Best Texas Medigap Medicare Supplement Plans
Table of Contents
What Are Medigap Plans?
Medicare supplemental insurance can help you pay some out-of-pocket costs in Medicare Part A and Medicare Part B (Original Medicare). In this article, we'll explore how much Medicare Supplement plans in Texas cost, the cost gaps each plan fills, which plans are available, when and how to enroll without underwriting, and how you can get premiums and discounts on all Medicare plans in your zip code.
What You Need to Know
- Medicare supplemental insurance policies in Texas are offered by private insurance companies and are designed to help cover some of the out-of-pocket costs not covered by Original Medicare.
- Supplemental insurance policies are standardized, meaning each plan letter offers the same basic benefits regardless of the insurer.
- Medicare supplemental insurance is available to Texas residents at age 65 and over who have enrolled in both Medicare Part A and Part B.
- All supplemental plans offer coverage for Medicare Part A coinsurance and hospital costs, Medicare Part B copayments and/or coinsurance, and the first three pints of blood.
- All but two supplements cover the Medicare Part A deductible and Skilled Nursing Facility coinsurance.
- Supplemental insurance policies do not cover long-term care, vision, dental, hearing aids, or private-duty nursing.
- Policies are available in 10 different plan options, labeled A through N.
- Medicare SELECT plans require enrollees to use a local Texas provider network.
- Some insurers offer a household discount when both you and your spouse have a policy.
Do You Need Medigap in Texas?
The way Original Medicare (Part A and Part B) is designed, it pays about 80% of medically necessary healthcare costs. That leaves the remaining 20% for the Medicare beneficiary to pay through deductibles, coinsurance, and copays. Without additional coverage, these out-of-pocket costs can add up quickly.
Each time you use a Medicare-approved healthcare service, you pay a deductible, co-payment, or coinsurance. Due to the sky-high healthcare costs in Texas, if you are hospitalized, these costs are considerable.
To illustrate, Medicare Part A's benefit period deductible is $1,600. You pay this each time you are hospitalized unless you're readmitted within 60 days for the same issue. Plus, you're responsible for 20% of all Part B medical costs while you're an inpatient.
This is where Texas Medicare Supplement plan coverage comes in. Supplements, also called Medigap plans, pay many of the out-of-pocket costs in Original Medicare. So, if you're wondering, "What is Medigap?", it's gap coverage.
More Info: 7 Reasons You Need Supplemental Insurance with Medicare
Is a Medicare Supplement Right for You?
Yes, if you:
- Expect the need for frequent healthcare services now and/or in the future and want to limit your deductibles and co-pays.
- Can afford the monthly premiums of Medicare Supplement insurance and don't qualify for Medicaid.
- Want the freedom to choose your doctors and other Medicare providers without network restrictions.
- Need nationwide coverage and/or travel abroad and need coverage for emergency care.
- Are in your initial enrollment period and have guaranteed issue rights to join a plan regardless of your health condition.
- Don’t want a Medicare Advantage plan and the hassle of referrals and pre-authorization to receive services.
No, if you:
- Don’t expect the need for frequent healthcare now or in the future.
- Missed your Medigap open enrollment period and can't pass medical underwriting to get the Medigap policy you want.
- Want a Medicare Advantage plan with low or no monthly premiums.
- Have Medicaid, VA, retiree benefits, or other coverage options that will pay for most of your Medicare out-of-pocket expenses.
- Prefer an all-in-one HMO or PPO plan that includes a Part D prescription drug plan, SilverSneakers, and routine care for dental, vision, and hearing.
- Can adhere to the rules and restrictions of a Medicare Advantage.
What Does Supplemental Medicare Insurance Cover?
Every Medigap insurance company in Texas is required to follow both federal and state insurance laws. Carriers must offer the standardized Medicare plans identified by letters A through N.
For instance, a Plan F from Aetna Medicare has the same coverage and benefits as a Plan F from Mutual of Omaha, AARP Medicare, United Healthcare, Humana, Cigna, or Blue Cross Blue Shield. This is why Medigap plans are easier to compare than Medicare Advantage plans.
Medigap policies may include the following benefits:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A inpatient deductible
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care and hospice care coinsurance
- Part B deductible
- Part B coinsurance or copayment
- Part B excess charges
- The first three pints of blood
- Foreign travel emergency services
- Out-of-pocket limits
The plan comparison chart below is the best way to compare Medicare Supplement coverage options.
There are two high-deductible plan types, Plan F and G. If you enroll in a high-deductible plan, you pay all Part A and Part B out-of-pocket costs up to the annual deductible amount.
