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Private health insurers offer Medicare Supplement Plans. And while these plans are sold by private companies, the government ensures that all Medicare Supplement Plans with the same letter name provide the same benefit coverage throughout the country.
With that being said, premium prices will vary depending on the insurer you pick. So, it’s important that you compare Medicare Supplement Plans and providers in order to find the best plan for your needs and budget. Both can be compared with the help of EZ. But first, read our detailed explanation of Medicare Supplement Plans in Texas.
Texas Medicare Supplement Plans
If you need help paying for any coverage gaps in Original Medicare, you should look into a Medicare Supplement Plan.
If you live in Texas and are in need of a Medicare Supplement Plan, you should know that there are 10 different plans available to you. All of which begin with a different letter of the alphabet. All insurance companies are required to offer Plan A. However, Plans C and F are only available to those who became Medicare-eligible before January 1, 2020.
You’ll have to pay monthly premiums for a Medicare Supplement Plan. But in return you will get most (or almost all) of your out-of-pocket expenses covered. And in Texas premiums can cost just $51 to $603 a month, depending on your plan choice and where you live.
Plan A
Plan A is the most basic Medicare Supplement Plan on the market. But, despite its simplicity, it will cover what many consider to be the most vital thing that Medicare Supplement Plans can cover: the 20% of outpatient services that Part B does not cover. It also covers a few other vital basics that can greatly relieve the burden of your Medicare-related medical expenses.
All Medicare-approved health insurers must offer Plan A. But in some places, insurers do not have to do so for Medicare-eligible individuals under 65.
Plan A in Texas might cost anywhere from $94 to $603 monthly.
Plan B
Medicare Supplement Plan B covers everything that Plan A does, including:
- Medicare Part A coinsurance and hospital costs – Part A only fully covers your first 60 days of inpatient hospital stays in a benefit period, after that you are required to pay a portion of your bills for each day after your initial 60 days. So, days 61-90 have a coinsurance of $400 a day. If your stay is between 91 and 150 days, and you use your Lifetime Reserve days, your coinsurance will be $800 a day. Plan B covers 100% of these costs.
- Medicare Part B coinsurance or copay – You’ll typically have to pay Medicare Part B coinsurance for doctor visits and other outpatient care. That means Medicare Part B pays 80% of the Medicare-approved amount for covered services, leaving you to pay the remaining 20%. Plan B covers 100% of this.
- First 3 pints of blood – Original Medicare only pays for the fourth and subsequent pints of blood if you need blood during treatment. Plan B will pay for the first three pints.
- Part A hospice care and coinsurance – Hospice care is for patients who are nearing the end of their lives. These services are covered by Medicare, but copayments are required. These copayments include $5 for each symptom and pain relief medication prescription, as well as 5% of the Medicare-approved amount for inpatient assisted living. Plan B covers all expenses related to hospice care.
Plan B is less basic than Plan A, since it also covers the Medicare Part A hospital deductible, which Plan A does not. The deductible for Medicare Part A in 2023 is $1,600. Having a plan that covers this deductible could be quite helpful. Because it is not charged annually but rather based on 60-day benefit periods, meaning you may have to pay it more than once in a single year.
Costs for Plan B for Texas residents range from $116 to $311 a month.
Plan C
In terms of coverage, Plan C is one of the best Medicare Supplement Plans available, but not all beneficiaries are eligible to purchase it. Plan C covers everything except Part B excess charges, meaning it covers the 20% coinsurance for all outpatient care, as well as your Parts A and B deductibles.
Coverage includes the following:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B coinsurance and copayments
- Part B deductible
- Other Medicare-approved expenses associated with Part B coverage
Plan C is no longer available to Medicare recipients who became eligible for the program after January 1, 2020. If you had Plan C prior to January 1, 2020, you can keep it, and if you were Medicare-eligible then but did not enroll, you may be able to purchase it.
In Texas, Plan C premiums cost between $126 and $385 a month.
