October 6, 2016
Searching for Medicare Supplement plans in Texas? Let PlanPrescriber be your resource for Texas Medicare Supplement information and plan comparisons.
Are you a Medicare beneficiary in Texas? If you’re enrolled in Original Medicare (Part A and Part B) you might have the option of signing up for a Medicare Supplement (Medigap or MedSupp) plan to cover some of Original Medicare’s out-of-pocket costs. These costs might include deductibles, copayments, and coinsurance.
There are 10 standardized Medigap plans in 47 states, including Texas. The plans are identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N). All plans of the same letter offer the same benefits. Massachusetts, Minnesota, and Wisconsin have their own standardized Medigap plans. Note that some companies may also offer additional innovative benefits.
As a Texas Medicare beneficiary, you can apply for a Medicare Supplement policy from any insurance company that is licensed to sell one in the state of Texas. However, not all companies necessarily offer all 10 standardized plans. Insurance companies have the option to choose which Medicare Supplement plans to offer; however, they must at least offer Plan A. If an insurance company wants to offer more Medicare Supplement plans, the company must offer Plan C or Plan F in addition to any other Medigap plans. For the most part, enrollment in standardized Medicare Supplement is denied for individuals under the age of 65; however, Texas requires insurance companies to offer at least one kind of Medicare Supplement policy to Medicare beneficiaries under age 65.
If you’re interested in a Medicare Supplement plan in Texas, in most cases it’s best to enroll during your Medigap Open Enrollment Period so that your acceptance into the plan is guaranteed. You can apply outside that period but some conditions might apply; read here for details.
The table below lists the 10 standardized Medigap plans and the benefits associated with each plan. An X in any table cell means that the service (or item) is 100% covered; if a portion of the service or item is covered, it’s indicated by a percentage value; and a blank cell indicates the item or service is not covered.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional|
365 days after Medicare benefits are exhausted
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility (SNF) care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B ‘excess charges’||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Medicare Part B preventive care coinsurance||X||X||X||X||X||X||X||X||X||X|
|Out-of-pocket limits apply**|
*Medicare Supplement Plan F may also be available as a high-deductible plan in which beneficiaries pay a deductible amount before the plan covers any services. From one year to another, this deductible amount may change.
**After you spend up to the out-of-pocket limits (including the Part B deductible), Medicare Supplement Plans K and L pay 100% of covered services in the above table for the rest of the calendar year.
***Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, except for a copayment of up to $20 on doctor visits and up to $50 on emergency room visits that do not result in an inpatient admission.
While Medigap plans with letter names are standardized, plan premiums and availability may vary. It may be a good idea to compare Medicare Supplement plans in your part of Texas to find a plan that may fit your health needs as well as your budget. To get started, enter your zip code where indicated above to see a list of plans in your area.
Learn more about how Medicare plans work in Texas including:
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.