Texas Medicare beneficiaries who may need assistance paying their additional costs of their Original Medicare expenses should consider a Medicare Supplement plan (Medigap). Medigap plans can be found through private insurance companies in Texas which then help your additional health costs which are incurred with Original Medicare (Part A) & (Part B). Additional costs come in the form of copayments, deductibles, coinsurance and any other additional out of pocket medical costs. Texas residents have several Medigap plans giving you additional options. These options can vary based on the zip code you reside in.
You must be currently enrolled in the Original Medicare (Part A & Part B) to qualify for enrollment in Medigap for Texas or the other states offering the same Medigap plans. During the six month Medigap Open Enrollment Period “OEP” is the best time to enroll. This begins on the first day of the same month you are 65 years old or older and that you are already enrolled in Medicare Part B. You can enroll in any Medigap plan during the OEP that is being offered by any of the insurers that are in your area without having to submit to a medical underwriting check. You can still enroll in a Medigap plan after the Medigap Open Enrollment Period, the insurer may request a medical background resulting in a pre-existing condition causing restrictions to be placed on your coverage. This could also cause your Medigap coverage to cost more or you could possibly be denied coverage all together.
Keep in mind that the Medigap plans are not intended to take the place of Original Medicare and to keep your supplementary coverage you must continue paying your premium for Medicare Part B to keep this coverage.
Any insurance company that that sells Medicare Plans must also off Plan A. This is the most basic policy that covers the parts of Medicare Part A and Part B which the government doesn’t pay.
Plan C will cover all that Medicare approves going up to the approved amount of the payment. So there are only 2 cases where Plan C will not cover what’s left of your medical charges after Medicare pays its share of the bill. First case is when Medicare did not approve the charge at all. The second case is when the healthcare provider has charged more than the amount Medicare approved. This is due to Plan C not covering Medicare’s Part B Excess Charges.
The most popular of all supplement plans is Plan F. It will offer a comprehensive coverage for everything that the Original Medicare won’t cover provided the charge is approved. No co pays or deductibles as well as no out of pocket costs using Plan F. Basically if Medicare Part A & B only pay a penny on doctor or hospital charges then Plan F policy will cover the difference.
Plan G will have almost the same amount of coverage as the Plan F. Difference being with Part B deductible. After the annual deductible for Medicare Part B has been met, the plan covers the coinsurance amount of medical services approved by Medicare. Generally, this would be 20 percent of the approved amount.
Plan K will cover the cost sharing of Part B preventive services, then Part A hospital co-insurance. This features additional 365 days for hospital coverage. Plan K will also cover 50 percent of Part A & B blood deductibles or the Part B co-insurance, skilled nursing facilities co-insurance, and cost sharing that is associated with hospice benefits, as well as Part A hospital deductibles.
Plan N benefits are similar to Plan D only it features a co-payment for doctor visits an emergency room visits. The co-pays are applied after the annual deductible has been met.
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