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Buying Affordable Medigap Insurance in Texas

You can find Medigap plans in Texas by using Medicare’s Medigap Plan Finder tool to check out available policies in your location, review coverage options, and compare costs. You can also call the Texas State Health Insurance Assistance to provide you with a Medigap rate comparison shopping guide for the state. You can contact them by calling (800) 252-9240.

The Texas Department of Insurance (TDI) provides a list of insurance companies that sell Medigap plans in the state. You can contact them directly. You can also speak to an insurance agent. A licensed health insurance agent in Texas can help you find the best plan to meet your healthcare needs.

How to Shop for Medigap Insurance?

You can follow the steps and tips when shopping for Medigap insurance in Texas:

  1. Decide the Medigap plan you want. There are ten standardized Medigap plans in Texas. Plans A, B, C, D, F, G, K, L, M, and N. You can choose the plan you want by comparing their benefits. You can draw up a scale of preference from the most suitable plan for you to the least suitable plan. The Texas Department of Insurance (TDI) provides a chart summarizing the benefits of each plan.

  2. Find out different policies in Texas and compare their costs. You can do this by using the Medicare website to find a Medigap policy. You can also contact the Texas State Health Insurance Assistance and inquire if they have a “Medigap rate comparison shopping guide.” They can also provide you with free assistance in selecting a policy.

  3. From the different policies and costs, you can list companies where you could buy your Medigap plan.

  4. Do your research on the insurance companies that you shortlisted. You can do any of the following:

    • Contact TDI and request records of complaints against the insurance companies.

    • Do online research for information about the insurance companies, including their financial rating.

    • Call the insurance companies.

    • Speak to someone you trust, like:

    • A licensed insurance agent in Texas. A health insurance agent can be helpful in the following ways:

    • Provide you with professional advice on the best coverage for you

    • Assist you with your application

    • Answer questions relating to Medigap and other health insurance

    • Assist you with inquiries regarding billing, claims, and appeal.

    • A family member, close friend, or colleague who has a Medigap policy. They can share their Medigap-related experiences, which can be helpful in guiding you when shopping for Medigap plans.

  5. When you have decided on the company and plan, you should make sure that you are buying the plan within an open enrollment period. If you are, then you can go ahead and buy the plan.

Other things to know when shopping for a Medigap policy in Texas include:

  • Read the policy thoroughly. You have a 30-day “free look” period (TAC 3.3832). You can get a full refund if you are dissatisfied and want to cancel.

  • Ensure that all of the information on your application is accurate. Your insurance company may cancel your policy or leave you with unpaid claims if you fill out the application incorrectly or with false information.

  • Do not cancel your current insurance until you have received your new coverage.

  • You should not buy more than one Medigap policy.

  • Do not pay with cash when buying a plan. Always make your payment to the insurance company, not the agent, with a check, money order, or bank draft.

  • Agents claiming to be from the government should not be trusted. The government does not sell Medigap insurance. It only regulates it.

  • You cannot get a Medigap policy if you have a Medicare Advantage plan. Medigap and Medicare Advantage do not work together.

What are my Medigap Insurance Options?

There are ten Medigap standardized plans in Texas. They are Plans A, B, C, D, F, G, K, L, M, and N. Plans F and G have high-deductible versions, with high deductibles of up to $2,490 in 2022.

Note that Plans C and F were no longer available to newly qualified Medicare enrollees on or after January 1, 2020. However, suppose you qualified for Medicare before this period but have not enrolled. Then, you can still buy Plan C or Plan F. Persons who newly qualified for Medicare on or after January 1, 2020, buy Plans D and G instead of Plans C and F.

How to Qualify for Medigap Insurance?

You qualify for Medicare supplement (Medigap) insurance if you are enrolled in Original Medicare (Medicare Part A and Part B).

Where to Buy Medigap Insurance?

Private insurance providers approved by Medicare sell Medigap insurance in Texas. You can buy a plan by contacting the insurance company directly. Check out the list of insurance companies that sell Medigap plans in Texas.

You can also buy a plan through a health insurance agent licensed in Texas. Medigap plans available in your location can be found when you use the Medigap Plan Finder or contact Texas State Health Insurance Assistance.

Generally, your best option for buying an affordable plan is by using the services of an experienced health insurance agent.

