Close the Medigap Act of 2025

This legislation introduces significant reforms to Medicare supplemental health insurance policies, aiming to enhance consumer protections and access. A core provision establishes a guaranteed issue right for all Medicare beneficiaries, prohibiting Medigap issuers from denying coverage, discriminating in pricing, or excluding benefits based on health status, claims experience, medical condition, or genetic information. This also eliminates pre-existing condition waiting periods, with these changes taking effect on or after January 1, 2026, and potentially phasing in until 2031. The bill further addresses pricing and coverage by requiring the Secretary to request the National Association of Insurance Commissioners (NAIC) to revise Medigap standards. These revised standards must prohibit pricing discrimination based on age or eligibility for Medicare due to disability or ESRD, and ensure premiums apply uniformly across a county. Additionally, it restores access to first-dollar Medigap coverage by repealing the prohibition on plans covering the Medicare Part B deductible. To increase transparency, the legislation mandates that Medigap policies, starting January 1, 2026, meet a medical loss ratio (MLR) that is at least as high as current thresholds and any NAIC recommendations. It also requires Medigap issuers to annually report payments and other transfers of value made to agents, brokers, and third parties, similar to existing transparency rules for drug manufacturers. Finally, the bill directs the Medicare plan finder website to provide more detailed information, including out-of-pocket costs, provider networks, and clear comparisons of Medigap options, alongside consumer testing and public comment opportunities.