Best Medigap Plans in Texas – Are you new to Medicare and trying to decide which plan to enroll in? Or have you been in the program for a while and are wondering if you’re still on the best plans for 2022? This article will answer both of those questions. We’re going to review the top Medigap plans in Texas so you can decide which one is right for you.
Plan F: Old Faithful
Plan F has the most benefits of all the Medigap policies. Medicare beneficiaries who enroll in this plan will have basically no out-of-pocket costs for Medicare-approved services. It will pay all the deductibles, copays, and coinsurance costs that remain after Original Medicare pays.
Plan F includes:
- Part A deductible
- Part A coinsurance and hospital costs with an extra 365 days after Part A benefits are exhausted
- Skilled nursing facility care coinsurance
- Part A hospice care coinsurance
- Part B deductible
- Part B coinsurance/copays
- Part B excess charges
- First three pints of blood
- 80% of foreign travel emergencies (up to plan limits)
Now, there are some downsides to this plan. First, enrollment is not open to everyone. You must have turned 65 before January 1, 2020, to be eligible for this plan. Second, as you probably expected, individuals who have this plan pay some of the highest premiums. Those premiums are increasing at a faster rate than other plans because as the pool of enrollees ages, their medical costs are going up. This causes the insurance companies to raise their rates.
Still, if you’re looking for the most coverage, you meet the age requirements, and you can afford the monthly premiums, Plan F is a solid choice.
Plan G: The New Kid
Not eligible for Plan F? Don’t worry; you’ll have a great alternative with nearly the same coverage. Plan G is open to anyone who is enrolled in Medicare Parts A and B, and there is only a minor difference between it and Plan F.
Plan G includes:
- Part A deductible
- Part A coinsurance and hospital costs with an extra 365 days after Part A benefits are exhausted
- Skilled nursing facility care coinsurance
- Part A hospice care coinsurance
- Part B coinsurance/copays
- Part B excess charges
- First three pints of blood
- 80% of foreign travel emergencies (up to plan limits)
Did you notice the difference? Plan G does not cover the Medicare Part B deductible. In 2022, that deductible is $233, so you’re not at much of a disadvantage if you can’t get Plan F. Actually, it may even be in your best interests to choose Plan G regardless of your age. Plan G has lower premiums than Plan F, which often make up for the difference in coverage. If you’re eligible for both, you should calculate your annual premiums and find out if you could save more than $233 by enrolling in Plan G.
Plan N: The Budgeter
There is another Medigap plan that is often overlooked by beneficiaries. Plan N also has great benefits and is an even more affordable option.
Plan N includes:
- Part A deductible
- Part A coinsurance and hospital costs with an extra 365 days after Part A benefits are exhausted
- Skilled nursing facility care coinsurance
- Part A hospice care coinsurance
- Part B coinsurance
- First three pints of blood
- 80% of foreign travel emergencies (up to plan limits)
Plan N does not include coverage for the Medicare Part B deductible, nor does it pay any Part B excess charges. Healthcare providers who do not accept Medicare assignment are allowed to add excess charges, which could be up to 15% more than the Medicare-approved fee for services. However, most providers in the U.S. accept Medicare, so excess charges are pretty rare. In addition, eight states prohibit the practice altogether.
Really the most significant difference in Plan N are the copays. You could pay up to $20 for every doctor visit and $50 for every emergency room visit. Your provider can charge less, but never more than those amounts. If you’re admitted to the hospital after an emergency room visit, your copay is waived. Individuals who are relatively healthy and don’t make frequent trips to the doctor are great candidates for Plan N.
There really is no one-size-fits-all in Medicare. Everyone must consider their own unique medical needs, as well as their budget. What’s best for your neighbor might not be best for you. To help you decide, you can schedule a visit with one of our licensed insurance agents. We are experts in the Medicare space and will work with you to help you choose the Medicare supplement plan that’s right for you.