Summary: Medicare Supplement plans in Texas provide supplemental benefits to cover the costs left behind when using Original Medicare. Finding the right one for your needs can be key to cutting your healthcare costs. Explore the most popular Medigap plan options in TX. Estimated Read Time: 11 mins
Medicare Supplement plans in Texas cover the costs Medicare Part A and Part B (Original Medicare) leave for seniors to pay. Also known as Medigap plans in Texas, your costs may vary depending on your carrier, plan, and ZIP Code.
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Original Medicare consists of two parts. Medicare Part A covers inpatient costs, and Part B covers outpatient costs. However, Original Medicare leaves you responsible for copayments, deductibles, and coinsurances. Therefore, you can be stuck with many gaps in coverage that could cost more than anticipated.
Regarding Medicare Supplement plans, Texas residents receive benefits that follow the same rules as Medigap plans in most other states. Medicare plans in Texas that supplement your coverage help cover these costs by filling in the gaps Original Medicare coverage alone leaves. These policies provide predictable healthcare costs for your future.
The federal government standardizes Medicare Supplement plans in Texas to provide identical coverage regardless of carrier. Ten standardized Medigap plans are available in Texas, plus two high-deductible versions. Finding the best Medigap plans in Texas means finding the right coverage for your needs, which differs for each person. Below, we discuss the different options Texans have for Medigap coverage and the state-specific guidelines you should know to find the right benefits for your needs.
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What Is the Best Medicare Supplement (Medigap) Plan in Texas for 2023?
The best Medicare Supplement plan in Texas will vary from person to person. This is because everyone has different needs for their healthcare and budget. Your needs aren’t the same as your neighbor, and there are several different Medicare Supplement plans in Texas to help provide a broader range of benefits because of this.
Having a variety of plan options means more people, including you, can enjoy a more personalized approach to healthcare. But of all of the Medigap plans in Texas available, three remain the most popular options: Medicare Supplement Plan F, Plan G, and Plan N.
You’ll note that Texas residents will receive a different level of coverage for each of these Medigap plans. But with varying benefits also comes differing premiums. Furthermore, if you’re looking to enroll in Medicare Supplement Texas coverage, enrollment restrictions apply to some benefits.
Each of the Texas Medicare Supplement plans offers its own benefits. What’s best for one person may not be best for you, and vice versa. While some may require lower premiums, other seniors may seek more benefits to meet their healthcare needs. Below, we’re breaking down the most popular supplemental Medicare plans in Texas available for you.
Medicare Supplement Plan F in Texas
Medicare Supplement Plan F in Texas leaves you with zero out-of-pocket costs aside from your monthly premium. So, if you are looking for complete healthcare coverage, this is the plan for you.
Because you receive the most comprehensive benefits available, you can expect Medicare Supplement Plan F rates for Texas to be higher than other plan options. However, you’ll also need to be eligible to enroll in the benefits.
It’s important to note that Medigap Plan F in Texas is unavailable to those new to Medicare. You must have become eligible for Medicare benefits before January 1, 2020, to enroll.
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Medicare Supplement Plan G in Texas
Medicare Supplement Plan G in Texas continues to become one of if not the most popular options available. You’ll find that Medigap Plan G in Texas is growing in part because of the unavailability of Plan F for newly enrolled seniors.
The difference between Medicare Plan G Texas coverage and Plan F is that you’ll still be responsible for covering your Medicare Part B deductible. But the Medicare Plan G cost in Texas, even with needing to cover your deductible, is often still more cost-effective than handling out-of-pocket expenses that come with your healthcare alone.
Overall, seniors see savings on the best Medicare Supplement Plan G in Texas coverages. But remember, the best Medigap Plan G in Texas will vary from person to person and carrier to carrier. You’ll still need to compare rates and companies in your area with a licensed Medicare agent.
Medicare Supplement Plan N in Texas
If you’re looking to enroll in benefits but keep your premiums low, Medicare Supplement Plan N in Texas continues to be a popular option. There are out-of-pocket expenses, such as your Medicare Part B deductible and copays at the hospital and your doctor’s office. You’ll also still need to cover your Medicare Part B excess charges, which are unusual but can exist. But overall, your coverage can help mitigate expenses for costly healthcare services while helping you save on premiums.
Medigap Plan N in Texas is a great way to provide a sense of balance and peace of mind to your healthcare costs, but the only way to know for sure is by comparing benefits in your area. By working with a licensed agent, you can identify your needs, compare plans, estimate your annual out-of-pocket costs, and enroll in an appropriate level of coverage.
Who Is Eligible for Medicare Supplement Plans in Texas?
If you are eligible for Medicare Part A and Part B, then you are eligible for Medicare Supplement plans in Texas. Remember, Medigap plans in Texas are there to fill in the gaps by covering healthcare costs left over when relying on Original Medicare benefits alone. It’s supplemental coverage available to qualifying Medicare beneficiaries.
