing holders cannot pass underwriting requirements outside the initial enrollment period. Plan F offers first-dollar coverage that includes Part B deductibles—unlike Plan G—which attracts high healthcare users but also concentrates risk. While some carriers may close specific policy forms or rating blocks independently, there is no federal mandate to do so nationwide.
Topics: insurance regulation MACRA Act Medicare Medigap Plan F