Medicare Supplement plans in Texas include 10 standardized options, lettered A – N. Each insurance company must offer at least Plan A but can offer any of the other plans as well.
We have great insurance companies offering plans here. Many offer the most popular plans, like Plan F and Plan G. Our agency is also located in Fort Worth, so we can provide you great information on Medicare supplement plans here.
Medicare Supplement Plans in Texas
As you may already know, Medicare only covers 80% of your outpatient costs. It also leaves you paying deductibles. See this year’s Part B outpatient deductible rates.
All Texas Medicare supplement plans cover the other 20% of your Part B coinsurance, as well as your Part A coinsurance and copayments. All Medicare supplement plans also cover the hospital deductible. However, there are two plans (Plan K and Plan L) that don’t cover the Part B coinsurance and Part A deductible at 100%.
People who choose Medicare Supplement Plan F have no out of pocket spending beyond their monthly premium. For this reason, we call it first dollar coverage. However, Plan F will no longer be available to new Medicare enrollees as of January 1, 2020. While Plan F has been popular for a long time, Plan G is priced competitively.
The only thing that Plan F covers that Plan G does not is the Part B deductible. However, because you can usually save on the premium with Plan G vs Plan F, Plan G can be more cost-effective even with you having to pay the Part B annual deductible.
Also, many Plan G policies may have lower rate increases from year to year than Plan F policies. It’s worth checking out so that you can consider which Texas Medigap plan best fits your needs and budget.
When to Enroll in Texas Medigap Plans
The best time to buy a Medicare supplement is during the first six months after you enroll in Part B. This open enrollment window allows you to purchase any Texas Medigap policy without health underwriting. After this window expires, you may have to answer health questions when you apply.
Our agency works with some of the best Texas Medicare Supplement Plan F and Plan G insurance companies, such as Aetna Medicare Supplements and Mutual of Omaha Medicare Supplements. There are over 30 great carriers offering comprehensive plans. Feel free to check out our reviews of these carriers.
Texas Medicare Supplement Plan Features
Medicare supplement plans in Texas have some common features. First, you can choose any doctor, no matter who your Medicare supplement carrier is. About 93 percent of healthcare providers in America accept Medicare. You can see any of these doctors at any time, regardless of which insurance company you purchased your Medigap policy from.
Another feature is that there are no referrals required. These plans have no networks, so you are not required to see a primary care physician first to get a referral to see a specialist. You can book your own appointments with doctors hassle-free.
Sometimes specialists who are unfamiliar with Medigap’s rules will ask you to first get a referral. Simply explain that your insurance doesn’t require a referral if you have a Medigap plan.
All Medicare supplement plans in Texas are also guaranteed renewable. Your coverage can never be canceled based on a health condition that you develop. As long as you are paying your monthly premiums on time, your Medicare supplement will remain in place and be there for you when you need it.
Leaving Employer Coverage for Texas Medigap Plans
Some people delay enrollment into a Medicare supplement because they have other creditable coverage, such as group health benefits. If you delay Part B until you retire, then you will be able to get a Medigap plan during your six-month open enrollment following your Part B effective date.
However, if you enroll in Part A and Part B while still working and then retire, you will later be eligible to buy a supplement outside of your open enrollment window under guaranteed issue rules.
In Texas, to qualify for guaranteed issue, you must provide proof that you involuntarily lost your other health insurance coverage. If you can provide this proof, the law allows you the right to purchase certain Medicare supplement plans within 63 days of the end of your prior coverage. The insurance company cannot place any restrictions on pre-existing conditions if you apply during this window.
For instance, if you enroll in Medicare Part A and Part B when you turn 65, but you continue to work and hold employer coverage, you will activate a special enrollment period once you lose your coverage that will last for about 63 days. If you don’t enroll in a Medigap plan during that time, you will likely have to answer health questions to obtain a Medigap plan in the future.
Sometimes we find that leaving the employer coverage for Medicare is actually cheaper for you. For this reason, you should carefully review your coverage options when you first enroll in Medicare Part B.
Compare costs for your employer insurance against the cost of Medicare and a Medigap plan. Consider all factors – cost, health status, etc. – before making your choice.
Medicare Advantage Plans in Texas
Some people may not be able to afford Medigap coverage. Fortunately, there are many Medicare Advantage Plans in Texas to look into as an alternative.
Medicare Advantage plans are designed for people who are willing to get their care from a network of doctors. You will pay some costs as you go along, like daily copays for hospital stays and doctor visits.
This is different than Medicare supplement plans, which allow you to see any doctor who takes Medicare. On a Texas Medicare Advantage plan, you must stay within your plan’s network to get the best pricing for your care.
Insurance carriers offer a wide variety of Medicare Advantage plans in Texas from several different reputable insurance companies. Plans are available by county. You must enroll in both Medicare Part A and Part B. You must also live in the plan’s service area to be eligible. Our agency can help you compare plan options.
Most Medicare Advantage plans are an HMO or PPO format. HMO plans usually require you to choose a primary care doctor. You will see him or her first to get a referral if you need to see a specialist.
PPO plans are usually more flexible, allowing you to see doctors without referrals. You can also see out-of-network doctors at a higher cost.
Medicare Savings Programs Texas
For certain low-income people, Medicare premiums can be a hardship. If you find it difficult to pay for Medicare Parts B and D, you can consider applying for Medicare Savings Programs in Texas. This program helps to pay for some or all of the monthly premiums, copayments, and deductibles that you might experience on Medicare. There are different levels of qualification.
It’s easy to apply for a Medicare Savings Program by contacting the state Medicaid office. Just dial 211 or visit www.yourtexasbenefits.com. This helpful website will help you learn about the benefit programs offered and to find out if you should apply for benefits. You can also find a benefits office near you where you can speak with a representative. People already enrolled in a savings program can also use this site to renew benefits.
Get Help with Texas Medicare Supplements
With so many options to choose from, it can be overwhelming to try to find the right coverage. We can make this easier for you in several ways. First, our agents will explain Original Medicare to you so that you understand your base benefits. Then we can help you narrow down to which type of coverage feels best for you.
Finally, we provide a comparison report for the top 3 to 5 Medicare Supplements in your area after comparing 25+ carriers, so that you can see each company’s rates, financial ratings and even their history of Medigap rate increases. Decisions are easy when you have the right data.
To speak with a licensed insurance agent about your plan options, contact Boomer Benefits today: