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Upcoming Open Enrollment Deadlines for Nevada Dialysis Patients

2025-10-29T18:34:36+00:00October 29th, 2025|Categories: Article, Medicare Advantage, Medigap Coverage, Protect Patient Care, State Advocacy|

In a major victory for under age 65 Nevadans living on dialysis, Senate Bill 292 became law earlier this year. SB 292 provides access for under-age 65 dialysis patients to purchase affordable Medigap insurance plans A, B and D at the same premium rate as those who are age 65. The remaining Medigap lettered plans are available at 200% of the age 65 premium. This legislation impacts not only individuals who have just started dialysis and enrolled in Medicare Part B, but it also includes a one-time, 6-month open enrollment window for dialysis patients who are already enrolled in Medicare Part [...]

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Ongoing Government Shutdown

2025-10-29T14:39:54+00:00October 6th, 2025|Categories: Article, Medicare Advantage, News, Promote Financial Security, Protect Patient Care|

The federal government is currently shut down due to a spending impasse in Congress over extending Affordable Care Act subsidies and restoring Medicaid cuts in H.R.1, the reconciliation bill passed in July. It is unclear how long the shutdown will last.  The shutdown halts many of the federal government’s “nonessential” functions, but your benefits under entitlement programs such as Medicaid and Medicare continue. According to communications from the Department of Health & Human Services (HHS) sent to patient advocates (10/1/25), 1-800-MEDICARE will continue to operate as usual. State Health Insurance Assistance Programs (SHIPs) should be able to continue their regular program activities but designated [...]

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Rhode Island Passes Birthday Rule and Evaluates Community Rating for Medigap Plans

2025-06-25T14:04:54+00:00June 20th, 2025|Categories: Article, Medicare Advantage, Medigap Coverage, Promote Financial Security, Protect Patient Care, State Advocacy|

On Friday, June 20, the Rhode Island House passed SB610, Sub B, joining the Senate in approving a birthday rule and evaluation of adopting community rating for all Medicare Supplement plans.  SB 610 is awaiting the Governor’s signature. SB 610 does a number of things, including establishing a guaranteed-issue 6-month open enrollment period for individuals under-age 65 enrolled in a Medicare supplement (Medigap) plan who wish to switch to a different plan upon turning age 65.  While all individuals turning age 65 who enroll in Medicare Part B are entitled to this 6-month open enrollment period, this language eliminates any confusion [...]

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Delaware Unanimously Passes Medigap Birthday Rule

2025-06-25T13:59:21+00:00June 13th, 2025|Categories: Article, Medicare Advantage, Medigap Coverage, Promote Financial Security, Protect Patient Care, State Advocacy|

With a unanimous vote in the Delaware House of Representatives on June 12, the Delaware General Assembly has unanimously passed SB 71 in both chambers. This legislation, called a birthday rule, creates a special open enrollment window for persons already enrolled in a Medicare Supplement policy (also called Medigap) to switch to another plan that provides the same or lesser benefits, allowing Enrollees to find a plan that better fits their financial circumstances. Further, this bill allows those on Medicare Advantage plans to switch back to Medicare Supplement coverage, but does include a pre-existing condition limitation.  The special open enrollment window [...]

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State must guarantee Medigap for dialysis

2025-04-22T18:42:06+00:00April 18th, 2025|Categories: Medicare Advantage, Medigap Coverage, Patient Ambassadors, Patient Stories in the News, Promote Financial Security|

I have progressive chronic kidney disease (CKD). One day, my kidneys will fail. Dialysis — a life-saving treatment that removes waste from the blood when the kidneys fail — is in my future. Right now, I am doing everything I can to slow the progression of my disease. But one thing I can’t control is whether I’ll be able to afford very expensive dialysis treatment when the time comes. I recently lost my job, which means I lost my private insurance. I bought my own private plan to keep the care I need, but that’s only a temporary fix. My [...]

