If you are enrolled under a Medigap plan in Texas, you pay your premiums separately from your Medicare Part B premiums. Medigap premiums are paid directly to the insurance company that provides the plan.
Your insurance company will instruct you on how to pay for your Medigap coverage. The best payment methods include all electronic means of payment, money orders, checks, or bank drafts. Make all payments to the insurance company, not an insurance agent. If you purchase your coverage from an agent, make sure you get a receipt indicating the name, address, and phone number of the insurance company for your records. Always keep evidence of payments.
Every person enrolled under a Medigap plan is responsible for paying their premiums. A Medigap plan covers only one person. There are no Medigap group plans in Texas. So if you and your partner want Medigap coverage, you will have to purchase separate plans.
Your Medigap insurance provider will inform you of the payment options for your Medigap premiums and other costs. Common modes of payment in Texas include checks, money orders, bank drafts, and various electronic means of payment. Some insurance providers offer discounts based on how you pay, like if you make an advance payment for the year or make payments through electronic funds transfer (ETF). Using an ETF, you can make the monthly payment to be deducted automatically from a bank account or a credit or debit card. Different payment options are made available for different plans by their insurance provider.
Medigap insurance is paid every month. However, you can discuss the possibility of paying quarterly, biannually, or annually with your insurance provider.
Usually, your Medicare-approved bills are sent directly to your Medigap plan provider by Medicare. However, if it is not sent, you can directly send it to your insurance provider.
Generally, in Texas, you pay deductibles directly to the doctor. When you have finished paying your deductibles and your Original Medicare and Medigap coverage kicks in, you may have to pay to Medicare and your plan provider. If the doctor accepts Medicare assignment, you make your payments to Medicare and your Medigap plan, where necessary. If the doctor does not accept Medicare assignments, you will have to pay the cost directly to the doctor and submit a claim to Medicare and your Medigap plan for reimbursement.
Contact a licensed health insurance agent in Texas to learn more about who you should pay for medical services.
No, Medigap insurance does not have any additional (sales) tax on top of the premium costs. Moreover, Medicare and Medigap costs in Texas are tax-deductible. The IRS allows you to deduct medical expenses that are below a certain threshold of your adjusted gross income (AGI). Discuss the details of the taxation with a certified tax professional.
Yes, as long as it does not go beyond the 90-day grace period in Texas. If it does, you can be disenrolled from your Medigap plan.
Yes. Medigap in Texas has a grace period of 90 days for consumers to pay their outstanding premiums before their insurance provider can drop them from their plans.
The grace period for Medigap in Texas is 90 days.
You can re-enroll in a canceled plan within the open enrollment period from October 15 to December 7 in Texas. However, before your re-enrollment request is considered, your plan provider will need you to settle any outstanding payments.
Your plan can be reinstated under Medicare’s “Good Cause” provision by showing that you have a legitimate reason for not paying your premiums during the grace period. If your request is approved, you will be required to pay any unpaid premiums. Within 60 days of your disenrollment, you must request Good Cause.
If you cannot pay for your Medigap coverage, you have the following options:
You should check if you qualify for Texas Medicaid. This government health program helps people with low income and resources with their medical costs. You can check if you are eligible for Texas Medicaid or apply for it on the Texas Benefits website or call 211 or (877) 541-7905 (711 for TTY).
If you are not eligible for Medicaid but still want Original Medicare coverage, you should consider switching to a cheaper Medigap policy. However, suppose you apply for a Medigap coverage outside of the original open enrollment period. In that case, insurance providers are generally entitled to decline your application or charge you additional premiums based on medical underwriting.
Enrolling in a Medicare Advantage plan is another option. Medicare Advantage plans provide all Medicare Parts A and B benefits with lower cost-sharing than Original Medicare. They also offer out-of-pocket limits. However, you will not have access to a wide range of physicians, unlike under Original Medicare. Medicare Advantage requires you to use physicians within your plan’s network. You will pay extra if you see a provider outside your plan’s network. Furthermore, your Medicare Advantage plan may charge you monthly premiums in addition to the Medicare Part B premiums.
To know more about your Medigap options in Texas, you can speak to a state-licensed health insurance agent.
No. If you skip a payment in Texas, your Medicare coverage does not automatically lapse. However, it will lapse if you skip payments after giving adequate notification and the grace period specified in the plan. Medigap’s grace period is 90 days.