How Minnesota, Massachusetts and Wisconsin Plan to Comply with MACRA in 2020

Insurance regulators in Massachusetts, Minnesota, and Wisconsin currently manage their own Medigap programs. Using the same state rules for over 2 decades.

New MACRA minimum deductible requirements change the way each state operates the Medicare program.

Regulators in these states must comply with new changes even though policies options aren’t the same.

Today’s requirements are likely to conflict with any previous state rules’ from almost 30 years ago.

How First Dollar Coverage Plan in Minnesota, Massachusetts and Wisconsin Will Be Impacted Come 2020

Massachusetts, Minnesota, and Wisconsin obtained waivers

Massachusetts, Minnesota, and Wisconsin obtained waivers from implementing the standardized Medicare Supplement plans because these states already had statewide standardized plans prior to 1990.

These waivered states must comply with eliminating coverage for the Part B deductible.

Below, we’ll breakdown what we know so far regarding how these states plan to comply with MACRA by 2020.

How these States Plan to Comply with MACRA by 2020


There are two Medicare Supplement plans available in Minnesota known as basic & extended basic with optional riders.

Any policies sold to new enrollees on or after January 1, 2020, will no longer be able to provide coverage for the Medicare Part B annual deductible.

People who are eligible for Medicare before January 1, 2020, will be able to purchase a policy that covers the Medicare Part B deductible.

We’ve reached out to the Minnesota DOI multiple times to see how they plan to comply with MACRA, but have not received a response. Once any information is released by the DOI, it will be published to their online bulletins.


There are two Medicare Supplement plans offered in Massachusetts known as the Core Plan & Supplement1.

The Massachusetts Division of Insurance says:

“they are frantically trying to come up with a solution, but nothing has been decided yet.”

We think there will be a new Plan offering called “Sup1a” but nothing is confirmed as of now.

The DOI has filed proposed amendments to 211 CMR 71.00 & a hearing has been scheduled for Monday, July 8th at 2:00 p.m.


Wisconsin offers a basic benefit plan with up to 7 additional benefit riders.

There was a hearing on May 10, 2019, to propose changes.

The proposed rule implements changes to Medicare Supplement benefits that are permitted to be offered after January 1, 2020.

Policies issued to individuals that are first eligible for Medicare benefits on or after January 1, 2020, may not contain the option to purchase a Part B deductible rider.

You can follow the status of the proposed rule on

How these MACRA Changes Impact the Above States Medicare Beneficiaries

The 2020 MACRA changes shouldn’t impact the above states Medicare beneficiaries significantly. The only difference is beneficiaries that are not eligible for Medicare until January 1st, 2020 will now be responsible for the Medicare Part B deductible. As of 2019, the Part B deductible is $185. During September-October of each year, CMS announces the new deductible for Part B for the following year.

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