Medicare Supplement (Medigap) plans help pay your out-of-pocket costs under Original Medicare (Part A and Part B). According to data collected by America’s Health Insurance Plans Center for Policy and Research, over 11 million people are enrolled in a Medicare Supplement plan as of 2014.
If you are under age 65 and disabled, and enrolled in Original Medicare, you may be eligible to enroll in certain Medicare Supplement plans in Texas. Here’s what you need to know.
What is covered under Medicare Supplement plans in Texas?
Under Original Medicare, there are certain costs you must pay out of pocket in addition to your monthly Part B premium, which include coinsurance, copayments, and excess doctor charges when you see providers who don’t accept Medicare assignment. Medicare Supplement plans may help you pay these costs and better plan for your health care expenses.
There are 10 different Medicare Supplement plans in Texas approved by the federal government, designated by the letters A, B, C, D, F, G, K, L, M, and N, and all must include these basic benefits covered at least 50%:
- Hospital inpatient coverage for up to 365 additional days after your Part A benefits end (covered at 100%)
- Part B coinsurance after you’ve met your Part B deductible (covered at least 50%)
- Hospice copayments and coinsurance under Part A (covered at least 50%)
- First three pints of blood each year under Part A and Part B (covered at least 50%)
Beyond that, Medicare Supplement plans may also cover all or part of your Part A and Part B deductibles, copayments, and coinsurance amounts, excess doctor charges, and even emergency medical care while you travel overseas, up to plan limits.
When can I buy Medicare Supplement plans in Texas if I’m under 65 and disabled?
Unlike other types of Medicare coverage, including Medicare Advantage plans, companies that offer Medicare Supplement plans are generally allowed to use medical underwriting to determine who qualifies for coverage and what premium he will pay. However, during the Medicare Supplement open enrollment period, you can purchase any of the Medicare Supplement plans sold in your area for the same monthly premium as someone in good health, and you will not be subject to any restrictions or waiting periods for a pre-existing condition or disability.
The Medicare Supplement open enrollment period begins as soon as you enroll in Medicare and lasts for six months. Under federal law, the private companies that offer Medicare Supplement plans aren’t required to sell them to people under 65 who get Medicare due to a disability.
However, if you live in Texas and get Medicare before age 65 because of a qualifying disability, you are entitled to a six-month open enrollment period once you first get Medicare during which you can buy a Medicare Supplement plan without medical underwriting. Texas is one of about 30 states that have laws at the state level allowing individuals under age 65 to purchase Medicare Supplement plans, although your plan options may be limited. You must be enrolled in both Part A and Part B to buy Medicare Supplement plans in Texas.
Once you turn 65, you will have another six-month Medicare Supplement open enrollment period; during that time, you have the right to switch between Medicare Supplement plans without medical underwriting.
One thing to keep in mind: If you are under age 65 and decide to drop your Medicare Supplement coverage at any time, you may be unable to buy another Medicare Supplement plan until your open enrollment period when you turn 65.
Need more information about Medicare Supplement plans in Texas?
I am happy to answer your questions; you can schedule a phone call or request an email by clicking on the buttons below. You can find out about Medicare Supplement plans in your area by clicking the Compare Plans button.