In Texas, eligibility for Medicare supplemental plans varies with age – there are rules for each of the plans. However, before we plunge into the rules, you should know that when you first activate Part B, there is a window for open enrollment for a Medigap plan without having to go through any form of health underwriting. As long as you are a Part B holder, you’ll be guaranteed access to any plan for six months beyond the effective date of their Plan B. Everyone is granted this special application window, regardless of when they first obtain Medicare. The eligibility rules determine which plans each of the two groups can access. There is, however, a limit for the plans offered to those below 65.
How Eligibility Rules Work
For age 65 or older who are on Medicare in Texas, have access to all 10 supplement plans – Plan A through Plan N. Plan F being the most popular is the highest-deductible option available because it includes all deductibles and co-insurance you would have paid. Nonetheless, membership for Plans G and N is on the rise as they are offering a relatively low premium for a little cost-sharing with beneficiaries.
For folks under age 65, there is a clause. A great number of these people have access to just Plan A, and the reason for this is because each insurance company can decide on the supplement plans they want to offer to the public. The only supplement plan they are required by law to offer to all is plan A.
These insurance companies are aware that those under 65 must have got Medicare due to some form of major health issues, so they anticipate these people to use benefits more frequently, and this will cost more money to the company. Thus, since Plan A has fewer benefits and more cost-sharing on the part of the policyholder, most insurance carriers decide to offer just Plan A to individual below 65.
Well, you should also know that Plan A supplement still has many benefits. Just that it doesn’t cover deductibles or skilled nursing co-insurance, but it’s still great as it covers a very important gap – 20% co-insurance for Part B outpatient care that you would have paid. It is really great because Part B covers items such as radiation, chemotherapy, and dialysis and not just doctor regular visits. Without Plan A coverage, thousands of dollars would be spent on a major health condition.
This plan A is still very suitable for those who are uncomfortable with network-based advantage coverage, probably want access to more than one doctor and hospital considering that a standard supplement plan allows the beneficiary to see any doctor that accepts the original Medicare. However, due to the increasing rate of all supplement plans, it may be inconvenient for a younger Medicare beneficiary to keep up with the increasing rate of their Plan A for many years, and their health condition in most cases prevent them from getting access to a lower-priced company because they are unable to pass through health underwriting.
The great news is that when a beneficiary gets to age 65, they will receive another enrollment window which will give them the opportunity to switch to any other supplement plans they wish to obtain. Knowing the eligibility rules of the supplements is almost impossible for the average individual, so it would save much of your time if you consult an independent insurance agent for help in understanding your qualifications and eligibility for the next open enrollment window.
Learn more about Texas Medicare Supplemental Insurance rates, plans, and more at http://www.emedicare-supplemental-insurance.com/medicare-supplement-plans-texas. Our Texas Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans in Texas. To talk to an expert in Texas Medicare coverage toll free 888.404.5049 today!