Medigap Policies in Texas
Medigap Plans Made Easy
Ashford Insurance offers a selection of Medigap Policies from many top carriers including UnitedHealthcare® Medicare Solutions.
Medigap Policies are standardized by the Federal Government. They are labeled A, B, C, D, F, G, K, L, M, and N. 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 Medsup plan unless you decide you need to switch policies.
Depending on the Medicare supplement policy 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.
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 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 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.
To see a list of all the Medicare supplements available – take a look at a Medigap supplement chart. This chart can be found in the booklet called “Choosing a Medigap,” which is published by Medicare itself. The chart details the benefits that are included in each Medicare supplement, which are labeled Plan A – Plan N.
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.
Insurance plans that aren’t Medigap
Some types of insurance aren’t Medigap plans, they include:
- Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)
- Medicare Prescription Drug Plans
- Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP)
- Veterans’ benefits
- Long-term care insurance policies
- Indian Health Service, Tribal, and Urban Indian Health plans
Sarah began working in the healthcare industry in 2001, where she worked for many years with elderly Alzheimer and Dementia patients. From there she worked as a Group Benefits Administrator with a local healthcare company in the Human Resource Department for a period of 10 years. Since then, she has decided to work in the Medicare insurance industry full time and has joined the family business, Ashford Insurance, as a Medicare Insurance Agent.
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* A licensed sales agent may call or e-mail as a result of completing the information to discuss Medicare Advantage, Prescription Drug Plans or Medicare Supplement Insurance.