Empowering Patients Through Improved Access & Choice
KCP continues to support policies that protect kidney failure patients’ access to all types of health insurance that best meet their healthcare needs and the needs of their families. Unfortunately, some insurance plans in recent years have changed their policies by refusing to allow patients to access nonprofit charitable assistance programs for help cover their monthly premiums – thereby reducing patient choice and complicating their care decisions.
Similarly, some insurance plans have implemented policies to incentivize or mislead patients in their marketing materials into enrolling early into Medicare. They’ve done this by implementing higher cost sharing requirements after a patient is diagnosed with kidney failure or misleading patients about their right to retain private health insurance coverage. KCP supports change that ensure insurance plans do not discriminate against dialysis patients and that patients can continue to make their own decisions about their coverage based on the intricacies of their individualized care.
The CKD Improvement in Research and Treatment Act would incentivize the improvement of care coordination by granting individuals with kidney failure earlier access to Medicare Advantage plans, thereby allowing ESRD beneficiaries the same freedom of choice and access to improved coordinated services that other Medicare-enrolled individuals enjoy.
Further, KCP supports policies that would allow ESRD beneficiaries to have access to Medigap plans that assist with costs that aren’t covered by Medicare, such as co-payments, deductibles, and healthcare outside of the U.S. Currently, Medigap coverage is only guaranteed for Medicare beneficiaries age 65 and over, and is not available in every state to people 64 and younger, leaving many ESRD Medicare beneficiaries under the age of 65 to face the serious financial strain imposed by Medicare Part B’s 20 percent cost sharing on their own. Safeguarding access to high-quality care for younger patients requires that these individuals be able to afford the high cost of care and guaranteeing Medigap eligibility to individuals under the age of 65 is an important step towards that goal.
As part of our goal to further patient access and choice in insurance, KCP believes that individuals who have commercial insurance through an employer should be able to retain that insurance for an additional 12 months, granting these individuals the ability to decide whether or not to keep their insurance for up to 42 months after becoming eligible for Medicare, since many private plans have more robust healthcare offerings an lower co-pays and out of pocket expenses. Expanding the 30-month coordination period of ESRD beneficiaries to 42 months would allow these patients to make more informed decisions about their healthcare, relieving unnecessary pressure on patients with a life-threatening disease.
In summary, Congress should protect the rights of individuals with kidney failure of all ages, including those under 65, by allowing ESRD patients to access charitable assistance programs, outlawing policies that incentivize and mislead patients to switch to Medicare, providing earlier access to Medicare Advantage plans, allowing access to Medigap plans for all patients and by lengthening the coordination period that these individuals have to make informed decisions about their health insurance. Enacting these reforms will alleviate the increasing strain on dialysis patients in the United States and will defend the right of dialysis patients to select their own insurance.