Medicare Coverage

Texas Medicare Plans

Texas Medicare Supplement Plans From Houston to Plano, San Antonio to Corpus Christi, Dallas/Ft. Worth to Austin, El Paso to Arlington, Amarillo, Beaumont, Brownsville, Denton, Frisco, Garland, Irving, Laredo, Lubbock, Pasadena or Waco it is important that you find the medicare coverage that fits your life and your lifestyle. We feel that the best care is received when you have your choice of Doctors, and you and your Doctor make your medical decisions. Medigap plans in Texas are available with no medical underwriting during your initial enrollment period. This is when you become eligible for Medicare Part B. You may however, apply to a company and fill out the medical underwriting questions at any time.

We are pleased to introduce our Texas Medicare Supplement Comparison Quoting System. It is a very simple process where you enter a few bits of information and then we will quote all of the medicare supplement plans offered by several companies. The companies that we select to quote are based on their strong reputations and competitive pricing. Some of the companies that we represent are: Aetna, BlueCross BlueShield of Texas, Combined Insurance, Equitable Life, Heartland National, Omaha Insurance Company, UCT, United American and UnitedHealthcare®.

We understand that shopping for insurance can be a very confusing process. We take our job very seriously and do everything we can to be sure that you understand the plan that you purchase. We strive to be your agents forever, and promise to be there to offer our advice and insight. You can contact us using the links above if you need more information or advice in choosing the right plan for you.

Medicare Supplements
  • Secondary to Medicare
  • Helps cover the "gaps" that Original Medicare will not cover like coinsurance and deductibles
  • Plans A, B, C, D, F, G, K, L, M & N
  • Plan benefits are standardized, but premium can vary between carriers
  • Age may affect your premium Doctor access is determined by Original Medicare
  • You can choose any stand alone Part D plan
  • If you move, the plan may allow you to continue in the plan.
  • Must have both Medicare Parts A & B
  • Best time to buy a supplement plan is during the 6-month period that begins on the first day of the month in which you are both age 65 or older and enrolled in Part B
  • Other than a few exceptions, outside the first 6 month window the carrier may be able to underwrite you if you try to enroll for coverage.
  • [more information]
Medicare Advantage Plans
  • Your Medicare benefits are handled by the Company and plan you select
  • Covers all the same benefits as Original Medicare, as well as other services not typically covered by Medicare (preventive services, case management, vision, etc..)
  • Plans receive funding from Medicare
  • MA Plans must have a contract with the Centers for Medicare and Medicaid Services (CMS)
  • [more information]

Additional Resources

Part B Premiums - Higher income

Medigap changes

** If you bought Plan E, H, I, or J before June 1, 2010, you can keep that plan.

Medicare Supplemental Insurance (Medigap or MedSup) is specifically designed to supplement Medicare's benefits and is regulated by federal and state law, It must be clearly identified as Medicare Supplemental Insurance and it must provide specific benefits that help fill the gaps in your Medicare coverage. Other kinds of insurance may help you with out-of-pocket health care costs but they do not qualify as Medigap plans.

In Texas there are more than 45 companies that sell Medigap Plans. We represent many of them. It is important to us that we can offer the best value to our clients.

How much does Medigap coverage cost?

"The Cost of Medigap policies can vary widely. There can be big differences in the premiums that insurance companies charge for exactly the same coverage."

From the page 19 of the Federal Choosing A Medigap Policy Brochure

Standard Medigap Plans:

To make it easier for you to compare Medigap insurance policies, all states (except Minnesota, Massachusetts and Wisconsin), U.S. territories and the District of Columbia limit the number of different Medigap policies that can be sold in any of those jurisdictions. The plans were developed by the National Association of Insurance Commissioners and incorporated into state and federal law. They have letter designations," with Plan A being the "basic" benefit package. Each of other plans includes package plus different combination additional benefits. Insurance companies are not permitted to change benefits letter designations of any of the plans.

What is Medicare?

Medicare is a national health insurance program for people 65 years of age and older, certain younger disabled people and people with permanent kidney failure. Medicare is run by the Centers for Medicare & Medicaid Services . The Social Security Administration helps CMS by enrolling people in Medicare and by collecting Medicare premiums.

Medicare is divided into two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Part A helps pay for care in a hospital, skilled nursing facility, some home health care, and hospice care. Part B helps pay for doctor bills, outpatient hospital care and other medical services not covered by Part A. Your Medicare card shows the Medicare coverage you have--Hospital Insurance (Part A), Medical Insurance (Part B), or both--and the date your coverage started.

The 2016 Medicare Part A deductible is $1,288 and the 2016 Part B deductible is $166. Part B annual increases are based on Part B medical cost increases and are related to income levels.

Medicare Premiums for 2016:

Part A: (Hospital Insurance) Premium

  • Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
  • The Part A premium is $226.00 per month for people having 30-39 quarters of Medicare-covered employment.
  • The Part A premium is $411.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.

Part B: (Medical Insurance) Premium

Most existing beneficiaries will be "held harmless" and will pay $104.90 in 2016. Beneficiaries not subject to the “hold harmless” provision will pay $121.80, as calculated reflecting the provisions of the Bipartisan Budget Act signed into law by President Obama last week. Medicare Part B beneficiaries not subject to the “hold-harmless” provision are those not collecting Social Security benefits, those who will enroll in Part B for the first time in 2016, dual eligible beneficiaries who have their premiums paid by Medicaid, and beneficiaries who pay an additional income-related premium. These groups account for about 30 percent of the 52 million Americans expected to be enrolled in Medicare Part B in 2016. 

If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $121.80 per month. 

Medicare Deductible and Coinsurance Amounts for 2016:

Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2016 = $1,288) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.

For each benefit period you pay:

  • A total of $1,288 for a hospital stay of 1-60 days.
  • $322 per day for days 61-90 of a hospital stay.
  • $644 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
  • All costs for each day beyond 150 days

Skilled Nursing Facility Coinsurance

  • $161 per day for days 21 through 100 each benefit period.

Part B covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment

  • $166.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $166.00 deductible.)

(please see the CMS information on this)

Enrollment in Medicare is handled in two ways: either you are automatically enrolled or you must apply. If you are getting Social Security or Railroad Retirement Board benefits before you turn 65, you are automatically enrolled and your Medicare card will be mailed to you about three months before your 65th birthday. If you are not receiving retirement benefits, you must apply by contacting a Social Security Administration office or, if appropriate, the Railroad Retirement Board. You should apply three months before your 65th birthday to avoid a possible delay in the start of your coverage. If you have been a disabled beneficiary under Social Security or Railroad Retirement for 24 months, you will automatically get a Medicare card in the mail.