Frequently Asked Questions

The following is excerpts from a publication on the Texas Department of Insurance Web site.
This can help you in understanding and choosing your Health Insurance.

To view the entire publication click on the following link: https://www.medicare.gov/

Medicare Supplement Insurance
Medicare supplement insurance (often called Medigap insurance) fills in the gaps between what Medicare pays and what you must pay out-of-pocket for deductibles, coinsurance, and copayments. Medigap policies only pay for services that Medicare deems medically necessary, and payments are generally based on the Medicare-approved charge. Some plans offer benefits that Medicare doesn't, such as emergency care while in a foreign country.

There are 12 standardized Medigap plans, labeled A through L. All companies that sell Medigap insurance must offer Plan A, but do not have to offer the other 11 plans. If you bought a Medigap policy before standardized plans were first introduced in 1992, you may keep your existing policy. You do not have to switch to one of the 12 standardized plans.

Medigap policies are sold by private insurance companies that are licensed and regulated by the Texas Department of Insurance (TDI). Medigap benefits, however, are set by the federal government. The benefits provided by these plans are described in the appendix. Medigap policies are automatically renewed each year.

Shopping Wisely for Medigap Insurance

  • Buy during open enrollment. The best time to buy a Medigap policy is during your Medicare open enrollment period because companies must sell you any plan they offer without regard to pre-existing conditions.
    Shop around. Prices can vary considerably. Use the rate guide section of this handbook to compare the company prices for the plans (A-L) that interest you.
  • Consider other factors. Price should not be your only consideration. You can learn a company's complaint record and A.M. Best financial rating by calling TDIA's Consumer Help Line. Both are important indicators of the service you can expect from a company. Your family and friends are other sources of information about a company's customer service. Ask them if they have had any experiences with the companies you are considering.
  • Consider your needs. Although it is illegal to sell you more than one Medigap policy, insurers may offer other policies with benefits that may overlap Medigap coverage. These include cancer, specified disease, hospital indemnity, and long-term care policies. Any duplication of benefits must be disclosed in writing. In general, duplicate coverage wastes money because you are paying twice for the same coverage.
  • Look into Medicare Part D prescription drug coverage. If you have a Medigap plan that includes prescription drug coverage, consider getting a Medicare prescription drug plan. The prescription coverage in policies sold after 1992 is not as good as Medicare drug coverage.