Medicare Supplement Plans - Texas Medicare Solutions

If you’re a Medicare beneficiary, you should know that Medicare Part A and B do come with out-of-pocket costs, which have to be paid by you.

In over 45 U.S. states, there are around 10 standardized Medigap insurance plans, each denoted by different alphabet letters, from letter A through N. Although E, H, I, and J Plans are no longer available, you can still keep one if you have purchased it before June 1, 2010.

While private Medicare Supplement insurance companies aren’t required to provide every Medigap plan, they must offer at least Plan A.

If you plan on  buying a Medicare Supplement plan, here are a few important points to keep in mind:

 – You must be having Medicare Part A and Part B.

– Medigap plans are different from Medicare Advantage plans. The latter is a way to get Medicare benefits, whereas the former simply “supplements” your Original Medicare benefits.

– If you have a Medicare Supplement plan, you will pay a monthly premium for your Medigap insurance policy. This monthly premium is over and above the monthly premium for Medicare Part B that you pay to Medicare.

– A Medigap policy covers just one person. If you want a Medicare Supplement policy for your spouse, you will need to buy another one for him/her.

– You can buy a Medicare Supplement plan from any insurance company that holds a license to sell Medigap policies in your state.

– Even if you have health issues, your standardized Medicare Supplement policy is fully renewable without any clause. This means, your Medigap insurance company cannot cancel your policy as long as you pay the premium.

– It’s against the law for any Medigap insurance provider to sell a Medigap policy to someone, who already have a Medicare Advantage Plan. In such a case, one can only buy a Medicare Supplement once he/she switches back to the Original Medicare.

– TMS Insurance Brokreage, DBA. Texas Medicare Solutions is a licensed (License #1989071)Insurance Agency in San Antonio, Texas that offers several low-cost Medigap insurance plans from multiple carriers to help cover out-of-pocket healthcare costs.

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Each Medigap plan, denoted by a specific letter, must provide the same basic benefits, irrespective of the region or insurance company. For instance, Medicare Supplement Plan G in Texas will offer the same benefits as that of Plan G in Nebraska.

It is important to note that Medigap plans don’t usually cover dental, vision, hearing aids, or long-term care, but every Plan must cover at least a part of the benefits below:

 – Coinsurance costs of Medicare Part A up to an extra 365 days once the Medicare benefits are utilized

– Hospice care copayments or coinsurance under Medicare Part A

– Medicare Part B copayments or coinsurance

– The initial 3 pints of blood used in an approved medical procedure

Additionally, there are Medigap plans that offer some extra basic benefits. One such plan is Medicare Supplement Plan F, which is the most exhaustive Medicare Supplement plan, and comes with the benefits stated below:

– Medicare Part B deductible

– Medicare Part A deductible

– Medicare Part B extra charges

– Preventive care insurance Medicare Part B coinsurance

– Skilled Nursing Facility care coinsurance

– Medicare Part A hospice care coinsurance or copayment

– Emergency care during foreign travel

*Important note: Beginning January 1,2020, Plan C and F are no longer available to people who are new to Medicare.  If you already have one of these plans, you’ll be able to keep your plan.

Besides, there are other Medigap plans like Plan  D, G, M and N that cover healthcare costs when you are travelling outside of the U.S. If you have such a Medicare Supplement plan along with your Original Medicare, you can expect the following:

– Medicare will pay its part of the Medicare-approved amount for health care cost covered.

– Post that, your Medigap will pay its share.

If you have a Medicare Supplement plan that covers emergency cost during foreign travel, your Medicare Supplement plan will:

– Cover emergency care if the plan starts within the initial 60 days of your foreign trip, and if the Original Medicare doesn’t otherwise cover the cost.

– Pay up to 80% of the charges for specific medical emergency situations outside of the U.S. if you have US $250 as deductible for that year.

Coverage for foreign travel medical emergency with Medicare Supplement policies has a life-long limit of US $50,000.

With so many options to choose from, it’s easy to get confused. But,you don’t need to worry as Texas Medicare Solutions’ seasoned Medicare Supplement specialists in Texas can explain all Medigap plans thoroughly.

Once you are satisfied, they can even help you enrollover the phone or in person!

Although it is required by private insurers to offer the same basic benefits under every lettered Medigap plan, they can charge different premiums for each type of plan. It is suggested to look for the Medicare Supplement plan that meets your medical and budgetary needs before you buy one. Medigap companies can set the premiums of their Medicare Supplement plans in one of the following ways:

– Community No-Age-Rated: These Medicare Supplement insurance plans have premiums that are the same across the entire spectrum, irrespective of the enrollee’s age.

– Issue-Age-Rated: These Medigap plans decide their plan premiums on the basis of your age at the time of first enrolment. This means, the younger you are at the time of enrollment, the lower the premium would be.

– Attained-Age-Rated: These Medigap plans are similar to “Issue-Age-Rated” plans with the only difference that their premiums increase as you grow older.

It is to be noted that regardless of the rating method used by a Medigap insurance company, plan premiums may also increase for other reasons like inflation. The majority of Medicare Supplement plans sold in Texas are Attained-Age-Rated.

At Texas Medicare Solutions, our licensed insurance agents can help you choose the Medicare Supplement insurance plan that suits needs.

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The first criteria to enroll in a Medigap insurance plan is that you must be enrolled in both Medicare Part A and Part B.It is good to enroll in a Medicare Supplement plan during the Medigap Open Enrolment Period, which starts on the 1^st day of the month – on which you are 65 years or older as well as enrolled in Medicare Part B – and lasts for 6 months. During this phase, you can enroll in any Medigap plan available in your state. You can have access to all basic benefits, regardless of any preexisting health conditions, if you enroll during this period. However, a specific waiting period might be applicable, depending on the Medigap plan you choose.

In case you miss this enrollment period and want to enroll later, you may be denied, in some cases, the Medigap insurer may charge a higher premium on the basis of your medical history. In some states, including Texas, you can enroll in a Medicare Supplement plan even before the age of 65 years.