Introduction to Medicare Supplement in Texas (Medigap)

“Medigap” is a type of Medicare supplement insurance policy intended to fill in the coverage gaps related to Traditional Medicare Parts A & B. Even though Medicare attempts to be comprehensive, there are several healthcare needs that it does not cover. And if you don’t have any Medigap insurance to pay for these essentials, you could possibly find yourself having to pay thousands in out-of-pocket healthcare costs. In order to purchase Medigap insurance, you must first be enrolled in Original Medicare.

Federal Regulations for Medicare Supplements

There are actually 10 Medicare supplement plans on the market, all of which are governed by the Centers for Medicare and Medicaid Services (CMS). According to the CMS rules, All Medicare supplement plans offer the same coverage, regardless of the company selling the policy or where they are located. Just what does this indicate for you? Well, it means that Plan A is just the same in all 50 states. The only issues that will change are the price you pay, along with the company who provides your policy.

Medigap Enrollment In Texas

Nearly 375,000 seniors in the state of Texas right now have their Medicare A and B gaps covered by a comprehensive Plan F Medigap policy. Plans G, C and N have a substantial number of members also, but their numbers aren’t anywhere close to those of Plan F.

Plan Type A B C D E F G H I J K L M N
Enrollment 10,836 6,247 31,065 14,061 2,367 371,723 66,543 2,611 7,586 44,759 4,724 7,862 55 22,906

Plan Coverage & Cost

Health insurance – and the overall cost for it – are personalized to you, as an individual. Your weight, smoking habits, age, gender, and exact location will all impact the monthly costs you have to pay for a Medicare supplemental insurance policy. To get an idea of what you should expect, and how it can fit into your budget, have a look at starting rates for common plans close to you.

Most Popular Medicare Supplement Plans in Texas

The most popular Medigap supplement across the country, and also in Texas, is Plan F. This plan is the reigning favorite simply because it covers every single Medicare coverage gap, and also because it requires little maintenance on the part of the beneficiary – all you need to do is pay your monthly premium, and you can rest assured that you are covered.

Unsurprisingly, the next most popular policies – G, C, and N – are very similar to Plan F. Plans C and G are nearly identical, save for one benefit each. But that one benefit can make a significant difference. For example, with Plan C, if you think the price difference between Plan F and Plan C will be greater than the Part B Medicare excess charges you expect to pay, you could save hundreds with Plan C over Plan F.

Helpful Medigap Tips & Tricks

Doctor/Provider Network Restrictions

The appeal of Medigap insurance is because of the way it enables retirees to choose their very own physicians and facilities. Medigap isn’t your only choice for supplementing your Medicare coverage. On the other hand, it is one of the few policies which won’t limit your options to a restricted network of medical doctors and facilities which have been pre-approved through your plan’s HMO or PPO. Any doctor or hospital which takes Medicare will be accessible to you with a Medicare supplement policy. This is a good option for older persons who vacation, or reside a long way away from large cities, where most of these restricted provider networks happen to be.

Doctors List

Drug, Vision and Dental Coverage

Regretfully, vision and dental coverage haven’t ever been provided by either Medicare, or Medigap supplement plans. If you need this type of medical treatment, you could pay out of pocket or purchase insurance on your own from a private company. Medicare Part D, however, can supply prescription drug coverage. Medigap no longer supplies such benefits, because Part D does it for them (and for you).

Enrollment Options & Best Time To Enroll

For straightforward enrollment with hardly any hassle, you’ll need to register for a Medicare supplemental insurance policy right around the time you enroll in Medicare (within your first 6 months of Medicare coverage, to be precise). The longer you wait, the more challenging the process can get.

  • Initial Enrollment Period: Enroll in a Medicare supplement plan inside your first 6 months of acquiring Medicare benefits, and you won’t get asked any intrusive health questions or denied coverage.
  • Guaranteed Issue: Enroll in a Medigap policy outside of your IEP, but before you lose coverage from a group or employer plan for a similarly hassle-free experience
  • Annual Enrollment Period (AEP): It is possible to sign up for or modify your Medigap plan anytime; having said that, this is the favored window for most types of insurance policies (including, but not limited to, Medigap policies).
  • Underwritten: The process through which a company asks you questions and perhaps runs medical tests in order to decide if or not they will supply you with coverage.

Free Look Period

The free look period protects older persons such as you from being saddled with a Medicare supplement plan which isn’t going to provide what you need. Inside your first 30 days of purchasing a new plan, you’re free to choose whether or not to keep your coverage, or terminate it without being financially responsible. Any upfront costs you pay within your first 30 days will be refunded in case you decide to cancel your benefits.

What Medigap Plan Is Best For Me?

Compare Medigap Plans Online

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