Best Texas Medicare Supplements

Medigap Made Simple

Best Texas Medicare Supplements - Medigap

Be sure to sign up for Medicare supplement insurance within the 6-month window after you turn 65 (or elder) AND enroll in Medicare Part B. When asked what the number one biggest mistake Americans make is regarding Medicare supplemental insurance, a spokesman with the U.S. Social Security Administration told us “Everyone thinks they have enough coverage when they’re 65 if they’re working or if they have insurance through their spouse. They don’t think they have to sign up. Then later they find out they have missed their open enrollment period.” Note: Medicare Plan F is no longer available to those who are eligible for Medicare after January 1, 2020.
 

Medicare Supplements, also known as Medigap, are standardized by the Federal Government. They are labeled A, B, C, D, F, G, K, L, M, and N. Each standardized Medigap policy must offer the same basic benefits no matter which insurance company sells it. Cost is usually the only difference between Medigap policies with the same letter sold by different insurance companies. Plan A pays the Medicare hospital and physician coinsurance, the first three pints of blood, and 365 days of hospitalization beyond Medicare. Plans B through N provide these benefits and add more benefits such as coverage for Medicare deductibles, excess charges and limited preventive care, and foreign travel. You can only have one Med Sup plan. No one should try to sell you an additional Medsup plan unless you decide you need to switch policies.

Open Enrollment for Medicare Supplemental Insurance is at age 65 for all consumers, including those already receiving Medicare due to disability. The Open Enrollment period is a six-month period. For six months beginning when you are both age 65 or older and enrolled in Medicare Part B, companies must sell you any Medicare supplement plan they offer. During the open enrollment timeframe, federal law bans insurers from denying you coverage or charging higher premiums if you have a pre-existing health condition or disability. If you try to sign up after that window, you will likely pay more for premiums and may even be denied. After this limited open enrollment period, companies can pick and choose whom they will cover and how much they will charge based on your health. If you have an individual or “bank group” insurance policy, becoming Medicare eligible does not require you to cancel it and purchase a Medicare supplement. Doing so may save premium costs but it is important to compare benefits before deciding which will work best.

If you are eligible for employer retirement insurance, review the plan carefully to understand what benefits are available and how it works with Medicare. Be aware that employer plans are not standardized and are not subject to the requirements governing standardized Medicare supplement policies. Also, it is important to remember, if you leave an employer plan you may not be able to go back on it.

Understanding the fine print in a supplemental policy makes a big difference. The research will help you avoid situations like being charged extra out-of-pocket or out-of-network fees. Ultimately, coverage options for supplement insurance vary by plan type and provider, so it’s difficult to know what factors are most important.

Some Texas residents are eligible to enroll in approved Medicare Advantage plans. These plans are offered by private insurance companies. Each year Medicare Advantage companies decide where they will offer their plans, what benefits will be offered, and what the premiums will be. Several include vision, dental, hearing, and wellness programs not covered by original Medicare. As noted earlier many Medicare Advantage Plans also offer prescription drug coverage. There are several Medicare Advantage plans available in Dallas, Tarrant, and surrounding counties. Depending on plan choice, a member may be responsible for paying co-payments for certain covered services. Most importantly, with Medicare Supplements, Medicare Advantage, and standalone Part D Prescription Drug Plans, you must continue to pay your Part A (if any) and part B Medicare premiums.

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Meet Sarah Fuhrmann

Sarah began working in the healthcare industry in 2001, where she worked for many years with elderly Alzheimer and Dementia patients. From there she worked as a Group Benefits Administrator with a local healthcare company in the Human Resource Department for a period of 10 years. Since then, she has decided to work in the Medicare insurance industry full time and has joined the family business, Ashford Insurance, as a Medicare Insurance Agent.

Sarah Fuhrmann