“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 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.
There’s no shortage of Medigap plans available in Texas. And even though the coverages are exactly the same when comparing “letter” to “letter” such as Plan F, the cost will vary from company to company. Ever wonder why? While the coverage is the same, different companies have different underwriting guidelines. The cost of your Medigap plan can depend on your overall health, age, gender, and medical history. Not surprising in Texas, exactly where you live, as narrow as your zipcode, will also play a role. To give you an idea of what to expect, we have provided a chart showing what people near you are paying.
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.
How do Medicare Supplement Ratings work?
The Overall Star Rating report is a useful report that Medicare provides annually to give consumers an idea about the performance of companies providing Medicare plans. The more stars, the better job Medicare has evaluated the company is doing. The areas they rate include management of chronic diseases like diabetes, the use of preventive measures like inoculations, complaints from consumers, customer service, and consumer experience with the company. You can use this report to compare companies.
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 in Texas. 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.
When you purchase a Medigap plan there are no restrictions on what doctor or other healthcare provider you use other than they have to accept Medicare. Most other plans will restrict your choice of providers to those in a limited network or PPO list. If you like your current doctor you can keep him or her. If they retire, or if you relocate, you’ll be free to choose anyone you like so long as they take Medicare (also known as Medicare assignment). Medigap is the ‘no restrictions’ plan when it comes to choices of healthcare providers.
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 Supplement in Texas 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 in Texas 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 in Texas 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?
In Texas, like everywhere else in the country, the best Medigap plan is one that is one you can afford, provides the coverage that fits your healthcare needs, and one that is easy to understand and use. It’s out there, the challenge is finding it. And there are plenty of Medigap companies, many you have never heard of. So we’re here to assist and guide you through the process to make it as easy and painless as possible. Medigap.com has prepared a comprehensive list of Medigap plans being offered in Texas. Just remember to not only compare premiums. When you need healthcare, you need excellent service from your Medigap plan. We advise you to make sure the company you choose has a good reputation and is financially stable.