Medicare Supplement Plans in Texas
With no annual out-of-pocket limit, it's no wonder so many Medicare beneficiaries choose to supplement their coverage in some way. Medicare Supplement plans in Texas help cover a variety of healthcare expenses.
What Is Medigap in Texas?
Medigap plans help cover some – or even all – of your out-of-pocket costs when you have Original Medicare. This includes Part A, inpatient services, and Part B, outpatient services.
There are 10 basic Medicare Supplement plans in Texas: A, B, C, D, F, G, K, L, M, and N, although not every Medigap insurer offers all 10 plans. Some insurance companies also provide high-deductible versions of one or more plans.
Medigap plans are standardized, meaning that you get the same benefits with a particular plan regardless of your insurance company. However, although benefits are standardized, costs are not. Medigap insurers may determine their own premiums as long as they follow state and federal guidelines.
Unlike Original Medicare, you are not guaranteed a Supplement plan just because you're 65 years old. Unless you have a guaranteed issue right, your application goes through medical underwriting, which involves answering a series of health-related questions. Insurance companies decide whether to sell you a Medigap policy and for how much based on your answers.
What Does Medigap Cover?
Medicare Supplement coverage varies according to the plan you choose. However, at a minimum, every Medigap plan pays your Medicare Part A coinsurance and gives you 365 additional lifetime reserve days for inpatient hospital care.
The following table details which benefits each Medigap plan includes:
No Medicare Supplement Insurance plan includes prescription drug coverage. To get this protection, you need to join a Medicare Part D prescription drug plan. You may also sign up for a Medicare Advantage Prescription Drug plan (MA-PD). However, if you join an Advantage plan, you cannot also have Medigap.
Who Qualifies for Medicare Supplement Insurance in Texas?
At the federal level, you qualify for Medicare Supplement Insurance in Texas as soon as you're aged 65 or older AND enrolled in Original Medicare. Most states also require Medigap insurers to offer plans to under-65 beneficiaries who qualify for Medicare due to a disability. This includes Texas, which requires insurance companies to offer Medigap Plan A to Medicare beneficiaries who are not yet 65.
Texas does not limit how much insurers can charge under-65 beneficiaries for a Medigap policy. If you qualify for Medicare due to a disability and aren't yet 65 years old, expect to pay several times more than what over-65 Medicare beneficiaries are charged.
Medigap Plan C and Medigap Plan F in Texas
Medigap Plan C and Medigap Plan F are not available to people who qualify for Medicare on or after January 1, 2020.
We recommend Medigap Plan D or Medigap Plan G instead. With the exception of the Medicare Part B deductible, these plans offer the same benefits as Plans C and F, respectively. Thanks to cheaper premiums, they also usually give you a lower out-of-pocket overall.
When Is the Best Time to Join a Medicare Supplement Plan in Texas?
The best time to join a Texas Medicare Supplement plan is during your 6-month Medigap Open Enrollment Period (OEP). It begins the day you enroll in both Medicare Part A and Medicare Part B. During your OEP, you have guaranteed issue rights.
- If you're age 65 or older, this means your application cannot be rejected. You also can't be charged a higher premium, even if you have preexisting conditions.
- If you're under age 65, you're guaranteed a Medigap Plan A policy during your OEP. However, you may be charged a higher premium.
People who qualify for Medicare due to a disability get a second Medigap Open Enrollment Period when they turn 65. It comes with the same protections that new Medicare beneficiaries receive.
How to Choose a Medigap Plan in Texas
We recommend choosing a Supplement plan that has the most comprehensive benefits you can afford. If you wait, it may be impossible to get the coverage you need.
The next concern is pricing. Most Medigap insurers use one of three pricing methods:
- Attained-age rated: Premiums start out low but go up as you age. These policies are usually the most expensive option over time.
- Community rated: Also known as no-age rated, these plans charge the same premium regardless of age. Over time, most experts agree that these are the cheapest Medigap plans.
- Issue-age rated: Premiums are based on your age at the time you join the plan, not your age throughout the life of the policy. They may rise over time due to inflation, though.
Texas Medigap insurers mostly use attained-age and issue-age pricing.
Our Find a Plan tool makes it easy to compare Medigap plans in Texas. Simply enter your location information and coverage start date to review Medicare plan options in your area.