Plan D
Plan D covers the majority of out-of-pocket expenses associated with Original Medicare, including:
- Part A hospital coinsurance and hospital costs up to an extra 365 days after Original Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Part B coinsurance
- First 3 pints of blood
- Skilled nursing facility (SNF) care coinsurance – After the 20th day of your stay as an inpatient in a skilled nursing facility, Medicare Part A requires you to pay coinsurance. Part A coinsurance for skilled nursing facility care is $200 per day in 2023.
- Part A deductible
- 80% of foreign travel emergency costs (up to plan limits)
This means that Plan D covers almost everything, except Medicare Part B deductibles and excess charges. If your doctor does not accept Medicare assignment, they can charge you more than Medicare will cover for the service, and you will be responsible for the difference, known as an “excess charge”. So, if you think you will want to see providers who do not accept Medicare assignment, you should look into a plan that covers these excess charges.
Medicare Supplement Plan D premiums can cost between $118 and $268 a month in Texas.
Plan F
Plan F is the most popular Medicare Supplement Plan and has been for a long time, but it is no longer available to all beneficiaries. It is so popular because it is extremely comprehensive: if you have this plan, you only need to worry about the monthly Plan F premium. This plan covers:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B 20% coinsurance and copayments
- Medicare-approved doctor’s office fees
- Part B deductible
- Medicare Part B excess charges
- Other Medicare-approved expenses associated with Part B coverage
The one restriction is that people who became or will become Medicare-eligible after 2020 cannot enroll in Plan F. You can enroll in one of these plans if you became Medicare-eligible before 2020, and you can continue to keep Plan F indefinitely if you already have it.
Medicare Supplement Plan F premiums range from $117 to $442 per month depending on where you live.
Plan G
Plan G is worth considering if you’re interested in something like Plan F, but don’t meet the requirements to buy it. You’ll get nearly all the benefits of Plan F with Plan G, including coverage for:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
- Blood transfusion (first 3 pints)
So, Plan G covers everything except for the Part B deductible, and is typically more affordable than Plan F. Plan G premiums often cost less than Plan F premiums do, ranging in Texas from $95 to $419 per month.
Plan K
Medicare Supplement Plan K helps pay for some of the costs not covered by Original Medicare, but at a lower rate than other plans. Until you hit your annual out-of-pocket maximum, Plan K only covers 50% of some costs. Coverage includes:
- Medicare Part B coinsurance – Plan K covers half of these costs, so you will be responsible for 50% of your 20% Part B coinsurance. For example, if your doctor charges $100 for a service, Medicare will cover $80, Plan K will cover $10, and you will cover the remaining $10.
- First 3 pints of blood
- Part A hospice care coinsurance or copayment – Plan K will pay for half of these costs.
- Skilled nursing facility care coinsurance – Plan K pays half of the coinsurance for medical care in skilled nursing care facilities.
- Medicare Part A deductible – Medicare Supplement Plan K will pay half of these deductibles, or $800.
Plan K has higher costs compared to other plans. But unlike other plans (and Original Medicare), Plan K has an out-of-pocket maximum. With Plan K, your maximum annual out-of-pocket expenses are capped at $6,620 (as of 2023). So, after you spend this much, the rest of the year’s permitted expenses will be covered by Medicare Supplement Plan K. At the beginning of each new year, your maximum will be reset.
Plan K also pays 100% of the coinsurance associated with Medicare Part A, which is required for hospital stays longer than 60 days. This is the only basic benefit that Plan K fully covers.
Plan K has lower monthly premiums because of its higher out-of-pocket expenses: in Texas, premiums range from just $51 to $149 a month.
Plan L
Similarly to Plan K, Plan L helps pay some of the costs not covered by Original Medicare, but it covers them at a higher percentage than does Plan K. It also has an annual out-of-pocket maximum, which is lower than Plan K’s ($3,310 in 2023), after which your insurance company will begin covering everything in full.
