2025 Medicare Supplement Plans in Denton County Texas

Do you need a Medicare supplement?

Not everyone needs a Medicare supplement policy. If you have other health coverage, the gaps might already be covered. You probably don’t need Medicare supplement insurance if:

• You have group health insurance through an employer or former employer, including government or military retiree plans.
• You have a Medicare Advantage plan.
• Medicaid or the Qualified Medicare Beneficiary (QMB) Program pays your Medicare premiums and other out-of-pocket costs. QMB is a Medicare savings program that helps pay Medicare premiums, deductibles, copayments, and coinsurance.

If you have other health insurance, ask your insurance company or agent how it works with Medicare.

Medicare Supplements are standardized by the Federal Government. They are labeled A, B, C, D, F, G, K, L, M, and N. Note: Medicare Plan F is no longer available to those who are eligible for Medicare after January 1, 2020.

Each standardized Medigap policy must offer the same basic benefits no matter which insurance company sells it. Cost is usually the only difference between Medigap policies with the same letter sold by different insurance companies. Plan A pays the Medicare hospital and physician coinsurance, the first three pints of blood, and 365 days of hospitalization beyond Medicare. Plans B through N provide these benefits and add more benefits such as coverage for Medicare deductibles, excess charges and limited preventive care, and foreign travel. You can only have one Med Sup plan. No one should try to sell you an additional Medigap plan unless you decide you need to switch policies.

Open Enrollment for Texas Medicare Supplement Insurance is at age 65 for all consumers, including those already receiving Medicare due to disability. The Open Enrollment period is a six-month period, beginning when you are both age 65 or older and enrolled in Medicare Part B, companies must sell you any Medicare supplement plan they offer. After this limited open enrollment period, companies can choose whom they will cover and how much they will charge based on your health. If you have an individual or “bank group” insurance policy, becoming Medicare eligible does not require you to cancel it and purchase a Medicare supplement. Doing so may save premium costs but it is important to compare the benefits before deciding which will work best.

If you are eligible for employer retirement insurance, review the plan carefully to understand what benefits are available and how it works with Medicare. Be aware that employer plans are not standardized and are not subject to the requirements governing standardized Medicare supplement policies. Also, it is important to remember, if you leave an employer plan you may not be able to go back on it.

Depending on the Medicare supplement plan you choose, the plan may provide a benefit for (Benefits and cost vary depending on the plan you choose.):

• Part A coinsurance (and most plans provide a benefit for the Part A deductible)
• Some of the out-of-pocket costs not paid by Part B (some plans also cover the Part B deductible)
• Cost of blood transfusions (first 3 pints)
• Cost of up to 365 extra hospital days after you’ve used up your Part A benefits
• Skilled nursing facility coinsurance or copayment
• Part A hospice/respite care coinsurance or copayment

You pay a monthly premium and some out-of-pocket costs.

Some Texas residents are eligible to enroll in approved Part C Medicare Advantage plans. Private insurance companies offer these plans. Each year Medicare Advantage companies decide where they will offer their plans, what benefits will be offered, and what the premiums will be. Several include vision, dental, hearing, and wellness programs not covered by original Medicare. As noted earlier many Medicare Advantage Plans also offer prescription drug coverage. There are several Medicare Advantage plans available in Dallas, Tarrant, and surrounding counties. Depending on plan choice, a member may be responsible for paying co-payments for certain covered services. Most importantly, with Medicare Supplements, Medicare Advantage, and stand-alone Part D Prescription Drug Plans, you must continue to pay your Part A (if any) and part B Medicare premiums.