MACRA’s Impact on Medicare

MACRA’s Impact on Medicare

Submitted by Kim Reyes, Benefits Counselor, Appalachian Council of Governments


MACRA is known as the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 which was signed into law on April 15, 2015.  So this Act has been around for a while and Medicare beneficiaries are now beginning to feel the changes.  One positive change for Medicare beneficiaries was the removal of Social Security Numbers from Medicare cards in effort to safeguard and protect beneficiaries’ personal information.  The mailing of the new cards was completed April 2019. CMS replaced Social Security numbers (SSNs) on Medicare cards with Medicare Beneficiary Identifiers (MBIs). The MBI is a randomly generated combination of letters and numbers used to quickly identify beneficiaries.  If you have not received your Medicare card omitting your Social Security number, you will need the new number by January of 2020 as your old card numbers will no longer be accepted.  You will need to call 1-800-633-4227 for Medicare or our local office is happy to assist as well by calling 1-864-242-9733.


Another massive change that’s coming as a result of MACRA is in relation to Medicare Supplements also known as Medigap plans. Specifically, two of the more comprehensive Medigap plans are being discontinued in 2020. These plans are Medigap Plans C and F, both of which are notable because they cover the Medicare Part B deductible. In fact, these are the only two Medicare Supplements that cover the Part B deductible, which is why they’re being discontinued. As part of MACRA, Congress voted to eliminate “first-dollar coverage,” which these two plans provide. Luckily, if you’re currently eligible for Medicare or will be prior to 2020, you’ll be eligible to enroll in either plan after the deadline. This change is only affecting people eligible for Medicare after January 1, 2020.  If you currently are enrolled in a Medigap plan C or plan F, you may keep those plans.


After 2020 starts, Medicare beneficiaries will also see changes relating to Medigap Plans D and G, which are similar to Plans C and F, respectively, minus coverage of the Part B deductible. Currently, Plans D and G aren’t guaranteed issue plans, but in 2020, they’ll become guaranteed issue plans for newly-eligible Medicare enrollees (people eligible for Medicare on or after January 1, 2020). Medicare-eligible individuals can enroll in guaranteed issue Medigap plans outside of their Medigap open enrollment period — even if they have past or present health conditions — as long as they have a guaranteed issue right. MACRA also creates a new, high-deductible Medigap Plan G plan.



Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) also replaces the Sustainable Growth Rate (SGR) formula for healthcare provider reimbursement. Created to control Medicare costs, SGR and its fee-for-service payments caused Medicare costs and spending to outpace GDP growth. If MACRA had not passed, Medicare providers would have been hit with a 21.2 percent decrease to reimbursements by the end of March 2015.


So MACRA affects beneficiaries as well as medical providers and being informed is part of being proactive with your healthcare choices.  State Health Insurance Program (SHIP) counselors can assist with your Medicare issues and needs.  To reach a SHIP counselor in your area, you may call 864-242-9733.