Texas Expands Medigap Coverage for People with Kidney Failure Under 65

Having health insurance doesn’t always eliminate concerns about out-of-pocket costs. Medigap policies help fill the gaps in Medicare coverage and are an important part of affordable care for millions of Americans.

But while many older adults on Medicare can buy Medigap plans to help pay for additional costs, younger people with end-stage kidney disease (ESKD) haven’t always had the same access—until now.

A new Texas law is making it easier for Texans with kidney failure to get the coverage they need.

• What Is Medigap and Why Does It Matter?
• Texas Closes the Gap for Younger People with ESKD
• Why This Change Matters
• Your Voice Matters
• Key Takeaways

Medigap, also called Medicare Supplement Insurance, helps cover the “gaps” in Medicare, including:

• Deductibles
• Copays
• The 20% coinsurance Medicare doesn’t pay

Without a Medigap plan, these bills can quickly add up, especially for people managing chronic conditions like kidney disease.

People aged 65 and older can usually buy a Medigap plan during a six-month window after enrolling in Medicare Part B, without needing a physical exam. But for younger people with ESKD, Medigap access depends on the state they live in. In many states, they don’t have the same rights as older adults.

Learn more about Medigap plans. 

Until now, people with kidney failure under age 65 in the Lone Star State had access to only one level of Medigap.

Thanks to advocacy from the National Kidney Foundation and other members of the kidney community, Texas has passed a new law expanding access. Now, all Medicare beneficiaries in the state, regardless of age, can choose from multiple Medigap plan options.

This change gives people with ESKD better coverage choices and potentially lower premiums. It’s a big step toward making care more affordable and fair for Texans living with kidney disease.

Even with previous guaranteed coverage, people with kidney failure often paid much higher monthly premiums than the general Medicare population. This new law helps address that inequity.

Read NKF's letter to Senator Schwertner.

People with ESKD often face high medical bills. Many have been forced to spend down their savings or enroll in Medicaid just to afford care.

With this expanded Medigap access, more Texans will be able to protect their health and financial security.

This is a big win for Medicare beneficiaries with kidney disease in Texas. But there’s still more work to do. Many states still don’t guarantee Medigap access to people with ESKD under age 65.

You can help change that.

Join NKF’s Voices for Kidney Health to use your voice to speak up for policies that protect people with kidney disease in every state.