Texas Medicare Supplemental Insurance (Medigap)

Texas residents have a variety of options for Medicare supplemental insurance. This type of health insurance for seniors, also called Medigap, is designed to fill in the coverage gaps which Medicare does not pay. By enrolling in a Medigap policy, you can reduce or eliminate your out-of-pocket expenses for health care.

Medicare supplemental insurance is sold through private insurance companies, and regulated by the federal and Texas state governments. Medigap policies are standardized, and are labeled with letters A through L. Standardization means that Medigap Plan C from Company X is going to offer identical benefits to Medigap Plan C from Company Y. The main difference you'll find between Medigap plans for seniors in Texas is price.

There are twelve Medicare supplemental insurance policies available in the U.S., and all twelve are available to seniors in Texas. However, health insurance companies are not required to offer all twelve policies; many offer only a few, so shop around to find a reputable company that offers the Medigap plans that are best for you and your partner.

If you are considered to be in the low-income bracket in Texas, you may be eligible for Medicaid. Medicaid is a state-sponsored program which pays for health care coverage for Texas residents who have low or no income. Because Medicaid covers Medicare premiums and the out-of-pocket costs normally covered by Medigap insurance, if you are Medicaid eligible, or you are already part of the program, you probably do not need Medigap.

The Specified Low-Income Medicare Beneficiary (SLMB), the Qualified Medicare Beneficiary (QMB), the Qualified Individuals (QI), and the Qualified Disabled Working Individuals (QDWI) programs are part of the Medicare Savings Programs in Texas. They are run by the Texas Health and Human Services Commission.

Members of these programs receive either full or partial coverage of their Medicare premiums, and members of the QMB program do not need Medigap. Members of the three other programs may still need a Medicare supplemental insurance policy.

The best time to buy your Medigap policy is during what is called your "open enrollment period". This is the six-month period after you have enrolled in Medicare Part B, and are age 65 or better. During your open enrollment period, Medigap insurers in Texas are required to sell any Medicare supplemental insurance policy they offer, without consideration of any pre-existing medical conditions you may have.