When buying your plan, make sure you read the policy. If you do not understand any part of the policy, ask questions. When buying your plan, carefully and correctly fill out the application, including medical questions. Your answers determine your eligibility for open enrollment or guaranteed issue rights.

Where to Get Medigap Insurance?

You can get Medigap insurance through any of the following means:

  1. Contact insurance companies that sell Medigap insurance. There is a list of insurance companies that sell Medigap plans in Texas.

  2. Reach out to an insurance agent in Texas.

  3. Use the Medigap Plan Finder or Texas State Health Insurance Assistance.

If you are trying to get quotes, make sure you use the services of an insurance professional to compare the benefits and costs. Do not buy a plan simply because it is cheap. Make sure you read the policy before buying the plan. If you do not understand any term or clause, ask questions or seek clarification from the insurance company or a licensed health insurance agent.

Where Can I Buy Affordable Medigap Insurance?

An insurance agent is your best option for buying an affordable Medigap insurance plan in Texas. When you use the services of an agent, you provide them with information about your health needs and budget. They use this information to find plans that fit your needs at the most affordable cost.

How to Apply for Medigap Insurance in Texas

  1. Choose the Medigap type of plan you want — A, B, C, D, F, G, K, L, M, and N.

  2. Find out information about the insurance companies that sell Medigap policies. You can do the research on your own or use the services of a licensed health insurance agent in Texas, who can guide through the process at no cost to you.

  3. Compare the costs that these discovered insurance companies offer for the different Medigap plans.

  4. Compare the terms of the plans to make sure they fit your from a Medicare supplemental coverage

  5. Buy the Medigap policy that you end up choosing. The insurance company will provide you with an application form and a clear summary of your policy. Ensure that you provide correct information when filling out your application form because misrepresentation can cause them to cancel your plan.

If you are using an agent, they can do all the paperwork and the submittals for you.

Who Can Help with Application for Medigap Insurance?

Only licensed health insurance agents that sell Medigap plans in Texas can help you with your application for Medigap. An insurance agent sells Medigap plans for insurance companies that operate in the state. Thus, they can offer you information about the coverage of those companies. There are two types of agents:

  • Captive agent and

  • Independent agent (broker).

A captive agent has an exclusive employment agreement with one insurance company to sell their plans. The agent you reach when you call a specific insurer is usually a captive agent.

An independent agent (or broker) sells plans from multiple insurance providers and can provide competing Medigap quotes

You can also contact the Texas State Health Insurance Assistance. They can give you a Medigap shopping guide and assistance in selecting policies.

An insurance agent can be your best option when seeking help with your Medigap insurance. An agent is a professional that will provide you with all of the required information about the various Medigap plans available in your area and will assist you in getting and applying for the best coverage for you.

Should I Use an Insurance Agent to Buy Medigap Insurance?

Yes. You should use a knowledgeable health insurance agent when trying to buy Medigap insurance in Texas. Agents are one of the best ways to get Medigap insurance in Texas.

Can you Purchase Medigap Insurance Through an Agent?

Yes, you can buy Medigap insurance in Texas through an agent. If you are getting Medigap insurance for the first time, an agent can provide you with the necessary information and help you select the appropriate plan for your health needs.

An experienced insurance agent is also very useful to persons who have purchased Medigap coverage before. An agent can provide updates regarding costs, benefits, and the application process. This can involve getting discounts, new healthcare plans that may be better appropriate for you, or a review of the terms of your policy.

Why Do I Need an Agent for Medigap Insurance?

There are many reasons you need an insurance agent for Medigap insurance in Texas. They can:

  • Explain complex insurance terms.

  • Help you search for plans that will meet your health needs and fit your financial budget.

  • Assist you with your application.

  • Provide you with information about plans and their benefits, particularly the plans that can suit your health situation.

  • Help you evaluate the costs and coverage benefits of different plans.

  • Give you yearly updates on Medigap generally.

  • Assist you with making Medigap claims.

  • Help you negotiate prices where necessary.

  • Provide you with a neutral view when advising you about your Medicare coverage options.

Plus, all these services come at no cost to you (the insured).

Why is an Insurance Agent Important for Medigap Insurance?

