Medicare Supplement (Medigap) Plans in Texas
Key Takeaways
- Original Medicare covers 80% of most covered services, and you pay the rest.
- Medigap plans can fill in “gaps” in Original Medicare coverage to make healthcare more affordable.
- The most popular Medicare Supplement Plans in Texas include Plan F, Plan G and Plan N.
- You can’t have a Medigap plan and a Medicare Advantage plan. You can only combine a Medigap plan with Original Medicare.
What Is the Best Medicare Supplement Plan for 2022?
Original Medicare in Texas includes Medicare Part A and Medicare Part B. This gives you hospital coverage (Part A) and medical coverage (Part B). But Medicare doesn’t pay for all your expenses. Medicare usually pays for 80% of the covered service, and you pay the remaining 20%.
Medicare Supplement Plans can help fill in this gap in coverage. Some of the most popular Medicare Supplement plans in Texas include Medigap Plan F, Plan G and Plan N. You can also find other Medicare Supplement plans like Medigap Plan A, Plan B, Plan C, Plan D, Plan K, Plan L and Plan M.
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Texas Medicare Supplement Plan Coverage
Medicare Supplement Plans in Texas are offered by private insurance companies, so cost and coverage can vary. There are ten types of Medigap plans that are named with letters (like Plan A and Plan D), plus high-deductible versions of two of these plans (Medigap Plans F and Plan G). The federal government has rules for what each Medigap plan has to cover (so coverage will not vary based on the insurance company that offers it), but not every insurance company offers every type of plan.
All Texas Medigap plans will cover:
- Medicare Part A coinsurance for hospital and hospice care
- Medicare Part B coinsurance and copayments
- Blood needed for medical procedures (first 3 pints in a year)
- Part A coinsurance for skilled nursing care facility
- Part A deductible
- Part B excess charges
- Up to 80% of foreign travel emergency healthcare
TX Medigap Plan Costs
Medigap plans in Texas are offered by private insurance companies, so costs can vary. Generally, there are three ways that plan costs are calculated:
- Community-rated: Everyone who enrolls in the plan pays the same premium.
- Issue-age-rated: Your premiums are based on how old you were when you first enrolled.
- Attained-age-rated: Monthly premiums are based on your current age, so premiums go up as you age.
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How Much Does Medigap Plan G Cost in Texas?
Medicare Supplement Plan G is one of the most popular Medigap plans in Texas. Plan G can also be sold as a high-deductible plan. If you enroll in a high deductible Plan G, you’ll have lower monthly premiums. But you’ll need to pay a yearly deductible before Plan G coverage kicks in. For 2022, the annual deductible amount for Plan G is $2,490.
Medicare Supplement Plan Eligibility & Enrollment in Texas
To enroll in a Medicare Supplement Plan in Texas, you need to enroll in Original Medicare Part A and Part B. You qualify for Medicare coverage if:
- You’re a U.S. citizen or permanent resident
- You’re 65 or older
- You’re under 65, but you’re living with a disability or chronic health condition such as end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS)
Medigap for adults under 65
If you’re 65 or older, you can enroll in any Medigap plan available in your area. But if you’re looking for Texas Medigap plans under 65, you’re only guaranteed the right to enroll in a Medigap Plan A. You may still be able to enroll in another Medigap plan, but each insurance company may have different eligibility criteria.
Are There Texas Medicare Supplement Plans with Prescription Drug Coverage?
Medicare Supplement plans in Texas do not include prescription drug benefits. You’ll need to enroll in a Medicare Part D plan to get medication coverage. You can enroll in Original Medicare Part A and Part B, add a standalone Part D plan, and also enroll in a Medigap plan. The Medigap plan will only help pay for Medicare Part A and Part B costs.
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Medigap vs. Medicare Advantage in Texas
Medigap plans and Medicare Advantage plans are very different. Medigap plans help fill in gaps in your Original Medicare coverage. This will lower your out-of-pocket costs when you’re enrolled in Original Medicare.
A Medicare Advantage plan, on the other hand, bundles your Medicare Part A and Part B benefits into one plan. Advantage plans usually include prescription drug coverage and additional benefits like dental or vision services.
Can I enroll in a Medigap plan and a Medicare Advantage plan?
Do I qualify for premium-free Medicare Part A?
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
- F, G & J Deductible Announcements. CMS.gov
- Medicare Supplement Insurance Guide. TDI.texas.gov
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.