Texas Medicare Supplement

Information you can use to pick the right plan

According to the Medicare & You 2008 handbook, "With more Medicare choices than ever, it's important that you look at your coverage every year. Plan costs and benefits change, and so can your health..."

Hello, my name is Mike and I am a licensed insurance agent in the great state of Texas.
 
I make it a point to understand as much as possible about medicare coverage. I enjoy reading the government publications about medicare and consider texas medicare supplement health plans to be a specialty of mine.
 
I'm want to help you understand more about medicare supplement insurance. Due to the strict nature of Medicare laws, I'll closely adhere to the language used in these publications.
 
What is a medicare supplement policy?
 
A medicare supplement policy is a health insurance plan sold by a private insurance company to fill the holes in original medicare. These plans will help you pay your share of the costs (coinsurance, copayments, or deductibles) associated with Medicare-covered services.
 
You'll need Part A and Part B coverage for medicare supplement coverage.
 
Part A (Hospital Insurance) - helps cover your inpatient care in hospitals, skilled nursing facilities, hospice care, and some home health care if you meet certain conditions.
 
Part B (Medicare Insurance) - helps cover medically-necessary services like doctors' services and outpatient care, other medical services that Part A doesn't cover (like physical and occupational therapists), and some home health. Also helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse.
 
There are different medicare supplement policies.
 
Insurance companies can sell you only a "standardized" medicare supplement policy. These policies are identified by letters (Plans A through L). Plans F and J also come in a high-deductible version. Each type of medicare supplement policy offers the same basic benefits, no matter which insurance company sells it. Usually the only difference between Medigap policies sold by different insurance companies is the cost.
 
What doesn't a medicare supplement policy cover?
 
They don't cover long-term care (like care in a nursing home), vision or dental care, hearing aids, eyeglasses, and private-duty nursing.
 
Any new medicare supplement policy is guaranteed renewable.
 
This means the insurance company can't cancel your policy as long as you pay the premium.
 
You'll have to buy prescription drug coverage too if you want it.
 
Although some medicare supplement policies sold in the past covered prescription drugs, no new medicare supplement policies are allowed to include prescription drug coverage. If you want prescription drug coverage, you may want to join a Medicare Prescription Drug Plan (Part D) offered by private companies approved by Medicare.
 
Open Enrollement is the best time to buy a medicare supplement policy.
 
This period lasts for 6 months and begins on the first day of the month in which you are both age 65 or older and enrolled in Medicare Part B. During this period, an insurance company can't use medical underwriting. They can't refuse to sell you any medicare supplement policy it sells. They generally can't make you wait for coverage to start. Finally, they can't charge you more for a medicare supplement policy because of you health problems.
 
How do insurance companies set prices for medicare supplement policies?
 
Each insurance company sets its own monthly premiums, and decides how it will set the price. It is important to ask how an insurance company prices medicare supplement policies. The way they set the price affects how much you pay now and in the future. Medicare supplement policies can be priced or "rated" in 3 ways:
 
1. Community-rated (also called "no-age-rated")
2. Issue-age-rated
3. Attained-age-rated
 
Can the cost of my medicare supplement polciy vary?
 
Yes, the cost of your medicare supplement policy may also depend on if the insurance company
 
- offers discounts (such as discounts for females, non-smokers, or people who are married; discounts for paying annually; or discounts for paying your premiums using electronic funds transfer).
 
- uses medical underwriting, or applies a different premium when you don't have a guaranteed issue right.
 
- sells Medicare SELECT policies. If you buy this type of medicare supplement policy, your premium may be less.
 
- offers a "high-deductible option" on medicare supplement plans F and J. If you buy a medicare supplement Plan F or J high-deductible option, you must pay the deductible beofre the medicare supplement policy pays anything. You must also pay a separate deductible for foreign travel emergency.
 
Do you still have questions?
 
This is not an exhaustive list of answers, but it does cover many of the questions I am often asked. You can always look-up the information at www.medicare.gov or contact your social security office.
 
Of course, if you live in Texas and need help, you can contact me here.
 
All the best to you,
Michael D. Coday II, Agent
Texas Medicare Supplement

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