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Letter to the Editor: Expanding Medigap Will Save Lives

2025-04-15T19:30:23+00:00April 15th, 2025|Categories: Medicare Advantage, Medigap Coverage, Patient Ambassadors, Patient Stories in the News, Promote Financial Security|

As a dialysis patient and healthcare professional, I urge California’s state legislature, especially Sen. Caroline Menjivar (CA-20) and Assemblymember Nick Schultz (CA-44), to support Senate Bill 242. This bill expands access to affordable Medigap plans for all dialysis patients, regardless of age. Kidney failure comes unexpectedly for most, as it did for me. Kidney failure requires routine dialysis treatment to stay alive while awaiting a transplant, and I spent two years on peritoneal dialysis before receiving a kidney and pancreas transplant. Without reliable healthcare coverage, my transplant wouldn’t have been possible and I would have died simply because I am [...]

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Expand Medigap Coverage

2025-04-22T18:11:53+00:00March 10th, 2025|Categories: Medicare Advantage, Medigap Coverage, Patient Ambassadors, Patient Stories in the News, Promote Financial Security, Spotlight|

My husband and I have end stage renal disease, or kidney failure, and depend on dialysis to survive. It is difficult for Texans in similar situations to afford lifesaving dialysis, especially people who don’t qualify for Medicaid. Medicare covers only 80% of dialysis costs, leaving many patients responsible for the rest. It can cost thousands of dollars a year without proper coverage. Supplemental insurance plans called Medigap can help fill the gap that Medicare leaves open. However, Medigap plans remain unaffordable for dialysis patients younger than 65. To fix this, Texas must guarantee affordable Medigap access for dialysis patients. State [...]

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Georgia Medigap Legislation Passes First Hurdle

2025-02-27T14:59:05+00:00February 25th, 2025|Categories: Article, Medicare Advantage, Medigap Coverage, Patient Ambassadors, Promote Financial Security, Protect Patient Care, State Advocacy|

On February 24, HB 323 was unanimously approved by the Health Committee of the Georgia House of Representatives. Sponsored by State Representative Karen Mathiak (R-82), this legislation will provide affordable access to Medigap coverage to the under 65 Medicare eligible population. DPC Patient Ambassadors Kristi Flynn and Christopher Richards shared their stories with the committee, helping legislators understand the unique challenges faced by both kidney transplant and dialysis patients. HB 323 will now go to the full House for consideration, and if approved, moves over to the Senate. Thank you, Kristi and Christopher, for traveling to Atlanta to advocate for all [...]

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Medicare Drug Plans Are Getting Better Next Year. Some Will Also Cost More.

2024-10-24T12:55:43+00:00October 21st, 2024|Categories: Article, Immunosuppressive Drug Coverage, Medicare Advantage, News, Promote Financial Security|

By Susan Jaffe October 21, 2024 When Pam McClure learned she’d save nearly $4,000 on her prescription drugs next year, she said, “it sounded too good to be true.” She and her husband are both retired and live on a “very strict” budget in central North Dakota. By the end of this year, she will have spent almost $6,000 for her medications, including a drug to control her diabetes. McClure, 70, is one of about 3.2 million people with Medicare prescription drug insurance whose out-of-pocket medication costs will be capped at $2,000 in 2025 because of the Biden administration’s 2022 Inflation Reduction Act, according [...]

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DPC Comments to CMS Sound Alarm on Workforce Shortages

2024-08-22T14:11:27+00:00August 20th, 2024|Categories: Article, Comment Letter, Innovation, Medicare Advantage, Promote Financial Security, Protect Patient Care|

In our comments responding to Medicare’s annual ESRD Payment Rule, DPC took the government to task over payment updates that lag increases in labor costs and failure to effectively cover new drugs for dialysis patients. The proposed rule grants a net increase in the base rate of only 0.8% during a year in which wages, according to Bureau of Labor Statistics, rose 4.2%. The Medicare Payment Advisory Commission estimates a margin of zero for dialysis facilities in 2024, with many rural and low-volume facilities in the red. This occurs at a time in which a Supreme Court decision has emboldened [...]

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