Northlake Medigap, aka Supplement Insurance, helps senior and disabled Texas residents pay for certain Medicare copayments, deductibles, and other costs. Currently, insurance companies can offer state residents up to 10standardized Medigap plan options: Plans 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 Medigap plan unless you decide you need to switch policies.

Open Enrollment for Medicare Supplemental 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. For 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 benefits before deciding which will work best.

Pricing Methods for Medicare Supplement Insurance Pricing

Medigap pricing methods are important because they dictate how your premiums may increase in future years. There are 3 different pricing methods:

• Attained-age rated: The premium increases as you age
• Issue-age rated: The premium is based on your age when you buy and it may increase due to inflation and other factors, but not due to your age
• Community rated: The same premium is charged to all Medigap policyholders

The majority of Medigap policies issued in Texas are attained-age rated, according to the Kaiser Family Foundation (KFF).

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.

Some Texas residents are eligible to enroll in approved 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 standalone Part D Prescription Drug Plans, you must continue to pay your Part A (if any) and part B Medicare premiums.