Choosing the best Medicare supplement in Houston, Texas can be a tedious undertaking. First of all, you must research and understand the various coverage options and narrow it down to the plan that fits your needs and requirements. Usually, you can acquire this best knowledge and wisdom after talking with a reliable insurance agent who has your best interests in mind.
The Centers for Medicare and Medicaid Services standardizes Texas Medicare Supplement Plans Insurance. This way, you will receive the same benefits despite the insurance company you choose to cover your Medicare costs. However, the price is a huge factor and may vary significantly between different insurance companies.
Likewise, Houston Medigap Plans are universal and are sold by most insurers. Thus, you can get the coverage which is the same in all states.
If you are looking for the best Medicare supplemental plans in Houston, Texas, remember that you must find the plan that meets your needs. Your relative or friend’s plan may not be the best for you. Thus, you must understand the different plans and what favors you the most.
A Brief Review of Medicare
Before dwelling on Medicare supplement in Houston, Texas, you must be enlightened about Medicare. Later on, you will find it easier to understand how Houston Medigap Plans are incorporated into your Medicare coverage.
Generally, the government funds Medicare and is offered for citizens aged 65 years and older. Also, individuals with certain illness are eligible for Medicare coverage. Meanwhile, Medicare has four parts: A, B, C, and D.
Once you are eligible, you automatically get Original Medicare which consists of Medicare Part A and Part B. Further, the four parts of Medicare vary in coverage.
- Medicare Part A: Also called Hospital Insurance, this is part of the Original Medicare together with Medicare Part B. Basically, it covers inpatient care in hospitals, skilled nursing care, hospice care and home health care.
- Medicare Part B: It is also known as Medical Insurance. Like Medicare Part A, Part B is inclusive in Original Medicare. Further, Part B helps pay for home health care, doctors’ services, and durable medical equipment.
- Medicare Part C: Medicare Advantage Plan. This is a second option insurance for seniors if they don’t want Original Medicare Insurance. Medicare authorizes private companies and can, therefore, offer this plan. It’s a combination of Medicare Part A, and Part B…. In some cases, Part D may also be included.
- Medicare Part D: Prescription drug coverage. Basically, this offers coverage for prescription drugs and helps prevent you from higher expenses in the future. Just like Part C Medicare, this is offered by private insurance companies which are Medicare-approved. The coverage also depends on the plan you choose.
What Is Medicare Supplement?
So what is the role of Medicare Supplement? Basically, a Medicare Supplement Insurance or Medigap policy helps cover some of your health care costs which Original Medicare doesn’t cover including:
How much does Medicare Supplement pay/cover?
Recall that Original Medicare pays 80% of health care costs. That being said, Medicare Supplement/Medigap pays 20%, which is why it’s called a Medicare supplement. It fills in the gap after the Original Medicare pays the 80% of your health care costs.
Private insurance companies sell Medigap policies. In some cases, a Medigap policy may cover for extra services such as medical assistance when you’re outside the U.S.
What does Medicare Supplement/Medigap cover outside the US?
Your Medigap policy may offer additional coverage for supplies and health care services outside the U.S. In fact, standard Medigap plans (C, D, F, G, M, and N) provide foreign travel emergency health care coverage when you travel outside the U.S.
Meanwhile, Medigap Plans C, D, E, F, G, H, I, J, M, and N pay 80% of the billed charges for certain necessary medical emergency care outside the U.S. Moreover, these Medigap policies cover foreign travel emergency care if it occurs under the first 60 days of your trip. In fact, Medigap policies provide a lifetime limit of $50,000 foreign travel emergency coverage.
8 Key Details You Must Know About Medicare Supplement In Houston, Texas
Before purchasing Medicare Supplemental Plans in Houston, Texas there are a few (technical) details you must know about Medigap policies:
- You must have Original Medicare (Part A, and Part B)
- If you have Part C Medicare, you may still apply for a Medigap policy. However, you must dismiss your Medicare Part C before your Medicare Supplement policy starts.
- You must pay a monthly premium to the private insurance company for your chosen Medigap policy. This monthly premium is in addition to your monthly Part B premium.
- Medigap policies only cover one citizen. If you and your partner both want Medicare Supplement Insurance, you will have to purchase separate Medigap policies
- You may buy a certain Medicare Supplement Insurance policy from any licensed insurance company in Houston.
- You can guarantee that Standard Medigap policies are renewable regardless of your health problems. Thus, the insurance company has no right to cancel your Medigap policy provided that you pay the said monthly premium.
- The policies for Medigap changed in 2006. Particularly, the inclusion of prescription drug coverage. Medicare Part D is not inclusive of Medigap plans. If you insist, you may join a separate Medicare Prescription Drug Plan.
- It’s unlawful for any individual to sell you Medigap policies if you possess a Medicare Medical Savings Account Plan
What Happens When I Get A Medigap Policy?
When you buy a Medigap policy and incorporate it with your Original Medicare, two instances occur:
- Medicare pays 80% their share of the approved coverage amount for health care expenses.
- Then, the Medigap policy pays its share by 20%.
One thing you must know is that Medigap policies are different from Medicare Part C. A Medigap policy augments your Original Medicare benefits. Meanwhile, Medicare Advantage Plans are available to help you acquire Medicare benefits.
How A Medicare Supplement in Houston, Texas Works
You may want to consider joining a Medicare Supplement in Houston, Texas which can help pay for your health-care costs which correspond with your Original Medicare. This includes coinsurance, copayments, and deductibles.
Further, there are various options for Texas Medicare Supplement Plans which depends on the county and zip code you live in. You must understand what Medigap in Houston, Texas covers and determine how to choose a Medigap plan that fits your individual requirements.
