Best Texas Medigap

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Best Texas Medigap – Medicare Supplements

 
The Medicare Supplement plans are designed to be subscribed to right alongside a valid Original Medicare plan, offering complementary coverage without ever overlapping. Supplement plans will not work with Advantage plans, so if you need one of them, then you need to choose only one.
 
Medicare Supplement Insurance (Medigap) can help with some costs that Original Medicare doesn’t cover. 
 
Medigap is extra health insurance that you buy from a private company to pay health care costs not covered by Original Medicare, such as co-payments, deductibles, and health care if you travel.
 
People tend to use the terms Medigap and Medicare Supplemental Insurance interchangeably but they refer to the same thing. There is no difference between Medigap plans and Medicare Supplemental Insurance. Medigap is simply the name for Medicare Supplemental insurance and Medigap plans are the only supplemental insurance available for Medicare plans.
 

Medicare covers many health services, but it doesn’t cover everything. Medicare Supplement Insurance (Medigap) helps pay for some of those uncovered costs. It is a private form of insurance that covers some Medicare out-of-pocket costs such as deductibles, co-payments, and co-insurance — which in some cases can add up to thousands of dollars in out-of-pocket costs a year. There are 10 standardized Medigap plans offered in most states. Each plan is named with a different letter and offers a different combination of benefits. However, as of January 1, 2020, Medigap plans sold to new people with Medicare aren’t allowed to cover the Part B deductible. Because of this, Plans C and F are not available to people new to Medicare starting on 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. 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.

Who Needs Texas Medigap?

 

Anyone eligible for Medicare can get a Medigap plan to help cover the expenses associated with Medicare and healthcare as you age. Whether or not you need it is totally up to you, as these plans are fully optional. You might consider it if you enjoy traveling because the 80% foreign travel benefit on many of the plans helps to cover costs if something happens while you’re abroad.

You should also consider the cost and how much it will save you in the long run. The most robust Medigap plans have higher monthly premiums. The more modest plans have lower premiums. When you consider how much a plan could save you in the long run through coinsurance and deductible coverage, it may very well be worth it. Each company prices their plans differently, so be sure to compare at least a few different plans to get the best monthly premium.

Medigap Open Enrollment Period

 

Generally, the best time to enroll in a Medigap policy (Medicare Supplement) is during your open enrollment period. Under federal law, you have a six-month open enrollment period that begins the month you are 65 or older and enrolled in Medicare Part B.

During your open enrollment period, Medigap plan companies must sell you a policy at the best available rate regardless of your health status, and they cannot deny you coverage. The best available rate may depend on a number of factors, including your age, gender, whether you smoke, your marital status, and where you live. To ensure that you are getting the best available rate, you may want to check with your SHIP. If you purchase a Medigap during your open enrollment period, policies are limited in their ability to exclude coverage for pre-existing conditions, meaning conditions you had before you enrolled.

Guaranteed issue right

If you miss your open enrollment period, you can also buy a Medigap when you have a guaranteed issue right. If you are age 65 or older, you have a guaranteed issue right within 63 days of when you lose or end certain kinds of health coverage.

When you have a guaranteed issue right, companies must sell you a Medigap policy at the best available rate, regardless of your health status, and cannot deny you coverage. The best available rate may depend on a number of factors, including your age, gender, whether you smoke, your marital status, and where you live. A guaranteed issue right also prevents companies from imposing a waiting period for coverage of pre-existing conditions. Check with your SHIP to help ensure that you are getting the best available rate for your Medigap.

You may have a guaranteed issue right if:

  • You, through no fault of your own, lost a group health plan (GHP) that covered your Medicare cost-sharing (meaning it paid secondary to Medicare)
  • You joined a Medicare Advantage Plan when you first became eligible for Medicare and disenrolled within 12 months
  • Or, your previous Medigap policy, Medicare Advantage Plan, or PACE program ends its coverage or commits fraud
  • Note: If you have a Medicare Advantage Plan, Medicare SELECT policy, or PACE program and you move out of the plan’s service area, you also have the right to buy a Medigap policy.
  • Be sure to keep a copy of any letters, notices, postmarked envelopes, and claim denials in case you need proof that you lost or ended health coverage. Medigap insurers may require these documents before they sell you a policy.

·        Buying a Medigap outside protected enrollment periods

  • You may run into problems if you try to buy a Medigap policy outside a protected enrollment period. For instance, companies can refuse to sell you one or impose certain medical requirements. If a company does agree to sell you a policy, you may need to pay a higher monthly premium and be subject to a six-month waiting period before the Medigap will cover pre-existing conditions. Be sure to contact Medigap insurers in your state to learn if they will sell you a Medigap policy outside protected enrollment periods.

·        Cancelling a Medigap policy

  • You have the right to review a new Medigap policy for the first 30 days. You can cancel it within that time for a full refund if it does not meet your needs.
  • After the first 30 days, you can cancel your policy at any time. However, be careful when cancelling. Depending upon where you live, you may not be able to buy another policy, or companies may charge you more because of your health.

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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