Related: How High Deductible Plan G Works
Insurance carriers are free to choose their plans, although Texas state laws might affect which ones they can offer. For more information, visit the Texas Department of Insurance website at http://www.tdi.texas.gov/.
Top 3 Medigap Plans Sold in Texas
The three most popular Medicare supplemental insurance plans in Texas are Medigap Plan F, Medigap Plan G, and Medigap Plan N, the latest plan option. Their comprehensive coverage is what makes them so popular.
Getting one of the top 3 Medicare Supplement plans in Texas is the best way to cover these out-of-pocket expenses. A Medigap policy is additional coverage from a private insurance company that will reduce or eliminate your Medicare Part A (hospital coverage) and Medicare Part B (medical coverage) expenses.
Plan F covers all gaps in Original Medicare. Plan G covers all gaps except the Part B deductible. And Plan N doesn't cover the Part B deductible or Part B excess charges. It also has a small copay when you see your doctor or use the emergency room.
NOTE: You do not qualify for Plan F if you became eligible for Medicare on or after January 1, 2020. Plan G is the most comprehensive coverage new Medicare beneficiaries can buy. The good news is that Medicare G plans cost less than F, even when you factor in the deductible Plan G does not cover.
Looking for a different Medigap plan? Ask us for free quotes on the top Medigap plans that interest you in your location.
Top 10 Plan F in Texas
Medicare Supplement Plan F is the most popular Medigap plan available in Texas. Here are the 10 best Plan F policies available in Texas based on our reviews (click for details):
Top 10 Plan G in Texas
Medicare Supplement Plan G is rapidly gaining popularity with Texas seniors. With Plan F no longer available to new Medicare beneficiaries, Plan G is the new gold standard. Here are the 10 best Medigap Plan G policies available in Texas based on our reviews (click for details):
Top 10 Plan N in Texas
Medicare Supplement Plan N is similar to Plan D, but covers Medicare Part B coinsurance costs differently. Due to its lower cost and good coverage, it's catching the attention of many Texas seniors. Here are the 10 best Medigap Plan N policies available in Texas based on our reviews (click for details):
Cost of Medicare Supplements in Texas
The official Medicare website has a Medicare Supplement plan finder tool that shows you the cost of supplemental Medicare insurance in Texas. But it's just a range. What the tool does not give you is the exact premium, rate increase history, rating scores, and household discounts.
Our FREE Medicare Supplement Plan Rate Quote Service is the best way to get the exact monthly premium for all carriers, household discounts, AM Best ratings, Medicare Supplement rate increase history, and more.
The next step is to get a FREE Medigap Rate Comparison Report. It will arm you with all of the information you need to make an informed decision.
Get Your Free Medicare Supplement Rate Comparison
MedicareWire is a Medicare consulting agency. We are not insurance agents. Our job is to help people navigate Medicare without marketing interference.
Our free report will show you rates from all carriers without a sales pitch. No Calls. No Email Spam. No Kidding!
If you would prefer to speak with an agent, our preferred, nationwide agency is HealthCompare, an Allstate company. Give them a call at 1-855-728-0510 (TTY 711).
How to Choose the Right Medicare Supplemental Insurance
Everyone on Medicare has different needs. Your age, gender, Texas zip code, use of medical services, providers, emergency care, supplies, and durable medical equipment are all factors you need to consider. That's because all of these things play a role in your plan options.
When "Best" Means "Most Coverage Available"
If you are signing up for Medicare with chronic health issues, or if you have done a good job saving for your retirement, most experts agree that Plan G is the best option in Texas. It offers the most coverage you can buy if you're getting your Medicare benefits in 2023.
When "Best" Means "Good Coverage and Monthly Savings"
If you are signing up for Medicare in excellent health, or if you need good coverage but can't handle the cost of Plan G, Plan N is a good option. Plan N offers comprehensive inpatient coverage for hospital stays, while also covering most medical care expenses.
When "Best" Means "Lowest Cost Coverage"
Not everyone in Texas can afford or needs the comprehensive coverage provided by Plans F, G, and N. When the amount of your monthly premium is a concern, ask your insurance agent to give you advice about Plan K and High Deductible Plan G (HDG). These are the two lowest-cost plans available.
Medicare Supplemental Insurance Eligibility
You can apply for supplemental Medicare insurance in Texas during your Medigap Open Enrollment Period (OEP). Your OEP is a six-month window of time that begins at age 65 when you enroll in Medicare Part B.
Federal law guarantees your right to buy insurance during your OEP. This Medigap protection will allow you to choose the Medicare Supplement plan that best suits your needs, regardless of your health history or chronic health conditions.
