Texas Medicare Plans
Everything is bigger in Texas. This includes the number of things to do and places to visit. Explore the San Antonio River Walk or take a step back into history at the Alamo. Suppose nature is more your thing, Big Bend National Park as breathtaking sites that demand a photo or two. There’s the Cadillac Ranch, the Dallas Museum of Art, and the Houston Space Center for something different.
Not only are the sites big in Texas, so is the number of people enrolled in Medicare! There are over 4 million Medicare beneficiaries in the Lone Star state alone! Luckily, Texas offers ten standardized Medigap plans and numerous Medicare Advantage plans to help with your healthcare needs. If you are coming into Medicare or already enrolled, you want to make sure you fully understand all of the rules, timelines, and options you have for your health insurance needs!
What are Medicare Options in Texas?
Texas, like many states, offers the standard Medicare Supplement plans, also known as Medigap plans. If you are a resident, you can choose from the following plans: A, B, C, D, F, G, H, K, L, M, N, high-deductible Plan F, and high-deductible Plan G. You’re able to enroll during the year, but if you want your coverage to be guaranteed, you want to enroll during your open enrollment period in Texas.
What are the Most Popular Medicare Supplement Plans in Texas?
- Medicare Supplement Plan F
- Medicare Supplement Plan G
- Medicare Supplement Plan N
When is the Open Enrollment Period in Texas?
As a Medicare beneficiary, you can enroll in any Medicare Supplement within your first six months of your Part B effective date. This is considered your open enrollment period. During this time, insurance carriers are required to approve your MediGap application, and are prohibited from declining the coverage you need because you have a pre-existing condition. You can still apply outside of this window, but you will be required to go through medical underwriting, and could be denied coverage based on your health history.
Can I Change Medicare Supplement Plans in Texas?
You can apply to change your Medicare Supplement during any month of the year in Texas, however there is one catch. Once you are more than 6 months past your Medicare Part B effective date, you must go through medical underwriting in order to be approved to enroll into, or change your Medicare Supplement plan. This means that insurance carriers are given the ability to assess your health history, prescriptions, height and weight, as well as other health-related factors to determine if you will be approved or denied coverage. During medical underwriting, insurance carriers have the ability to deny a Medicare Supplement plan application based on pre-existing conditions, so it is important to enroll in a MediGap plan during your open-enrollment period to guarantee your acceptance.
Medigap Plan F in Texas
Medicare Supplement Plan F has been a very popular plan with Medicare beneficiaries over time. The reason for the popularity of Plan F, is that it covers the gaps left by Medicare Part A and B with no out-of-pocket. However, if you became Medicare eligible after January 1st 2020, you are not eligible to enroll in MediGap Plan F. Luckily, there are other great Medicare Supplement plan options available.
Medigap Plan G in Texas
Medicare Supplement Plan G is a very comprehensive Medicare Supplement plan with very little out-of-pocket expense. Once you have met your Part B annual deductible, MediGap Plan G becomes a full coverage plan, covering all of the gaps left by Original Medicare, with no additional out-of-pocket expenses. Plan G is typically a very cost-efficient plan with an affordable monthly premium to ensure gold-standard coverage.
Medigap Plan N in Texas
Medicare Supplement Plan N is also a great, comprehensive MediGap plan available in Texas. This plan has slightly more out-of-pocket cost than MediGap Plan G, but also comes with a lower monthly premium. As with Plan G, you are still responsible for the Medicare part B annual deductible. Once you have met this deductible, your Original Medicare coverage kicks in, but you still have some cost-share. With MediGap Plan N, you will pay copayments up to $20 for office visits, and up to $50 for ER visits that do not result in an inpatient admission. Plan N also has the possibility of an excess charges if you use a doctor or healthcare provider that does not accept Medicare Assignment. Excess charges can be up to 15% of the Medicare-approved payment. If the monthly premium difference between Plan G and Plan N is large enough, Plan N is often times a very attractive option for your Medicare Supplement plan.
What is the Cost of a Medicare Supplement Plan in Texas?
Monthly premiums for Medicare Supplement plans are based on three main factors- age, gender, and location. There are other things that may impact your premium such as tobacco use. The premium amounts will vary based on these factors, so it is important to receive a quote based on your specific demographic information.
Medicare Plans in Texas for Those Under 65
When it comes to Medicare under 65 in Texas, insurance carriers are required to offer at least Medigap Plan A with a 6 month open enrollment period beginning when Part B begins. Insurance carriers, however, are not required to offer any other plan options, and can require medical underwriting for plan approval after the 6 month open enrollment period. If you’re under 65 and disabled but still qualify for Medicare, you may not pass this underwriting. If you fit within this category, there are Medicare Advantage Policies that you can look into.
Once you reach 65, more Medicare supplement plans will open up for enrollment in Texas without any health questions. This period guarantees acceptance
Medicare Advantage in Texas
Texas also offers options for Medicare Advantage plans. In these plans you must live in your plan’s service area and enroll during an appropriate election period. Medicare Advantage plans do not required medical underwriting if enrolling during an election period, but are also significantly different plans than Medicare Supplement plans.
Medicare and Medicaid in Texas
It is possible to qualify for both Medicare and Medicaid in the state of Texas. These two programs, however, are separate and have different qualifications you must meet in order to receive benefits. To qualify for Medicaid, you must meet state income requirements. To qualify for Medicare, you must be either over the age of 65, or under 65 but receiving Social Security Disability Insurance for a minimum of 24 months before applying for Medicare.
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