Original Medicare covers 80% of most covered services, and you pay the rest.
Medigap plans can fill in “gaps” in Original Medicare coverage to make healthcare more affordable.
The most popular Medicare Supplement Plans in Texas include Plan F, Plan G and Plan N.
You can’t have a Medigap plan and a Medicare Advantage plan. You can only combine a Medigap plan with Original Medicare.
Original Medicare in Texas includes Medicare Part A and Medicare Part B. This gives you hospital coverage (Part A) and medical coverage (Part B). But Medicare doesn’t pay for all your expenses. Medicare usually pays for 80% of the covered service, and you pay the remaining 20%.
Medicare Supplement Plans can help fill in this gap in coverage. Some of the most popular Medicare Supplement plans in Texas include Medigap Plan F, Plan G and Plan N. You can also find other Medicare Supplement plans like Medigap Plan A, Plan B, Plan C, Plan D, Plan K, Plan L and Plan M.
Find a local Medicare plan that fits your needs
Medicare Supplement Plans in Texas are offered by private insurance companies, so cost and coverage can vary. There are ten types of Medigap plans that are named with letters (like Plan A and Plan D), plus high-deductible versions of two of these plans (Medigap Plans F and Plan G). The federal government has rules for what each Medigap plan has to cover (so coverage will not vary based on the insurance company that offers it), but not every insurance company offers every type of plan.
All Texas Medigap plans will cover:
- Medicare Part A coinsurance for hospital and hospice care
- Medicare Part B coinsurance and copayments
- Blood needed for medical procedures (first 3 pints in a year)
Some Texas Medigap plans will also cover:
- Part A coinsurance for skilled nursing care facility
- Part A deductible
- Part B excess charges
- Up to 80% of foreign travel emergency healthcare
You can compare each of the 12 available Medigap plans in this side-by-side comparison chart. Each of these plans is offered in Texas, but availability can vary from one insurance company to another and between zip codes. One of GoHealth’s licensed agents can help you find the Medigap plans that are available to you.
Medigap plans in Texas are offered by private insurance companies, so costs can vary. Generally, there are three ways that plan costs are calculated:
- Community-rated: Everyone who enrolls in the plan pays the same premium.
- Issue-age-rated: Your premiums are based on how old you were when you first enrolled.
- Attained-age-rated: Monthly premiums are based on your current age, so premiums go up as you age.
Are you eligible for cost-saving Medicare subsidies?
Medicare Supplement Plan G is one of the most popular Medigap plans in Texas. Plan G can also be sold as a high-deductible plan. If you enroll in a high deductible Plan G, you’ll have lower monthly premiums. But you’ll need to pay a yearly deductible before Plan G coverage kicks in. For 2022, the annual deductible amount for Plan G is $2,490.
- You’re a U.S. citizen or permanent resident
- You’re 65 or older
- You’re under 65, but you’re living with a disability or chronic health condition such as end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS)
The best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period. This is a six-month period that starts from the month your Medicare Part B coverage starts. Medigap plan providers are required to sell you a Medigap plan during this Open Enrollment Period. But once this period is over, you may have fewer Medigap plan options, or your plan options may cost more.
Medigap for adults under 65
If you’re 65 or older, you can enroll in any Medigap plan available in your area. But if you’re looking for Texas Medigap plans under 65, you’re only guaranteed the right to enroll in a Medigap Plan A. You may still be able to enroll in another Medigap plan, but each insurance company may have different eligibility criteria.
What extra benefits and savings do you qualify for?
Medicare Supplement plans in Texas do not include prescription drug benefits. You’ll need to enroll in a Medicare Part D plan to get medication coverage. You can enroll in Original Medicare Part A and Part B, add a standalone Part D plan, and also enroll in a Medigap plan. The Medigap plan will only help pay for Medicare Part A and Part B costs.
Medigap plans and Medicare Advantage plans are very different. Medigap plans help fill in gaps in your Original Medicare coverage. This will lower your out-of-pocket costs when you’re enrolled in Original Medicare.
A Medicare Advantage plan, on the other hand, bundles your Medicare Part A and Part B benefits into one plan. Advantage plans usually include prescription drug coverage and additional benefits like dental or vision services.
Get real Medicare answers and guidance -- no strings attached.
Medigap plans and Medicare Advantage plans don’t work together. Medigap plans only fill in the gaps in Original Medicare. They don’t help you pay for any Medicare Advantage plan costs. If you’re enrolled in a Medicare Advantage plan, you may want to drop your Medigap plan.
If you’re 65 or older, and you or your spouse paid Medicare taxes for at least 10 years, you qualify for premium-free Medicare Part A. But you’ll still need to pay other Part A costs, including the yearly deductible, and any coinsurance or copayments. Enrolling in a Medigap Plan can cover these costs.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement