In this blog post, we will discuss Medicare coverage options in Austin, Texas, as well as some popular hospitals and Medicare plans that you might want to consider.
What type of Medicare coverage is available?
Medicare in Austin will cover hospitalization, medical expenses, and other health care services. There are several different types of Medicare coverage available to choose from.
Original Medicare
This is the standard Medicare program that everyone pays into throughout their working lives. It consists of Medicare Part A and Medicare Part B.
If you have worked for ten years or forty quarters, you are eligible to receive Medicare Part A for free. If you have not paid into Medicare throughout your working life, then you’ll need to pay a premium for Medicare Part A.
Medicare Part A is considered your “hospital insurance.” It covers inpatient care, hospice care, and some limited home health services.
Medicare Part B does come at a monthly premium of $148.50 in 2021. This premium can increase if you have a high income.
Medicare Part B is considered your “medical insurance.” It covers medical expenses like doctor visits, outpatient services (like lab work), preventative benefits (including physicals), and durable medical equipment.
Medicare Advantage Plans
Medicare Advantage is also called Medicare Part C. If the particular Advantage plan offers prescription drug coverage, it is also referred to as a Medicare Advantage Prescription Drug Plan, or MAPD for short.
Medicare Advantage plans are plans offered by private companies that contract with Medicare. It combines Medicare parts A and B, and it also provides additional benefits such as dental coverage or vision services at no extra cost. If you choose to go this route, your primary care physician will be the one to coordinate all of your healthcare needs.
Medigap Plans
Medicare Supplement plans, or Medigap for short, are available to supplement your Original Medicare coverage. There are ten different Medicare supplements that can help you pay out-of-pocket costs like copays and coinsurance when you’re in the hospital or receiving medical services from a doctor.
Unlike Medicare Advantage plans, Medigap plans do not combine your Original Medicare, Parts A and B, into one plan. A Medigap plan is a separate policy. If enrolled in a Medigap plan, individuals will also need to purchase a separate Dental, Vision, and Hearing policy, as well as prescription drug coverage (also known as Medicare Part D).
- Medicare in Austin will cover hospitalization, medical expenses, and other health care services.
Which Medicare plans are available in Austin, Texas?
Original Medicare is available across the United States. However, there are specific MAPD, Medigap, DVH, and Part D plans available depending on where you live. Let’s discuss your Medicare options in Texas.
Medicare Advantage Plans
Medicare Advantage plans are an excellent choice for residents of Austin, Texas. They are widely accepted throughout the state and each county has many options to choose from.
The current list of carriers and plans is much too long for a single post. There are approximately 270 Medicare Advantage Prescription Drug plans in Texas.
Some of the most popular MAPD plans are as follows:
- Erickson Advantage Champion (HMO-POS C-SNP)
- Erickson Advantage Freedom (HMO-POS)
- KelseyCare Advantage Rx+Choice (HMO-POS)
- United HealthCare Nursing Home Plan (PPO I-SNP)
- AARP Medicare Advantage Plan 1 (HMO-POS)
Medigap Plans
There are approximately 69 carriers offering Medigap plans to Austin, Texas residents in 2021. These carriers include all major insurance companies, as well as smaller ones unique to Austin.
These carriers will all offer the ten standardized plans of Medigap. Of the ten plans, Plan F, Plan G, and Plan N are the most popular and comprehensive.
Dental, Vision, and Hearing Plans
Dental, Vision, and Hearing plans are available all over the United States. There are multiple carriers and coverage levels. If you currently have a dentist, optometrist, and audiologist, you may want to find out which carriers they accept payment from.
Some popular Dental, Vision, and Hearing carriers are:
- Aetna
- Manhattan Life
- Medico
- Mutual of Omaha
- Nat Gen
Part D Prescription Drug Plans
If individuals choose not to enroll in an MAPD plan, they will need to purchase a separate Part D prescription drug plan.
There are several carriers for these plans. Individuals will need to understand how their current medications are covered under each plan to find the one with the most value.
The current Part D carriers in Texas are:
- AARP
- Amerivantage
- Blue Cross
- Cigna
- Clear Spring Health
- Elixir
- Exemplar
- Express Scripts
- Humana
- Mutual of Omaha
- SilverScript
- WellCare
Each of these carriers offers several plans to choose from and will vary by county.
Which hospitals in Texas accept Medicare assignments?
There are 595 hospitals in Texas, and most of them accept Medicare Assignment. Of course, you will likely want to seek care from the one closest to you in Austin, but the following six rank highest in the care provided.
- Ascension Seton Medical Center: Austin, TX
- St. David’s Medical Center: Austin, TX
- Arise Austin Medical Center: Austin, TX
- Houston Methodist Hospital: Houston, TX
- UT Southwestern Medical Center: Dallas, TX
- Baylor St. Luke’s Medical Center: Houston, TX
If you are a resident in Austin, Texas, and looking for ways to decrease your medical costs, give us a call. We’d be happy to review your needs and compare them to the available plans.
]]>In addition to the other 10 Medigap policies, Aetna offers Medigap Plan G, one of the market’s most comprehensive and fastest-growing Medigap plans. This article will give you an overview of Aetna’s Plan G offerings and a bit more information about Aetna as a company.
Aetna & Medigap
AM Best – the insurance industry gold standard for quality-assurance ratings – gives Aetna an “A” as a company. This alone should give you a high degree of confidence that Aetna’s plans are competitive and their services are reliable. When you’re shopping for policy’s, it’s important to keep in mind both price AND quality of service.
Additionally, you’ll want to keep in mind premium rates and out-of-pocket costs. Just because a policy has lower premiums doesn’t necessarily mean it’s a good policy. Higher premiums can sometimes save you money on out-of-pocket expenses.
Our licensed experts will tell you that when it comes to Aetna’s Medigap policies, it’s hard to beat their coverage, prices, and quality of service.
Now we’ll tell you a little bit more about Aetna’s Plan G policies, as this plan is one of the most asked-about plans on the market.
What Does Aetna’s Medigap Plan G Cover?
Plan G is the second most comprehensive Medigap plan behind Plan F. However, Plan F has been phased out by the federal government, so if you’ve joined Medicare on or after January 1, 2020, then you can no longer enroll in Plan F (if you had Plan F before January 1, 2020, you can keep it for forever). As a reminder, Plan F covered 100% of the gaps Original Medicare left behind. Plan G is nearly as comprehensive, except Plan G does not cover the Medicare Part B deductible. The 2021 Part B deductible is $203.
While new enrollees are no longer eligible for the more comprehensive Plan F, there is reason to be optimistic. Plan F has higher premiums than Plan G. The money you can potentially save in a year by paying Plan G’s lower premiums may outpace the money you save by not paying the Part B deductible under Plan F. As a matter of fact, if you’re enrolled in Plan F you may find that it is better on your budget to switch to Plan G.
So, Plan G covers everything that Medicare Part A and b cover at 100%, except for the Part B deductible. This essentially means that you will not have to worry about out-of-pocket expenses for covered services and treatments once you have met your Part B deductible.
As with Medigap Plan F, Plan G has you covered from “excess charges” as well. An excess charge is when you visit a doctor that doesn’t accept Medicare-appointment, and they charge you a higher price. Legally, doctors that do not accept Medicare can charge you up to 15% more than the Medicare-approved amount for the same service. With Aetna’s Plan G, there is no need to worry about these charges.
If you’re in poor health or otherwise have frequent doctor’s visits, or if you think you might need a good deal of medical help in the future, Plan G is a good plan for you. It’s highly comprehensive in coverage, and many policyholders like the peace of mind Plan G provides.
How Can I Enroll in Aetna’s Plan G?
The best time to enroll in Aetna’s Plan G – or in any Medigap plan – is during your Medigap Open Enrollment Period (OEP). Your OEP begins when you turn 65, and your Medicare Part B is effective. Your OEP remains open for 6 months. If you are 65 or older and on Medicare, you can buy a Medigap policy at any time, though you may be subject to medical underwriting and health screening if you enroll outside of your OEP. Crucially, if you enroll during your OEP, then providers must charge you the same price for the same plan regardless of your medical history or current medical status.
What is Aetna Medicare Supplement Rate Increase History?
Don’t forget; all insurance companies increase their rates. This practice is not unique to Aetna. It is helpful information to have an idea of a company’s rate increase history, but it is not necessarily make-or-break information.
Additionally, it’s extremely difficult to predict rate increases from year to year. You really just have to wait until the numbers come out to see what you will have to pay. Rate increases are affected by numerous factors such as your location, policy type, and the company you’re purchasing your rate form. For these reasons, predicting rates can be a bit of a fool’s errand.
Like most companies, Aetna historically increases its rates between 3 and 10 percent a year, depending on numerous factors. One bonus that Aetna offers is a 12-month rate guarantee that your rates will not increase in your first year of holding an Aetna policy. Aetna also has a 30-day Free Look Period, which allows you to cancel your policy within the first 30 days the policy is active, no questions asked.
Is Aetna the Best Medigap Provider?
“Best” is a subjective term, so we won’t go quite that far. The best policy for you will depend on your personal health situation, your budget, your location, and much more. However, we do stand by Aetna as a top-tier Medigap policy provider.
Enrolling in Aetna’s Medigap Plan G
If you like the sounds of having an Aetna Medigap Plan G policy, feel free to reach out to one of our licensed Medicare experts today. We can tell you a bit more about both Aetna and Plan G, as well as give a price quote. Additionally, we can walk you through other Medigap options so that you wind up having the best healthcare plan for your personal needs.
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