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Average Cost of Medicare Supplemental Insurance in Texas
Your monthly premium for a Medicare Supplement plan in Texas depends on a few different factors. These factors include your age, gender, location, plan’s level of coverage, and more. Monthly premiums can range anywhere from $50 to $500+.
Because monthly premium costs are not standardized like plan benefits, it is wise to compare plan costs before enrolling with the first carrier available in your area. Finding the highest-rated carrier at the lowest price point is the key to enrolling in the best Medigap plan in Texas.
While the cost of coverage for Medicare Supplement plans in Texas has many different actors, patterns emerge. You’ll note that in general, women pay less than men, non-smokers will also save when compared to smokers, and older beneficiaries will have higher premium rates as well. You’ll also pay more for having more benefits.
Our Texas Medigap cost comparison chart showcases the average monthly premium costs for a 65-year-old male and female compared to a 75-year-old male and female in the same Texas ZIP Code.
Female, No Tobacco, Texas ZIP Code 77494 | |||
---|---|---|---|
Medigap Plan | Monthly Premium Age 65 | Monthly Premium Age 75 | |
Medicare Supplement Plan F | $110-$484* | $138-$484* | |
Medicare Supplement Plan G | $90-$446 | $113-$446 | |
Medicare Supplement Plan N | $72-$417 | $90-$417 |
Male, No Tobacco, Texas ZIP Code 77494 | |||
---|---|---|---|
Medigap Plan | Monthly Premium Age 65 | Monthly Premium Age 75 | |
Medicare Supplement Plan F | $124-$546* | $156-$546* | |
Medicare Supplement Plan G | $102-$503 | $128-$503 | |
Medicare Supplement Plan N | $81-$471 | $102-$471 |
* If on Medicare before 01/01/2020
It’s worth noting that there are extra costs you will incur if you do not sign up for Medicare Supplement plans in TX as soon as you are eligible to do so. As you can see above, if you enroll at the age of 75 rather than during your Medigap Open Enrollment Period at 65, expect to pay a higher monthly premium.
Seniors will need to cover their monthly premium as well as various out-of-pocket costs required by your Medicare Supplement plan.
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Medicare Supplemental Insurance Companies in Texas
Texas Medigap coverage can be found through many popular brands. Here are some of the most notable Medicare supplemental insurance companies in Texas available:
- Aetna
- Bankers Fidelity
- Blue Cross Blue Shield (BCBS) of Texas
- Capitol Life
- Cigna
- GPM (Government Personnel Mutual)
- Humana
- Lumico Life Insurance
- Manhattan Life
- Mutual of Omaha
- National General
- United American
- UnitedHealthcare
Seniors searching for top-rated Medicare Supplement plans in Texas can rest assured that a wide variety is available to residents of the Lone Star State.
Medicare Supplement for Disabled Under 65 in Texas
If you become eligible for Medicare under the age of 65 due to a disability in Texas, you may enroll in a Medigap plan in Texas. When you first enroll in Medicare Part A and Part B, you receive a Medicare Supplement Open Enrollment Period. During this time, you have free rein to enroll in the Medigap Texas plan of your choice, but it is limited to Medicare Supplement Plan A coverage.
If you collect Social Security Disability Income (SSDI) for at least 24 months, you are eligible for a Medicare Supplement plan in Texas. However, the cost of a Medigap plan in Texas may be much higher when you are under 65 as the price is not regulated.
Often, Medicare beneficiaries under 65 enroll in a Medicare Advantage plan until they age into Medicare at 65. At this time, you will receive a second Medicare Supplement Open Enrollment Period and can enroll in supplemental coverage from Medicare plans in Texas at a much lower cost.
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Medicare Supplement Rating Method in Texas
Medicare Plans in TX providing supplemental coverage use rating methods to help determine the amount you’ll pay for coverage. Both issue age rating or attained age rating methods are allowed in the Lone Star State. Here is how each work:
- Companies that choose an issue age rating for determining your premiums for Medicare Supplement plans in Texas basing the cost off of when you receive your coverage. Younger enrollees pay lower prices as a result.
- If you are enrolling with a company using attained age rating methods, your premiums will be based on your age. Expect your premium to increase each year you get older.
While both affect your cost, there are many other factors that go into calculating your premium. Nevertheless, policies using issue age ratings will provide enrollees who buy a policy at an older age to pay more for someone who is the same age but purchased coverage earlier. Conversely, your length of enrollment doesn’t matter with policies using attained age ratings, as the cost always goes by your current age.
Texas Medigap Guaranteed Issue Right
The supplemental coverage provided by Medigap TX residents can enjoy guaranteed issue right when purchasing a policy outside of your Medicare Supplement Open Enrollment Period.
This can occur for those ages 65 and over when losing qualifying health coverage due to certain events for Texas Medigap Plans A, B, C, F, K, and L, including High Deductible Plan F. It’s worth noting that Texas Medigap Plans F and High Deductible F are only for those eligible for Medicare benefits before January 1, 2020. If you were eligible after this date, you have guaranteed issue right to Texas Medigap Plans G and High Deductible G.