An insurance agent is important for Medigap insurance in Texas because they assist you with finding coverage that suits your health needs. They can also explain how Medigap works to you and update you about annual changes made to Medigap.

What Kind of Insurance Agents Work with Medigap Insurance?

In order to sell Medigap insurance, the agent must be licensed as a Life, Accident, Health & HMO professional. Health insurance agents are further divided into two kinds of agents. They are captive agents and independent agents. A captive agent sells insurance coverage for one insurance company only. An independent agent, also called a broker, sells insurance coverage for many insurance companies.

How to Choose an Agent for Medigap Insurance?

Your choice of a Medigap insurance agent in Texas depends on your preferences. There are two types of Medigap health agents: captive and independent agents. Captive agents advertise and sell plans for only one insurance company. Independent agents handle the sale of plans of various insurance companies. If you want to compare the prices of various plans and providers, an independent agent will be the preferred type of agent for you. However, if you already know the provider you want to buy a particular plan from, you should reach out to their agent directly.

How Can I Find an Agent who is Proficient in Medigap?

You can find an insurance agent proficient in Medigap insurance around you by using the Texas Department of Insurance’s (TDI) a list of Medicare agents in Texas. It provides you with the name, address, and phone number of insurance agents in the state. The HealthCare.Gov’s Find Local Help search tool is another useful source.

What Do Insurance Agents Do for you in Medigap Insurance?

An insurance agent in Texas can help you get quotes and compare costs based on your health needs. Doing this on your own takes a lot of time and effort. Health insurance agents can also help you if you have to undergo a medical underwriting. You are not entitled to any guaranteed issue right when you buy Medigap coverage outside your open enrollment period. Insurance companies will not offer you coverage at open enrollment prices. Instead, they use medical underwriting to determine how much premium you have to pay for coverage. The insurer may choose not to enroll you in the plan due to underlying health concerns. A Medigap-qualified agent can assist you in determining if you will meet the underwriting conditions for the policies you are considering.

What Should your Medigap Insurance Agent Do for you?

In Texas and under federal law, there are certain things a Medigap agent can do for you before, during, and after your appointment with them. They are as follows:

BEFORE:

  • Before they can meet you in person, the agent must first get your consent and note the plan options you want to discuss.

  • The agent must not come to your house unless an appointment is scheduled.

YOUR AGENT MAY DO ANY OF THE FOLLOWING DURING THE MEETING:

  • Give you copies of the plan documents.

  • Tell you where you may get more information about the plan.

  • Tell me about the plan options you promised to discuss.

  • Give you an enrollment form if you are interested.

  • Collect your completed enrollment form.

  • Give you their business card so you can pass it on to your friends and relatives.

AFTER YOU DECIDE TO JOIN THE PLAN:

  • The insurance provider will contact you to confirm that you desire to join and that you understand the plan’s coverage and terms.

  • The agent who helped you sign up for the plan may contact you to discuss other plan possibilities.

How Important is to Have a Local Agent for Medigap Insurance?

You do not particularly need a local agent for Medigap insurance in Texas. When choosing an insurance agent, the most important thing is that the agent is licensed in the state and is experienced in assessing the needs of researching all available options. The locality of an agent is not important.

Does It Cost Me Extra To Use an Insurance Agent to Get Medigap Insurance?

No, it does not cost you extra to use an insurance agent to get Medigap insurance in Texas. Their services are free for customers and clients. Insurance carriers pay the agents that represent them and sell their plans.

How Does a Medigap Insurance Agent Get Paid?

Whichever Medigap insurer you choose to get coverage through pays the agent the commission in return for taking care of the sale, the explanations, and the administrative tasks for them. The payout is usually in the form of a commission based on a pre-agreed-upon formula. They are paid based on the number of people they enroll in a plan during their first year. They are also paid for each year that each person remains on the plan.The paid-out commission comes from the insurer’s special fund, which does not affect the insured’s costs in any way.

How to Compare Medigap Insurance Quotes?

There are many options for comparing Medigap insurance quotes in Texas. The Medigap Plan Finder allows you to compare Medicare quotes using your location. You can also get prices from insurance companies you know that sell Medicare policies.

