The Honorable Harvey S. Peeler Jr.
213 Gressette Building
Columbia, SC 29201

Dear Senator Peeler,

As the nation’s largest patient-led organization representing dialysis patients, Dialysis Patient Citizens (DPC) works to improve the quality of life for all dialysis patients through education and advocacy. On behalf of our membership, and particularly on behalf of the over 7,800 dialysis patients in South Carolina, we are writing today to thank you for introducing legislation to extend Medigap coverage to Medicare patients under the age of 65 with disabilities or end stage renal disease (ESRD). Once enacted, your legislation will help countless patients pay for critical services, while also saving the State’s vital resources.

Under current federal law, individuals living with ESRD under 65 years old are eligible for Medicare, due to their ESRD diagnosis. While Medicare covers most medical costs, those without a supplementary policy must pay co-insurance, co-pays and deductibles out-of-pocket. When Medigap plans were first introduced, Congress only guaranteed issue of these plans to traditional Medicare beneficiaries and therefore did not extend this protection to those who gain Medicare coverage prior to age 65, including ESRD patients. Many dialysis patients live on fixed incomes and having to pay deductibles and co-pays not covered by Medicare can cause serious financial strain. Because of this lack of access to supplemental plans, some ESRD patients under 65 are forced to spend down their assets to become eligible for Medicaid coverage. This is financially devastating for these individuals and, in the end, will cost the State – and its taxpayers – more money.

Currently, 29 states allow Medicare beneficiaries under 65 to purchase Medigap supplemental plans. By joining these states, South Carolina will protect ESRD patients from financial struggle and from having to spend down their assets just to gain critical insurance coverage. Preventing these patients from losing virtually all of their assets to pay for their care and enrolling in Medicaid will not only protect South Carolina citizens, but also help to preserve limited state funding. It makes sense for ESRD patients and for South Carolina and its taxpayers that private Medigap supplemental plans be sold to these beneficiaries. We thank you again for introducing this bill and look forward to working with you to build bipartisan support for this legislation. Please do not hesitate to contact DPC if you have any questions or if you need any additional information.


Hrant Jamgochian, J.D., LL.M.
Executive Director