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What are the Basic Benefits of a Medigap Plan D in Texas?

Saturday, October 15th, 2011

Medigap, or Medicare Supplement insurance, helps to pay for some of the gaps in coverage not paid by Medicare.  These out-of-pocket expenses like deductibles, coinsurance and copayments can add up fast and Medigap insurance can help. In Texas, there are ten Medigap plans, each with different combinations of benefits. You may have already decided that plan D is the best choice for you, but you’re not completely sure.

Remember, while Medigap plans are sold by private insurance companies, the specific benefits are set by the federal government and every Medigap policy must contain at least a minimum level of basic benefits. Take the time to review these benefits and the additional coverage offered through plan D to help you decide if this is the best plan for you.

Basic Benefits

Every single Medigap policy in Texas must provide the same basic benefits. Whether you choose plan D or plan F, the following benefits will be part of your Medigap coverage.

Hospitalization

Hospitalization costs are covered as part of basic benefits. More specifically, daily copayments for all hospitalization costs from the 61st through the 90th day of the Medicare benefit period, Medicare Part A copayments for time after the 90th day and the entire Medicare Part A coinsurance including  365 extra days after Medicare benefits end.

Medical Expenses

As for Part B coinsurance, all Medigap plans offered in Texas pay for your portion of the 20 percent Part B coinsurance for Medicare. Generally, this includes doctor bills, hospital and home health care. Of course, these benefits will only begin after you have met your Part B deductible. Texas Medigap insurance also pays the coinsurance for out-patient drugs and inpatient respite care as long as you meet Medicare’s requirements, including a doctor’s certification of terminal illness. In addition, the first three pints of blood each year under Medicare parts A and B are covered under Texas Medigap basic benefits.

Plan D

In addition to the basic benefits, Plan D offers additional coverage. The entire Part A deductible is covered, as well as any copayments for skilled nursing facility care from the 21st day through the 100th day in a benefit period for post-hospital skilled nursing facility care eligible under Medicare Part A. 

Foreign Travel Emergency Care

Plan D also pays for foreign travel emergency care, so if you are out of the country and need medical care, you are covered. More specifically, plan D pays 80 percent of the billed charges for foreign emergency care- as long as Medicare would have covered the expenses had they occurred in the United States. Also, covered care must begin during the first 60 days outside the United States. The calendar year deductible is $250 and the lifetime maximum benefit is $50,000.

Choose Only Dependable, Reliable Insurance Providers

All Texas Medigap policies are guaranteed renewable regardless of who sells them. This means that regardless of your health, an insurance company cannot refuse to renew your policy unless you fail to pay your premium. Nevertheless, be choosy when deciding between insurance providers. The benefits provided for every Medigap Plan D offered in the state may be the same, but the insurance providers are not.  Always choose credible, reliable companies who have earned the trust of Texans. Remember, policies are guaranteed renewable but the amount of the premium is not. Trust Blue Cross Blue Shield of Texas or United of Omaha and make certain that your Medigap plan D will be there when you need it most.

Now that you know some of the benefits of a Medigap Plan D in Texas take a look at rates from our Texas Medicare Supplement website. We have been representing quality insurance products since 1993 working with names you know and trust like Blue Cross Blue Shield of Texas, United of Omaha, Aetna and many more.

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