There are a number of benefits that come along with turning 65; one being the availability to healthcare insurance known as Medicare.  As with most programs that are sponsored by the government there are various aspects to understand.  It is important to note that once participants are enrolled in Medicare Part B of the Original Medicare program, you can enroll in a Medigap plan to fill in the gaps within the coverage.

Original Medicare Coverage:

  • Medicare Part A – 80% of in-hospital costs – More information
  • Medicare Part B – Expense for the physicians, outpatient treatments, and medical supplies – More information
  • Medicare Part C – Otherwise known as Medicare Advantage, this plan cannot be used in combination with Medigap plans – More information
  • Medicare Part D – This covers prescription medication coverage – More information
  • Texas Medigap Insurance Plans – More information on Medigap
  • There are ten Medigap plans labeled with the letters of the alphabet.  The benefits that come with these plans range depending on the plan that participants select.  Possible coverage includes:
  • The first three pint of blood that is needed in a medical procedure
  • Skilled nursing care
  • The Medicare Part A and Part B deductibles
  • Foreign travel emergency coverage

Insurance company rates vary a lot when it comes to Medigap premiums.  The one thing that does not however is the coverage of each plan.  No matter where you purchase Medigap Plan F the coverage is the exact same.  This is true of all ten Medigap plans.

The most popular option in Texas is Medigap Plan F.  This Medigap plan is the most popular since it offers the most benefits in comparison to other plan alternatives.

Texas Medicare and Medigap Plans are available for participants under 65 who qualify for coverage due to a disability.  Coverage options vary because each state is allowed to choose which Medigap supplemental plans to offer to Medicare beneficiaries younger than 65 that qualify.  In Texas Plan A is offered.  The rate that is charge is not the same to those under 65 in comparison to those over 65.

13% of the population in Texas receives Medicare benefits.  In 2015 that was almost 3.7 million recipients, participants with ESRD make up 1.3% of them.  In 2013 the distribution of participants was 16% being disabled and the remaining 84% of beneficiaries had reached the age of 65.

Texas Medigap Plan F Coverage

  • Part A hospital co-insurance costs for up to an additional of 365 days after your Medicare benefits are exhausted
  • Part B co-insurance, co-payments for outpatient services, supplies, physicians services, treatment, and other items
  • First three units of blood for approved medical procedures
  • Part A hospice care co-payment
  • Skilled nursing facility co-insurance
  • Medicare Part B deductible for hospitalization
  • Medicare Part B deductible for outpatient services
  • Medicare Part B excess charges – this is the difference between a providers charge and the Medicare  limit for the service
  • Foreign travel emergency expenses up to the plan limits
  • Medicare preventative care Part B coinsurance

Medigap plan G is similar to plan F except that it does not cover the deductible of Medicare Part B.  There may be other Texas Medigap insurance costs which could include monthly premiums, annual deductibles, co-payments, co-insurances payments.  These costs vary between insurance companies; however, insurance companies must notify enrollees in advance of premium increases.  As mentioned before, Medigap rates vary between insurance companies, where you live, your age, your gender, and health.

For a guide on Texas Medigap rates and comparison of Medigap plans contact a licensed Texas Medigap advisor.  They will help you with the options and offer you details to the coverage advantages and drawbacks.  There are many great options to choose from in Texas when it comes to Medigap options.  Be sure to choose the best fit for your lifestyle, budget, and healthcare needs.