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Texas Medigap Coverage

Texas Medigap Made Easy

Texas Medigap Coverage

Medicare beneficiaries who are enrolled in Original Medicare can also enroll in a Medicare Supplement insurance plan in Texas. These plans cover some of the out-of-pocket costs associated with Original Medicare. Private insurance companies approved by Medicare offer these plans, which can vary in coverage, cost, and availability.

Some Texas beneficiaries may find their out-of-pocket expenses associated with Original Medicare to be too high for their budget. Medicare Supplement insurance plans in Texas help cover some of those expenses. Medicare Supplement insurance plans are also known as Medigap. Ashford Insurance offers a selection of Texas Medigap Coverage from many top carriers.

Medicare Supplemental plans, or Medigap, cover the costs you’re responsible for with Original Medicare. There are 10 Medicare Supplement plan options available; A, B, C, D, F, G, K, L, M, and N. Warning: Medicare Plan F is no longer available to those who are eligible for Medicare after January 1, 2020.

A Medicare Supplement insurance plan in Texas may cover costs associated with Original Medicare, including copayments, deductibles, coinsurance, and other out-of-pocket expenses. These plans are designed to work in combination with Original Medicare and cannot be used as a stand-alone health plan. Medicare Supplement insurance plans sold today generally do not cover prescription medications. Beneficiaries that need this coverage can enroll in a stand-alone Medicare Part D prescription drug plan or a Medicare Advantage Prescription Drug plan.

Each plan has different, yet standardized, benefits and coverage that must follow federal and state laws and must be clearly identified as “Medicare Supplement Insurance.” This means that no matter which insurer you buy from, the basic benefits of each plan type of the same letter will be the same. 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.

A Medicare Supplement Insurance (Medigap) policy, sold by private companies, may help pay some of the health care costs that Original Medicare doesn’t cover:

  • Your Medicare deductibles.
  • Your coinsurance.
  • Hospital costs after you run out of Medicare-covered days.
  • Skilled nursing facility costs after you run out of Medicare-covered days.
  • Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S.

Open Enrollment for 2019 Texas Medigap 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.

As our Texas population ages, individuals inevitably encounter more medical problems that require additional, costly health care services. A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like care when you travel outside the United States. Medigap policies only supplement your Original Medicare benefits, and shouldn’t be confused with Medicare Advantage Plans.

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 2019 Medigap 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. 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 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.

Don’t forget your prescription drug coverage.

There are two ways to get Medicare prescription drug coverage, either through a Texas Medicare Prescription Drug Plan (Part D) or through a Texas Medicare Advantage Plan with prescription drug coverage (MA-PD). Let the sales agents at Ashford Insurance help you discover the most affordable Medicare plans available to you, and to understand when your coverage starts, what’s covered, and what to expect.

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.