In the state of Texas, Medicare Supplement Insurance plans fill in the gaps between the healthcare coverage provided by the Medicare Program. Though Medicare itself helps cover the cost of most primary healthcare services and treatments, beneficiaries still have to pay for coinsurance, co-payments, and deductibles. Medicare Supplement Plans in Texas help people prepare for such contingencies in a way that will fit his budget and, at the same time, will serve him best regarding medical health insurance coverage.
What is a Medicare Supplement Insurance Plan?
As mentioned previously, Medicare Supplement Insurance Plan covers for those healthcare-related expenses not covered by the Original Medicare. These costs are either payments for coinsurance, co-payments, or deductible. Let us first define what these expenses are for.
Coinsurance is the percentage of the amount a person is required to pay as his share of the cost for services after paying for any deductibles. Copayment, on the other hand, is the amount necessary to be paid as the person’s share for the cost of a medical service or supply, a doctor’s visit, a hospital outpatient visit, or prescription drug. A copayment is usually a set amount instead of a percentage.
Lastly, a deductible is the amount a person should pay for healthcare or prescription before the insurance coverage steps in.
Without a Medigap plan, a person will have to pay for these charges out of his pocket.
There are ten different types of Medicare Supplement Insurance Plan in Texas which offers a standardized list of essential benefits’ package. Labeled as Medicare Supplement Insurance Plans A, B, C, D, F, G, K, L, M, and N. Each plan offers a distinct set of coverage and may not include everything. The cost of each Medicare Supplement Insurance plans in Texas also differs, and it is essential to keep in mind that plans which have lower price may entail higher out-of-pocket expenses.
Medicare Supplement Plans in Texas
Medicare Supplement Insurance, or Medigap, is available through private insurance providers. There are a lot of companies offering coverage under Medicare Supplement plans in Texas. Let us first take a look at what Medicare Supplement Plans provides and why would a person avail of it.
In general, the list of coverage under Medicare Supplement Insurance Plans includes Medicare Part A coinsurance and hospital costs of up to an additional 365 days after Medicare benefits have been used up. Also covered are Medicare Part B coinsurance or copayment, first three pints of blood, and Part A hospice care coinsurance or copayment. All these benefits’ coverage is included in all ten different types of Medicare Supplement Insurance and may only differ in the percentage of the amount covered.
Let Us Help!
Meanwhile, the following benefits are only offered under some Medicare Supplement Insurance plans. These plans cover for skilled nursing facility care coinsurance, Part A deductible, Part B deductible, Part B excess charge and foreign travel emergency. Only Medicare Supplement Insurance Plans C and F cover Part B deductible while Part B excess charges are included only under Plans F and G.
Among the ten, Medicare Supplement Insurance Plan F is the most comprehensive since it offers a complete range of Medigap benefits. Given that, it is also the most expensive plan and is ideal for those persons who want maximum health care protection and coverage and has the financial capacity to pay for such.
Except for Part B deductible, Plan G also offers an almost complete set of Medigap benefit making it the most popular among consumers. It provides an excellent value for those who have a limited budget for additional healthcare insurance. Plan C, on the other hand, provides most of the benefits except Part B excess charge. It also pays for the 80 percent of the expenses incurred as part of the foreign travel emergency care service, up to plan limits, just like the rest of the plans.
Meanwhile, Plan D and N offers almost all of the benefits except for the Part B deductible and excess charges. It is also worth noting that Plan N pays for 100 percent of Part B coinsurance, except for a copayment of up to $20 for office visits and up to a $50 copayment for emergency room visits that do not develop into an inpatient admission.
The rest of the Medicare Supplement Insurance plans in Texas includes coverage, as follows:
Plan A offers 100 percent coverage for Medicare Part A coinsurance and hospital costs; Medicare Part B coinsurance or copayment, first three pints of blood, and Part A hospice care. While it offers the least number of covered benefits, it is also the cheapest among the bunch.
Plan B offers the same package as Plan A with an additional 100 percent coverage for Part A deductible.
Plan K, on the other hand, only pays 100 percent for the cost of Medicare Part A coinsurance but only covers 50 percent of the cost of Medicare Part B coinsurance or copayment, first three pints of blood, Part A hospice care coinsurance or copayment, skilled nursing facility care coinsurance, and Part A deductible. It also has an out-pocket-limit of $5,240 in 2018.
Plan L offers almost the same benefits’ coverage with that of Plan K, only that it covers 75 percent, instead of Plan K’s 50 percent. It also has an out-of-pocket limit of $2,620 in 2018.
Lastly, Plan M covers 100 percent of Medicare Part A coinsurance and hospital costs, Medicare Part B coinsurance and copayment, first three pints of blood, Part A hospice care coinsurance or copayment, Skilled nursing facility care coinsurance, and 50 percent for Part A deductible.
To be eligible to avail of Medicare Supplement Plans in Texas, one has to be a resident of the state, has already enrolled under Medicare Part A and Part B, and is already 65 years old or older.
It is also important to remember that Original Medicare and Medigap plans do not include Medicare Part D or the Prescription Drug Coverage, and a person must also avail of such to get coverage for prescription drugs. These types of plans are also available through private insurance providers.