One of the advantages of comparing quotes yourself is that you will have sufficient information about the available options. However, you will most likely choose the most cost-effective option, which does not automatically mean the best option. Comparing quotes without professional assistance may lead to selecting a low-cost plan that will not provide you with the coverage you need, because you did not fully appreciate or verify the terms of the policy. As a result, employing the services of a Texas-certified health insurance agent to compare prices is a more reliable choice.

How Many Medigap Quotes Should I Get?

You should compare not less than two or three Medigap quotes. However, there is no “standard” number of quotes that you should get. The more quotes you get, the more options you can consider. However, if you do not know much about Medicare insurance or insurance in general, you may not be able to evaluate these options properly. If this happens, you should reach out to a licensed insurance agent in Texas to assist you with sorting through prices and plan benefits. When you hire a registered insurance agent in Texas, you save time and effort.

Can I Buy Medigap Coverage Online?

You can find and buy Medigap coverage through Medicare’s Medigap Plan Finder and reach out to the sales agents of the chosen plan.

Can Anyone Get Medigap Insurance?

No. Only Original Medicare enrollees can get Medigap insurance in Texas.

When Can you Get Medigap Insurance?

You can buy Medigap during your Open Enrollment Period. Your Open Enrollment Period is a six-month period that starts the first month you are 65 years old and have Medicare Part B. Insurance companies cannot refuse you Medigap coverage during this period because of your medical history or a preexisting condition. After this enrollment period, if you try to get a Medigap plan, you may be subjected to medical underwriting and may be rejected if you have a preexisting condition. And if you get a plan, it may be more expensive.

If you wait to enroll in Part B because you (or your spouse) have group health coverage, your Medigap Open Enrollment Period will not begin until you enroll in Part B.

Speak with a qualified Texas health insurance agent for more details.

Do I Need to Renew my Medigap Insurance?

Medigap plans are guaranteed renewable. This means that your plan will continue to be active as long as you pay your premiums on time. You do not need to renew your plan. Also, your insurance provider cannot cancel your plan unless:

  • You refused to pay your premiums beyond the grace period.

  • You materially misrepresented information in your coverage application.

  • Your insurance company’s contract with Medicare is expiring in the coming year.

  • Your insurance company intends to leave the Medicare program in the middle of the year.

  • Medicare terminates your insurance company’s contract.

If any of the above happens, you will get a non-renewal notice.

How to Reinstate Medigap Insurance that you Stopped Paying?

  • Contact your former Medigap insurance carrier or the insurance agent you used to get the plan within 60 calendar days after disenrollment due to non-payment of premiums.

  • Provide them with a genuine reason why you stopped paying your premiums. Medicare’s Good Cause policy allows a beneficiary who can show good reason(s) for not paying premiums within the grace period, such as an unexpected event or emergency, to seek reinstatement or re-enrollment.

  • If the insurance carrier grants the request, you will have to pay all previously owed premiums within the period of the disenrollment to get the plan back.

How to Find Out What Medigap Insurance I Have?

You can find out what Medigap insurance plan you have by:

  • Contacting your insurer or insurance agent, or

  • Reading your insurance policy.

How Do I Know if I Have Medigap Insurance?

You can know if you have Medigap insurance by contacting your insurance provider.

Can Medigap Insurance Be Combined with Other Insurance to Become More Affordable?

Medigap insurance can only be combined with Medicare insurance. It was made as supplemental insurance coverage to help enrollees of Original Medicare get more affordable coverage.

Can I Bundle Medigap and Original Medicare?

Yes. You can bundle Medigap and Original Medicare. Original Medicare provides comprehensive coverage and handles payments of services according to your policy. After Medicare has paid, your Medigap plan will cover your out-of-pocket costs wholly or in part.

Can I Bundle Medigap and Medicare Advantage?

No. Under federal law, it is illegal to have a Medigap plan and a Medicare Advantage plan at the same time.

Is Medigap Insurance a Good Deal?

Yes. Generally, healthcare costs in the U.S. are very expensive. Although the government tries to provide comprehensive coverage at a reduced cost for Medicare enrollees, there is still a substantial portion of bills that enrollees have to handle themselves. With a Medicare Supplement (Medigap) plan, Texans can have all or a major portion of these out-of-pocket costs settled. Original Medicare enrollees can speak to licensed insurance agents in Texas to discuss their Medigap and other health coverage options in the state.