# No gap insurance allowed with Medicare drug benefit **URL:** \ **Category:** Great Debates\ **Created:** [December 7, 2003, 6:16am UTC](https://boards.straightdope.com/t/no-gap-insurance-allowed-with-medicare-drug-benefit/217517 "2003-12-07T06:16:38Z")\ **Posts on this page:** 8\ **Page:** 1
**Author:** ![lee](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lee/32/7455_2.png) [@lee](https://boards.straightdope.com/u/lee)\ **Post date:** [December 7, 2003, 6:16am UTC](https://boards.straightdope.com/t/no-gap-insurance-allowed-with-medicare-drug-benefit/217517/1 "2003-12-07T06:16:38Z")
From the New York Times > [@](#): > > Medicare beneficiaries will not be allowed to buy insurance to cover their share of prescription drug costs under the new Medicare bill to be signed on Monday by President Bush This seems like a terrible idea that would hurt everyone except the drug companies. Not only are seniors forbidden to buy gap insurance, not all drugs count towards the amount they have to pay. It looks like if they have drugs not on the list, they have to pay for them out of pocket no matter how much they cost. Am I reading this correctly? Does anyone think that this part of the new Medicare law is a good idea? ---
**Author:** ![TeaElle](https://avatars.discourse-cdn.com/v4/letter/t/8491ac/32.png) [@TeaElle](https://boards.straightdope.com/u/TeaElle)\ **Post date:** [December 7, 2003, 6:20am UTC](https://boards.straightdope.com/t/no-gap-insurance-allowed-with-medicare-drug-benefit/217517/2 "2003-12-07T06:20:04Z")
This entire “benefit” program is a joke from start to finish. The prohibition against gap insurance is but one of many drawbacks of it. But the people clamored for a drug benefit and that’s what they got. Be careful what you ask for… ---
**Author:** ![Rhum\_Runner](https://avatars.discourse-cdn.com/v4/letter/r/2bfe46/32.png) [@Rhum\_Runner](https://boards.straightdope.com/u/Rhum_Runner)\ **Post date:** [December 7, 2003, 6:42am UTC](https://boards.straightdope.com/t/no-gap-insurance-allowed-with-medicare-drug-benefit/217517/3 "2003-12-07T06:42:58Z")
What on Earth is the justification for this? ---
**Author:** ![Nobody](https://avatars.discourse-cdn.com/v4/letter/n/94ad74/32.png) [@Nobody](https://boards.straightdope.com/u/Nobody)\ **Post date:** [December 7, 2003, 11:47am UTC](https://boards.straightdope.com/t/no-gap-insurance-allowed-with-medicare-drug-benefit/217517/4 "2003-12-07T11:47:13Z")
I haven’t really heard any of the details of the bill, but isn’t the new program voluntary? Can’t you choose between the current system or the new one? Or is the new one supposed to totally replace the current one? ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [December 7, 2003, 12:52pm UTC](https://boards.straightdope.com/t/no-gap-insurance-allowed-with-medicare-drug-benefit/217517/5 "2003-12-07T12:52:42Z")
\*\*What on Earth is the justification for this? \*\* What’s the justification for any regulation? Because many in government are control freaks. Why is there a regulation dictating the radius of a toilet bowl? People’s butts are different sizes, why can’t toilet bowls come in different sizes? ---
**Author:** ![Early\_Out](https://avatars.discourse-cdn.com/v4/letter/e/6f9a4e/32.png) [@Early\_Out](https://boards.straightdope.com/u/Early_Out)\ **Post date:** [December 7, 2003, 3:37pm UTC](https://boards.straightdope.com/t/no-gap-insurance-allowed-with-medicare-drug-benefit/217517/6 "2003-12-07T15:37:29Z")
I think this is one of those provisions that will be modified before the program takes effect (in 2006, IIRC). An individual should be allowed to insure himself against ANY eventuality. As long as there’s an insurance company willing to write a policy, I should be able to buy it, if I want the coverage. I can’t imagine what the justification for this provision is, but I’m very certain that **adaher’s** speculation falls into the “raving” category, and has nothing to do with the facts. Perhaps someone else can ferret out the rationale behind this decision, made by a Congress that’s controlled by “less government is better government” Republicans. AFAIK, **Joel** , there’s nothing voluntary about the changed Medicare program. ---
**Author:** ![Early\_Out](https://avatars.discourse-cdn.com/v4/letter/e/6f9a4e/32.png) [@Early\_Out](https://boards.straightdope.com/u/Early_Out)\ **Post date:** [December 7, 2003, 3:40pm UTC](https://boards.straightdope.com/t/no-gap-insurance-allowed-with-medicare-drug-benefit/217517/7 "2003-12-07T15:40:05Z")
This, from the very article cited: > [@](#): > > \*\*Congress cited two reasons for banning the sale of Medigap drug policies. Lawmakers wanted to prevent duplication of the new Medicare benefit. They also wanted to be sure that beneficiaries would bear some of the cost. Health economists long have asserted that beneficiaries, when insulated from the costs, tend to overuse medical services. \*\* I’ll wager that it gets changed in the next session of Congress. ---
**Author:** ![Early\_Out](https://avatars.discourse-cdn.com/v4/letter/e/6f9a4e/32.png) [@Early\_Out](https://boards.straightdope.com/u/Early_Out)\ **Post date:** [December 9, 2003, 1:04am UTC](https://boards.straightdope.com/t/no-gap-insurance-allowed-with-medicare-drug-benefit/217517/8 "2003-12-09T01:04:17Z")
I was wrong, **Joel**. It appears that seniors can choose between sticking with the current Medicare program, without a drug benefit, or they can pay the additional premium and get the drug benefit. That leaves a couple of things very unclear. First, if a person elects to stick with the current Medicare program, but currently has an insurance policy that covers prescription drugs, will that person lose that insurance policy in 2006? I think the answer may be “yes,” which makes it a very tough choice. Second, if you’re currently with a Medicare HMO, like Kaiser, that provides prescription drugs (in return for a premium on top of the regular Medicare premium), what’s going to happen to that HMO drug benefit? Very confusing. I’ve also heard that if you opt out of the new program, but you later change your mind, it’ll cost you a lot to get into the new program, but I can’t find any concrete information about that.