It is more difficult to get Medicare supplemental insurance after your Medigap open enrollment period is finished. It's one of the disadvantages of Medigap plans.
An insurance company may ask you questions about your health and charge you higher premiums. They might also reject your application because of your past health. A six-month waiting period may be offered by the carrier before coverage starts.
NOTE: If You take early retirement, Medicare eligibility does not change. Unless you have Social Security Disability Insurance (SSDI) benefits, the Medicare eligibility age is 65.
Texas Enrollment Process for Medicare Supplements
Texas Medigap plan enrollees require the assistance of a licensed insurance agent. Before you can apply, you need to be enrolled in both Medicare Part A and Part B. You can do this through the Social Security Administration website, or by calling them directly at 800-772-1213.
If you don't have an insurance agent, we recommend HealthCompare, an Allstate company. Call them at 1-855-728-0510 (TTY 711). They work with all major Texas plans. There's no obligation.
Another option is your local SHIP. The State Health Insurance Assistance Programs (SHIPs) provide free, one-on-one insurance counseling and assistance to Medicare beneficiaries. Texas's SHIP is available by phone (1-800-252-9240) or through their website.
Adding a Medicare Prescription Drug Plan
In the past, Medicare Supplements sold in Texas were allowed to add extra benefits, including prescription drug coverage. This is no longer the case.
The only way to get coverage on prescriptions with a Medigap policy now is to get a Texas Medicare Part D plan. In most areas of Texas, basic prescription drug plans start at less than $20 per month.
Texas Medicare Supplements vs. Medicare Advantage
It's natural to compare the best Medigap insurance with other health insurance plans, like Medicare Advantage. On the surface, Medicare Advantage plans appear to cost less. And, in some cases, they do save money. However, the out-of-pocket expenses in most Texas Medicare Advantage plans are as much or more than Original Medicare.
Original Medicare does not have an out-of-pocket maximum. However, all health insurance companies offering Medicare Advantage plans are required to set an annual out-of-pocket limit, up to the annual limit set by CMS. A Medigap plan's coverage creates an out-of-pocket limit for Original Medicare.
Can I Get a Policy If I'm On Medicaid in Texas?
It is not legal for a health insurance company or insurance agents licensed in Texas to sell individuals a Medigap policy if you have Medicaid benefits.
If you can't afford a Medigap plan or the co-insurance costs in Medicare Advantage policies, there is a third option. Many areas of Texas have access to dual-eligible Medicare Special Needs Plans (D-SNP). If you qualify for both Medicare and Medicaid, a Texas Special Needs Plan plan might be your best option.
What About Dental, Vision, and Hearing Benefits?
We all need routine dental care and dental restoration work as we age, but it's not covered by Original Medicare or a Medigap plan. For coverage, you'll need a stand-alone Texas dental insurance policy.
Next Steps
The next step is to get a FREE Medigap Rate Comparison Report. It will arm you with all of the information you need to make an informed decision.
Get Your Free Medicare Supplement Rate Comparison
MedicareWire is a Medicare consulting agency. We are not insurance agents. Our job is to help people navigate Medicare without marketing interference.
Our free report will show you rates from all carriers without a sales pitch. No Calls. No Email Spam. No Kidding!
If you would prefer to speak with an agent, our preferred, nationwide agency is HealthCompare, an Allstate company. Give them a call at 1-855-728-0510 (TTY 711).
Frequently Asked Questions (FAQs)
It all depends. Your age, gender, {state_code} zip code, and tobacco use all need to be factored in. You can take advantage of our Free Plan G Quote Service to find the lowest prices and discounts in your area.
Here's a list of top carriers by cost in Texas:
- Pekin Insurance
- AARP
- Bankers Fidelity
- Thrivent
- United American
Citations & References
medicare.gov- Costs of Medigap policies, Medicare.gov, Last Accessed February 2, 2023
- What's Medicare Supplement Insurance (Medigap)?, Medicare.gov, Last Accessed February 2, 2023
- Find a Medigap policy that works for you, Medicare.gov, Last Accessed February 3, 2023
- How to compare Medigap policies, Medicare.gov, Last Accessed February 3, 2023
- How Original Medicare works, Medicare.gov, Last Accessed February 3, 2023
- Your Medicare coverage choices, Medicare.gov, Last Accessed February 5, 2023
- The United States Social Security Administration https://www.ssa.gov/
- Medicare Benefits | SSA https://www.ssa.gov/benefits/medicare/
The Medicare insurance plans and Medicare Supplement companies on this page originate from CMS Data Files. Content is maintained by David Bynon, and was last updated on .