Medicare Supplemental insurance, more commonly called Medigap, is a collection of insurance policies designed to fill the gaps in Medicare coverage. While Medicare is a government program, Texas Medigap policies are provided by private insurance companies. However, Medicare Supplemental insurance is regulated by Federal and state laws designed to protect patients.
The original Medicare program covers some hospitalization and regular doctor visits – but Medicare parts A and B do not cover prescriptions, copayments, coinsurance, or deductibles, and will not cover some procedures.
Texas Medicare Supplemental insurance policies are intended to bridge some of these missing coverage areas. For those covered by both Medicare and Medigap, health care billing is first submitted to Medicare. Then, once the program has paid for its portion, the bill is forwarded to the Medicare Supplemental provider for additional payment. The patient is responsible for any amount remaining after Medigap kicks in.
Keep in mind that Medicare Supplemental insurance plans have an Open Enrollment Period. Once you turn 65, if you’re enrolled in Medicare Part B and you join a Medigap program within six months, insurance companies can’t deny coverage – so it’s in your best interests to choose and enroll in a supplemental plan as soon as possible.
Medicare Supplemental insurance plans are standardized policies that are named by letters, similar to Medicare, but there are more policies available for Medigap than Medicare. In fact, there are a total of 19 plans available, identified by the letters A through N. Recently, policies E, H, I, and J are no longer available for new enrollees, but those who have these existing policies can continue with them.
Because Medicare Supplemental insurance is regulated by Federal and state laws, the policies must contain the same basic benefits, regardless of the insurance company providing them, across all 50 states. However, available policies vary from state to state. Texas insurance companies currently offer plans A through D, F and G, and K through N.
The cost for Medigap coverage is not regulated by Federal or state laws. Therefore, it varies according to the insurance company offering Medicare Supplemental insurance.
You can find a complete listing of Texas insurance companies offering Medigap policies and their respective prices for each type of policy by filling out the zip code form and comparing rates side-by-side.
In Texas, insurance companies are permitted to offer all 10 available Medigap policies to seniors and other people eligible for Medicare. Additional laws in Texas require insurance companies to offer certain Medicare Supplemental insurance policies to all qualified seniors, regardless of pre-existing conditions, at any time.
There are many different types of Medicare Supplemental insurance policies. Your health care provider may be able to help determine which is right for you.
When considering Medigap insurance, be sure to ask your provider the following questions:
If you would like more information on a Medigap or Medicare Advantage plan in Texas, fill out the zip code form to compare policies and prices instantly.