Fundamentals Briefing

Medicaid, Employers, and Medigap: Wrapping Around Medicare
February 6, 2009


Mary Ellen Stahlman


Most Medicare beneficiaries supplement their Medicare coverage with secondary or wrap-around insurance, most commonly Medicaid, employer-sponsored retiree health insurance, or Medigap. These insurance plans help pay Medicare’s cost-sharing requirements, such as deductibles and coinsurance, and they cover some health care services that are not covered by Medicare at all.Coordinating insurance policies can be a challenge for Medicare beneficiaries, and congressional offices are frequently involved in resolving issues. How does secondary insurance work with Medicare? Which insurance pays first, and what happens to the claim after Medicare pays its share? What are the special issues for beneficiaries who have both Medicare and Medicaid (dual eligibles)? What are the trends in employer-sponsored retiree health insurance? What is “Medigap” insurance, and is it getting too expensive for typical beneficiaries?This session explored these and other issues surrounding Medicare wrap-around policies.


James Verdier, Senior Fellow, Mathematica Policy Research, Inc.; Hinda Chaikind, Specialist, Health Care Financing, Congressional Research Service; Brian Webb, Manager, Health Policy and Legislation, National Association of Insurance Commissioners

Slides from the presentations by Mr. Verdier, Ms. Chaikind, and Mr. Webb are available for download.

Related Materials

This session was the second of three follow-ups to the Forum's 2009 Medicare and Medicaid Briefings, held January 15 and 16, 2009. See also "The World of Prescription Drugs: Approvals, Pricing, and Purchasing" (January 30, 2009) and "Comparative Effectiveness: What Is It? Who Does It? And Where Is It Going?" (February 13, 2009).

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