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2025 Medicare Supplement Plans in Tarrant County Texas

Ashford Insurance

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2025 Medicare Supplement Plans in Tarrant County Texas

What’s Medicare Supplement Insurance?

Let’s start with what a Medicare Supplement plan, also known as a Medigap policy, is and how it helps you. Medicare Supplement or Medigap policies, referred to collectively as Medicare Supplements, are policies sold by private insurance companies to Medicare beneficiaries like you. They are overseen by state insurance departments. Plans are standardized and prices can vary based on where you live.

What’s the Purpose of Medigap?

With Original Medicare, you pay the deductibles, copays, and 20% for services you receive from doctors. Medicare Supplement plans can pay some or all of these costs for you. They “supplement” or fill the “gaps” in Original Medicare. If Medicare doesn’t cover the service, then generally your Medicare Supplement plan doesn’t cover the costs either and you would pay for those services yourself.

Medicare Supplement or Medigap policies are designed to pay your costs related to Original Medicare. Depending on the plan you choose, they could pay the Part A hospital deductible, the Part B deductible, and the 20% coinsurance that you are responsible for, as well as other out-of-pocket costs.

In general, Medicare plans are individual plans and only cover one person per policy. This is a great advantage since a husband and wife with different needs can have different plans. They can pick the plan that is right for them.

Medigap Explained

Medicare Supplements are standardized by the Federal Government. They are labeled A, B, C, D, F, G, K, L, M, and N. Also, 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 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 six months, 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 pick and 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 are 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. These plans are offered by private insurance companies. 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 a 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.

What Is the Best Time to Enroll in a Plan?

In the event you happen to be considering signing up for these Medigap plans you need to know that the best time to enroll in some of these would be during what’s called the Medicare Supplement Open Enrollment Period. This starts when you are older or 65 years old and you have Part B Medicare.