How To Enroll: Medicare Supplement Plan
The following are instances when enrolling for a Medicare Supplement in Houston, Texas:
- Eligible for Original Medicare: In the event that you decide to purchase a Medicare Supplement in Houston, Texas, you must be eligible for Original Medicare.
- Enrollment Period: Further, you should know when’s the best time to sign up. Usually, this occurs during the Medigap Open Enrollment Period. This six-month period commences on the day you turn 65 or older.
- Guaranteed issue rights: Also, once you get Medicare Part B, you may acquire specific Medigap protections including “guaranteed issue rights.” It serves as an assurance that you may join any Medigap plan in your particular location.
- No medical underwriting: Moreover, the insurance company you choose will not require you to go through any medical undertakings. You won’t receive any rejections as long as you enroll during this period.
- Signing up after Enrollment Period – You may still have to wait around six months before receiving coverage for pre-existing conditions. Meanwhile, when you decide to sign up for Medigap beyond the open enrollment period, you may be denied coverage. Also, you may be spending more on your insurance plan. Moreover, after enrollment period, you may have difficulties in switching between Medicare plans. Especially, if you have underlying health problems.
- Stay enrolled in Original Medicare – Remember that Medigap plans are not meant to replace your Original Medicare. Instead, Medigap plans only supplement it. You must stay enrolled and continue to pay monthly premiums for Original Medicare, particularly Part B. Doing so helps keep your health insurance coverage.
- Stand-alone Part D Medicare: Meanwhile, if you need coverage for prescription drugs, it would be wise to enroll in a separate Part D Medicare plan. Medigap Plans in Houston, Texas like the rest of the states, do not offer prescription drug coverage.
10 Types of Medigap plans in Houston, Texas
Generally, there are 10 systematized Medicare Supplement Plans which are classified and established by a specific letter. There are some plans that offer the same benefits among all states. These Medigap Plans are Medigap A, B, C, D, F, G, K, L, M, and N.
Knowing what are the different Medicare supplement plans will help you understand the specifics of each plan. Further, it guides you in making a wise decision when choosing a Medigap plan.
Chart for Medigap Plans
Moreover, study the chart below to give you an easier way to understand the different Medicare supplement plans. The X’s indicate that the specific service is 100% covered. Meanwhile, the percentage specifies the coverage amount of service/s. Lastly, a blank cell means the plan does not cover that specific service.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A hospital and coinsurance costs up to an additional 365 days after Medicare benefits are exhausted||X||X||X||X||X||X||X||X||X||X|
|Medicare Part B coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B excess charges||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out-of-pocket limits apply.**|
* Medigap Plan F provides a high-deductible variety where you may pay a specific deductible amount before your plan commences coverage. The amount may alter every year.
**Once you’ve exhausted the out-of-pocket limits which include Part B deductibles, Medicare Supplement Plans L and K pays 100% of covered services for the rest of the year.
***Medigap Plan N pays full coverage of the coinsurance for Medicare Part B. However, it does not include copayments beyond $20 on doctor visits and above $50 on emergency room visits which don’t conclude in an inpatient admission.
How to Choose A Medigap Plan in Houston, Texas
As mentioned previously, Medicare Supplement plans in Houston, Texas bearing the same type don’t vary in benefits or coverage. Although, since these plans are provided by private insurance companies, Medicare supplement costs may vary. Also, each company possesses the freedom to establish the structure of their monthly premiums.
This means, wherever you live in Houston, Texas you may pay less or more, depending on the plan and the insurance company you purchase it from.
Therefore, it is crucial to be smart when choosing the best Medicare supplement plans. You must understand the probable costs and compare it with other options in your area. Also, your decision must be based on your health and budget requirements.
Key Things to Consider When Choosing a Medigap Plan
- Individual health status: First of all, consider the status of your health, and family medical history. Studying the various plans may be confusing, so you must examine your health and choose a plan that will suit your medical needs.
- Use a Medicare tool: Utilize available Medigap online search tools. Check out medicare.gov, click “Supplements & Other Insurance,” then click “How to Compare Medigap Policies.” The tool should help you break down what each Medigap plan covers, range of premiums costs, and list of companies which offer those plans in your area.
- Choose cheap: Remember that Medigap policies with the same letter cover the exact same benefits. Therefore, choose an insurance company who offers the plan for the cheapest cost.
- Enrollment period: Signing up within the six months after Medicare Part B enrollment is the best period to purchase. You will get the best prices during the open-enrollment period. Also, the insurer cannot reject you from a policy, nor charge you more for your health status.
- Three pricing methods: Also, you must be familiar with the three pricing methods which can affect the cost of your Medicare supplement in Houston, Texas. Usually, insurers sell Medigap policies in three ways: “attained-age,” “issue-age,” or “community-rate” policies. The premiums of “attained-age” policy start low but it inflates as you get older. Meanwhile, the premiums of “issue-age” increase because of inflation, not age. Lastly, “community-rate” policies charge everyone in the same area similar premiums regardless of age.
- No drug coverage: Recall that Medicare Supplement Plans do not cover prescription drug expenses. Therefore, if you don’t own a prescription drug coverage, consider purchasing a separate Part D Medicare. Also, take note that Medigap plans do not cover dental, vision, hearing, or long-term care.
So, It is essential to have an in-depth study on Medicare and the scope of Medicare Supplement in Houston, Texas. This way, it ensures that you get to purchase the best Medigap plan that will fit your health and budget needs. Also, remember everything about Medicare Supplement including its enrollment process, and the factors to consider. Meanwhile, Call Inzur agents at 1-888-999-0089 for more information on Medicare and Medicare supplement costs.