Medigap Policies in Texas

Medicare is a federal program which helps provide health services to people aged 65 or older. Original Medicare comes in two parts, one primarily for hospital services and the other geared more toward preventive treatment. However, traditional Medicare does not cover all the medical benefits a person may need, resulting in supplemental policies meant to work with Medicare, often called Medigap. Medigap policies are standardized, but all are not available in every state. As of 2010, private companies in Texas offer ten supplemental Medicare policies.

Basic Benefits

• Though each Medigap plan in Texas is slightly different, they all offer the same basic benefits. These include the hospital charges for up to 365 additional days after you've used up your Medicare benefits, the cost of the first three pints of blood and the co-insurance costs for hospice care. They will also pay daily co-payments for hospitalizations from the 61st day through the 90th day and the Medicare Part A co-payments beyond 90 days.

Additional Benefits

• Additional benefits are available depending on which Texas Medigap plan you purchase. Plans B, C, D, F, G and N pay all of the Medicare Part A deductible. Plans C and F include payments for the Medicare Part B deductible. Plans C, D, F, G, K, L, M and N help pay for skilled nursing facility care. Plans C, D, F and G pay 80 percent of the charges for foreign travel emergency care, if they are something Medicare would have covered if the beneficiary had been in the United States. Plans F and G cover 100 percent of the excess fees for Medicare Part B services.

Deductibles and Cost-Sharing

• Certain Medigap plans offered in Texas are available as cost-sharing or high-deductible plans. Customers will pay more for services before benefits kick in, but monthly premiums will be lower. Plan F is available as a high-deductible plan with the same benefits as the regular policy. The deductible is changeable, but as of 2010 was $2,000 per year. Plans K and L are cost-sharing plans. Plan K has 50 percent co-insurance and a yearly out-of-pocket cost of $4,620. Plan L has 75 percent co-insurance and an out-of-pocket cost of $2,310.

Medicare Select

• Texas allows the insurance companies which sell Medigap plans to also offer them as Medicare Select plans. Medicare Select policies offer comparable benefits to the standard plans, but customers get their services from providers which are part of that plan's network. You can go outside the network for your services, but you will pay higher costs.