Medicare
Supplement Insurance FAQs
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:
http://www.tdi.state.tx.us/pubs/consumer/medsup.html
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 TDI´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.
