Some beneficiaries who live in Texas experience that their expenses associated with Original Medicare policy (Parts A and B) and monthly premiums are too high for their finances. Texas Medicare advantageal insurance plans help cover some of these expenses.
A advantageal Medicare plan can cover the costs related to Original Medicare, including deductibles, co payments, and other expenses out of pocket. These plans are designed to be combined with Original Medicare and can’t be used as independent health benefits.
If you are a resident of Texas and are new to Medicare, you may have heard that Medicare advantageal plans can help you with certain costs. The following is an overview of how Medicare advantageal plans work in Texas, including what you may want to do when you enroll and how to locate a policy that suits your situation.
How do complementary Medicare plans work in Texas?
Just like all states, Medigap plans are offered in Texas by private insurers. Medicare advantageal plans, also called Medigap, can help cover some costs that Original Medicare plan does not cover, such as:
- Co insurance, Copayments, and deductibles.
- The first 3 pints of blood.
- Limited emergency care outside the country.
- Part B charges (an amount you can owe if you use a provider that does not accept a Medicare policy)
There are about 10 standardized Medigap plans in most states, including Texas, and the benefits are the same for all plans of the same type of letter (though some plans may include additional benefits). For example, Plan F has the same standard coverage everywhere in the state, regardless of where you obtained the plan or where you reside.
Do I qualify for Medicare advantages in Texas?
To qualify for a Medicare advantage policy in Texas, you need to sign up for Original Medicare, Part A, and B. Generally speaking, the best time to register is the time during the Medigap Open Enrollment period, i.e. the first month after you turn 65 years old. During this 6-month period, you will have “guaranteed-issue right” for each Medigap plan offered at your location, irrespective of existing conditions.
You cannot refuse insurance or demand higher premiums because of your health problems. In some cases, the insurance company may postpone coverage of an existing health condition for up to six months. It may be more difficult to change Medicare advantages or to enroll for the first time without guaranteed rights if you have medical problems.
While some states do not require insurance firms for the sale of Medicare Advantageal policies to Medicare beneficiaries below the age of 65, Texas does. If you have Medicare because of a disability or due to certain health conditions, Texas request companies which sell Medigap insurance plans to sell Plan A. Should you be below 65 years old, you will have an open enrollment phase in Medigap that will begin as soon as you enroll in Medicare Part B. Within these 6-months, you have a guaranteed right of recognition to receive only the Medicare Advantage Plan A.