Recent Proposals to Limit Medigap Coverage and Modify Medicare Cost Sharing

This paper discusses Medicare’s current cost-sharing requirements, Medigap insurance, and proposals to modify Medicare’s cost-sharing and eliminate first-dollar coverage in Medigap plans. It reviews the evidence on the effects of first-dollar coverage on spending, some objections to eliminating first-dollar coverage, and results of research that has modeled the impact of eliminating first-dollar coverage, modifying Medicare’s cost-sharing requirements, and adding an out-of-pocket limit on beneficiaries’ spending.