Things to Know about Texas Medigap Policies


Things to know about Texas Medigap policies

  1. Medicare Part A and Part B are required.
  2. Texas Medigap policies only covers one person. If you and your spouse both want Medigap coverage, you will need to buy separate policies.
  3. You can buy a Medigap policy from any insurance company that’s licensed in your state to sell one.
  4. You can apply for Medigap(Medicare Supplement Insurance), if you have a Medicare Advantage Plan, but make sure you can leave the Medicare Advantage Plan before your Medigap policy starts.
  5. You pay the monthly Part B premium that you pay to Medicare in addition to the monthly premium for your Medigap policy.
  6. Any standardized Medigap policy is guaranteed renewable even if you have health problems. You can not be cancelled as long as you pay the premium.
  7. Medigap policies sold after January 1, 2006 are not allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
  8. If you have a Medicare Medical Savings Account (MSA) plan, it’s illegal for anyone to sell you a Medigap policy.
  9. Medigap policies do not cover everything. They generally don’t cover long-term care, vision or dental, hearing aids, private-duty nursing or eyeglasses.
  10. Some types of Insurance plans are not Medigap plans.  Those include:
    • Medicare Advantage Plans (like a PPO, HMO or Private Fee-for-Service Plan)
    • Medicaid
    • Medicare Prescription Drug Plans
    • TRICARE
    • Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP)
    • Long-term care insurance policies
    • Veteran’s Benefits
    • Indian Health Service, Urban Indian Health plans and Tribal Plans.
  11. You need to be careful about the timing if you decide to drop your entire Medigap policy. For example, you might decide to switch to a Medicare Advantage Plan that offers prescription drug coverage or you may want a completely different Medigap policy (not just your old Medigap policy without the prescription drug coverage).If you drop your entire Medigap policy and the drug coverage wasn’t creditable prescription drug coverage or you go 63 days or more in a row before your new Medicare drug coverage begins, you have to pay a late enrollment penalty when you join a new Medicare drug plan. l

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