When you are nearing Medicare age, you have choices to make. Your primary decision will be whether you sign up with Original Medicare or select a Medicare Advantage Plan. Were you aware there are add-on options for your Medicare financial needs? These can assist you with covering medical expenses from your coinsurance to even your Part A deductible. These are called Medicare Supplement Plans (MSPs). At CoverMile we want to help you get the best care in your golden years and understand how Medicare Supplement Plans in Texas work. Through this piece, we will explain each MSP and how they pair up with your Original Medicare insurance plan.
What are Medicare Supplement Plans in Texas?
The first thing to understand about Medicare Supplement Plans in Texas is that you can only purchase them as an add-on to Original Medicare. You cannot add any of them to a Medicare Advantage Plan. It is illegal for an insurance agent to sell MSPs to those with Medicare Advantage. The second is that it only covers one individual. If your spouse wants an MSP, they will need to purchase a separate MSP.
There are up to ten Medicare Supplement Plans in Texas. Eight of them we will be discussing in this article. The other two are no longer available for newly eligible Medicare recipients. The plans are lettered Plan A through Plan N. Each covers a different area of medical need and coverage toward Medicare Parts A and B.
What is Medigap?
Medigap is the term used for Medicare Supplemental Plans. It is given because, with typical Medicare health insurance, there are gaps in coverage that a covered person would have to pay out of pocket. These can be such things as deductibles, facility charges, and even foreign travel fees. Medigap policies are intended to bridge the gap and pay for these services.
The best Medicare Supplement Plans (Medigap) in Texas are letter-based. Each covers a different area of out-of-pocket cost. Below is a look at how each policy covers an area of medical need.
BENEFITS | PLANS | |||||||
A | B | D | G | K | L | M | N | |
Part A coinsurance | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Part B coinsurance | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
Blood benefit | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
Part A hospice | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
Skilled Nursing | No | No | Yes | Yes | 50% | 75% | Yes | Yes |
Part A deductible | No | Yes | Yes | Yes | 50% | 75% | 50% | Yes |
Part B deductible | No | No | No | No | No | No | No | No |
Part B excess | No | No | No | Yes | No | No | No | No |
Foreign travel | No | No | 80% | 80% | No | No | 80% | 80% |
Let’s explain a bit how this works.
Even when you have premium-free Medicare Part A you will have out-of-pocket expenses in the form of copays, deductibles, and coinsurance to pay. These can exceed thousands of dollars. Thus, the purpose of a Medigap policy. Each Medicare Supplement Plan helps with a different area of need:
Medigap Plan A
This plan assists those who want additional coverage than what Medicare Part A and B provide.
Medigap Plan B
Identical to Plan A but provides a bit more coverage for hospitalization and hospital services.
Medigap Plan D
Here is where Medigap can benefit you, where Medicare lacks coverage for Skilled nursing. You also receive a benefit when you travel abroad.
The same benefits to Plan D but provide an excess benefit. If there is an amount over what the Medicare limit pays, they will still cover the bill up to 15 percent. There is also a high deductible option available. Plan G is the most popular of all the Medigap plans. Contact our Medicare insurance agents in Austin Texas for more information.
Medigap Plan K
This is one of the Medicare Supplement Plans in Texas that is a bit different. Your Part A is at 100 percent, but your other benefits are paid at 50 percent until you meet a deductible. The deductible for 2024 is $7060.
Medigap Plan L
This plan is the same as Plan K, only the coverage is at 75 percent after a deductible of $3530 is met.
Medigap Plan M
Medicare Supplement Plan M helps with nearly all Medicare costs. Its primary difference is the Part A deductible, it covers 50 percent.
The final Medigap Plan has a contingency on the Part B benefit. There is up to a $20 copay for office visits and $50 for emergency room if you are not admitted.
It must be noted that there are also Plans C and Plan F. However, both of these plans were discontinued in 2020. Plans D and G are their replacements. Those who already have these plans can still keep them, and if you were eligible for Medicare before Jan 1, 2020, you can still purchase either plan.
As far as what is the best Medicare Supplement Plan in Texas, it would depend on your medical need. According to an American’s Health Insurance Plans study, 41 percent of Texas Medicare recipients have a Medigap Plan G. It is the most exhaustive plan. It provides all coverages including Part B excess and foreign travel coverage. However, if coverages like Skilled Nursing or paying your Part A deductible are not a concern, then you can consider a Plan A or B. Our Bastrop Texas Medicare agents can help you determine which plan is best for your needs.
How Do I Apply for Medicare Supplement Plans in Texas?
The best time to apply for Medicare Supplement Plans in Texas is during the Medigap Open Enrollment Period. This is different than a Medicare Open Enrollment Period. Here is what you need to know:
- A Medigap Enrollment Period begins the first month you have Medicare Part B, and you are 65 or older. It ends six months later.
- An insurance company cannot deny coverage due to health conditions. However, if you apply outside of this six-month period, you will be subject to underwriting and your cost may be higher or your policy could be denied.
- Medigap Open Enrollment is a one-time enrollment. You do not need to re-enroll each year or renew your policy.
Who Offers Medicare Supplement Plans In Texas?
Not every health insurance company offers Medicare Supplement Plans in Texas. Some may offer a handful of them, some none at all. The one benefit is that all Medigap policies are standardized. The cost will be the only difference between the different companies. When selecting a health insurance provider, your choice will more likely be on other products they offer than the MSP alone.
Humana Medicare
Humana Medicare Supplemental plans do not have a Plan D, but with Plan G, those benefits are covered. The same can be said of Plan M and Plan N. Humana simply offers the better plan.
UnitedHealthcare Medicare
UHC Medicare Supplement plans offer additional Wellness Extra services such as dental and vision discounts, gym memberships, and a 24/7 nurse line to their plans. Plan costs from $57.04 for a Plan K up to $282.97 for a Plan A with the wellness extras.
Blue Cross Blue Shield Medicare
BCBS of Texas has fewer Medicare Supplement plan offerings. They have Plan A, Plan G (both standard and high deductible), and Plan N. They also have a Plan F, but as a reminder, this plan is only available to those who had become eligible for Medicare before 2020. Plan G High Deductible can cost $60.48. A Standard Plan A can be $248 per month. Keep in mind the above coverage options.
Cigna Medicare
Cigna offers four plans in the area we tested. High deductible plan G costs $56.66 per month and Plan A can cost as low as $135.77 per month. They also offer a standard Plan G, and a Plan N. Cigna offers several discounts that offer members lower premiums, this includes online discounts and multiple policies in the home. They also have programs that promote healthy living and a 24/7 nurse health line.
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Aetna Medicare
Aetna Medicare Supplement Plans are the same as other companies’ offerings with the exception that they do not offer Plans K or L. They offer Plan B, which several other companies have left off. As a reminder, Plan B covers the Part A deductible. Aetna offers Plan F at $51.65 up to Plan F at $236.74. They like Cigna have a household discount with a qualifying adult.
CoverMile has the Medicare Insurance Agents Near Me
When you are looking for the best Medicare Supplement Plans in Texas CoverMile can assist you with finding the best health insurance provider in your area. Medicare insurance agents in Austin TX and surrounding areas are waiting to start your quote today.