If you are under the age of 65 and enroll in Medicare Part B due to disability, you too enjoy guaranteed issue rights. However, this only applies to Medicare Supplement Plan A in Texas.
Your guaranteed issue rights include scenarios like loss of Medicaid, moving out of your plan’s service area, and more. It lasts 63 days beginning when your coverage ends or when you’re notified your coverage will end, depending on which is later.
During this period, companies cannot deny coverage because of preexisting conditions. While you’ll need to provide proof of lost benefits, such as a letter from your company ending your coverage, this protection helps Texans retain the benefits they rely on for their healthcare.
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When to Enroll in Medigap Plans in Texas
The best time to enroll in Medicare Supplement plans in TX is during your six-month Medicare Supplement Open Enrollment window. At this time, you can enroll in a plan without answering Medicare Supplement underwriting questions.
If you miss enrolling in a plan during this time, you can still sign up at any time of the year. Although, if you choose to do so outside your open enrollment window, you may have to go through medical underwriting. This means answering a series of health questions that may allow a healthcare carrier to deny your application or charge you higher premiums if you have a pre-existing condition.
Yet, if you become eligible for a Special Enrollment Period, you may receive guaranteed issue rights to enroll in supplemental Medicare plans in Texas without health questions.
Additional Medicare Coverage for Beneficiaries in Texas
Enrolling in Original Medicare and supplemental coverage is a great way to help cover many healthcare costs, but there are additional costs that may apply and alternatives available. In the Lone Star State, here are some critical healthcare coverage considerations:
- Medicare Part D helps you cover the expense of costly prescription drugs. Each plan comes from private companies offering coverage for specific medications listed on each plan’s formulary.
- Additional benefits may be necessary for dental, hearing, and vision coverage, as your Medicare benefits won’t cover these healthcare services. Thankfully, ancillary policies are available.
- Alternatively, while Medicare Supplement plans in Texas are great options for many beneficiaries, you may also benefit from Medicare Advantage coverage. It all depends on your personal healthcare needs, but you should note that you can only have Texas Medigap or Medicare Advantage coverage but not both at once.
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How to Enroll in Medicare Supplement Plans in Texas
Comparing Medigap plans in Texas is essential for your healthcare. We understand searching for a policy can be overwhelming and are here to help you identify the right coverage for your needs.
At MedicareFAQ, our licensed agents are experts. Our team is up-to-date with the latest changes affecting your coverage and provides services that are always 100% free. We'll compare rates from 30+ top carriers to find the right match for your needs. Also, when you enroll in a plan through us, you have unlimited support from our Client Care Team.
To get started today, call us at the phone number above to identify your needs and the benefits best suited for your coverage. You can also use our online rate comparison tool to see rates for Medicare Supplement plans in Texas now.
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Sources:
MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.
- Medicare Supplement Insurance Guide, Texas Department of Insurance. Accessed April 2022.
https://www.tdi.texas.gov/pubs/consumer/medsup.html - Medigap Enrollment and Consumer Protections Vary Across States, KFF.. Accessed April 2023.
https://www.kff.org/medicare/issue-brief/medigap-enrollment-and-consumer-protections-vary-across-states/
my husband and I are relocating to texas probably in april- we both have medicare and our secondary is blue shield pro, i have humana for my prescriptions and he has a blue shield plan. we want to stay with a ppo secondary to supplement our medicare plan. can you suggest plans for us to consider? our zip code will be 77354
Terri, it is difficult to recommend plans without having more information on your health history or individual needs. If you want our expert opinion, speaking with one of our licensed agents would be a great place to start. They can go through all the plans available in your new area to help find the perfect match for you and your husband. If you would like, you can call the number at the top of the page or complete our rate form.
I’m a diabetic and take several medications. The 2 that cost me the most is my 2 insulins once I hit the donut hole. Looking for help in that area.
Tod, drug plans can be frustrating, especially if you have chosen the wrong plan. Once enrolled in Medicare Part D you can only change your plan during the Annual Enrollment Period. This means that unless you have a qualifying event, you will not be able to review new plans. However, if you are looking to reduce costs on your current plan, you can always apply for Extra Help to see if you qualify for reduced Part D spending.
My Medicare will begin in December. Will I be required to remain on my husband’s insurance through his employer or do I have the option to get off of his insurance so Medicare will be primary and find a supplement?
Hi Stephanie! You’re not required to stay on your husbands’ insurance, but you can if that’s the best option for you. It really comes down to how many employees his employer has and which coverage is better for your healthcare needs. Usually, Original Medicare in combination with Medigap & Part D gives you better coverage and less out-of-pocket when compared to group employer coverage. However, the premium for Part B, Medigap, & Part D may be more than the premium for employer coverage.