Wichita Falls Medicare Supplements

Ashford Insurance helps Medicare beneficiaries navigate the Medicare Maze. Our goal is to offer exceptional customer service and go above & beyond for our clients. There are many different plans & rates – so it can be overwhelming! We educate you, simplify all your plan options, and then guide you towards the plan that works best for you. We consider it a privilege to serve our clients!

What is Supplemental Insurance?

Medicare supplemental insurance picks up where Medicare leaves off, paying for medical expenses that Medicare does not cover.
Private companies approved by Medicare provide diverse ways to get your health care and prescription drug coverage. The Medicare plan that you select will affect your out-of-pocket expenses, benefits, ability to select a doctor, administrative convenience, and quality.

Medigap is Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost of covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like:

• Copayments
• Coinsurance
• Deductibles

Grapevine Medicare Supplements are standardized by the Federal Government. They are labeled A, B, C, D, F, G, K, L, M, and N. Note: Medigap plans sold to people who are newly eligible for Medicare aren’t allowed to cover the Part B deductible. Because of this, Plans C and F aren’t available to people newly eligible for Medicare on or after January 1, 2020. If you already have or were covered by Plan C or F (or the Plan F high deductible version) before January 1, 2020, you can keep your plan. If you were eligible for Medicare before January 1, 2020, but are not yet enrolled, you may be able to buy one of these plans that cover the Part B deductible.

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.

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.

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 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 essential 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 that if you leave an employer plan you may not be able to go back on it.

8 things to know about Medigap policies 

1. You must have Medicare Part A and Part B.
2. A Medigap policy is different from a Medicare Advantage Plan.  Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.
3. You pay the private insurance company a monthly
   
   premium

    for your Medigap policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare.

4. A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you’ll each have to buy separate policies.
5. You can buy a Medigap policy from any insurance company that’s licensed in your state to sell one.
6. Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy if you pay the premium.
7. Some Medigap policies sold in the past cover prescription drugs. But, Medigap policies sold after January 1, 2006, aren’t allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D). If you buy Medigap and a Medicare drug plan from the same company, you may need to make 2 separate premium payments. Contact the company to find out how to pay your premiums.
8. It’s illegal for anyone to sell you a Medigap policy if you have a Medicare Advantage Plan unless you’re switching back to Original Medicare.

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.

To see a list of all the Medicare supplements available – look at our 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.

If you are ready to work with experienced and knowledgeable Medicare insurance Agents for Texans, please give us a call at 817-682-3153. Please take a few minutes to explore our site, to learn about the types of Medicare coverage we provide, and the educational resources offered. Remember, we’re here to help.