Plan L is a pretty comprehensive Medicare Supplement Plan, covering 100% of Medicare Part A hospitalization and coinsurance costs. It also covers a percentage of the following:
- Medicare Part B coinsurance – Plan L covers 75% of your Part B coinsurance.
- Blood – If you require blood while in the hospital, Plan L will cover 75% of the cost of the first three pints.
- Part A hospice care copayments – Plan L pays 75% of your Part A copays for hospice care.
- Skilled nursing facility care coinsurance – Plan L pays 75% of the $200 per day (after the 20th day of your stay) coinsurance for medical care in skilled nursing care facilities.
- Part A deductible – Medicare Supplement Plan L will cover 75% of your Part A deductibles for each 60-day benefit period . You must still meet your Medicare Part B deductible, which is $226 per year in 2023, if you choose Plan L.
Plan L premiums cost between $64 and $224 a month in Texas.
Plan M
Medicare Supplement Plan M, like Plans K and L, helps with some but not all of the costs that come with having Original Medicare coverage. But, unlike these plans, it covers many expenses in full.
Medicare Supplement Plan M covers Medicare Part A hospital costs in full. Additionally, it covers:
- Medicare Part B coinsurance – Plan M pays your Part B coinsurance and/or copayments in full.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan M will cover the first three pints of blood in full.
- Part A hospice care coinsurance or copayment – Plan M will cover all of your hospice care coinsurance and copays in full.
- Skilled nursing facility care coinsurance – Plan M covers the entire cost of Part A skilled nursing facility coinsurance.
- Part A deductible – Medicare Supplement Plan M will cover half of your Medicare Part A deductible. If you have Plan M, you will have to pay half of the $1,600 (or $800) deductible rather than the full $1,600.
Prices for Plan M premiums range from $75 to $210 a month in Texas.
Plan N
Medicare Supplement Plan N covers most of the gaps in coverage in Original Medicare. The only exclusions are the Part B deductible and any Medicare Part B excess charges, or portions of doctor bills that exceed the Medicare-approved amount. But unlike with other plans, you might have to pay a copayment for some services.
This means Medicare Supplement Plan N covers all of the following:
- Medicare Part B coinsurance – Plan N will cover your Part B coinsurance costs in full, with the exception of a copayment of up to $20 for some office visits. For emergency room visits that do not result in an inpatient admission, a second copayment of up to $50 may be required.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan N will cover the first three pints.
- Part A hospice care coinsurance or copayment – Plan N pays your hospice care coinsurance and copayments in full.
- Skilled nursing facility care coinsurance – Your skilled nursing facility coinsurance will be fully covered by Medicare Supplement Plan N.
- Part A deductible – Medicare Supplement Plan N pays your $1,600 deductible in full for each 60-day benefit period.
- Foreign travel emergency care – Original Medicare typically does not cover medical care received outside of the United States. If you need emergency care while traveling outside of the United States. Medicare Supplement Plan N will cover 80% of the costs of qualified emergency medical care.
Prices for Plan N can range from $77 to $400 a month in Texas.
When To Enroll
While there is no set annual enrollment period for Medicare Supplement Plans, federal rules allow you a one-off six-month period. During which you will be given guaranteed-issue access to a Medicare Supplement Plan. Having guaranteed-issue rights means that insurance companies will not be able to deny you or charge you more for coverage. This six-month period begins when you turn 65 and enroll in Medicare Part B.
It’s important to note that federal rules do not guarantee access to Medicare Supplement Plans for people under 65. But most states, including Texas, have rules that ensure that disabled Medicare recipients have some access to Medicare Supplement Plans. Texas law says that Medicare Supplement insurers must offer at least Medicare Supplement Plan A to disabled Medicare Part B enrollees under the age of 65 for the first six months after they sign up for Medicare Part B.
How To Choose
When it comes to Medicare coverage, don’t be afraid to ask questions. Speak to an EZ agent who can explain everything and give you guidance on enrolling. EZ can assist you in enrolling in Medicare, comparing Medicare Supplement Plans, or simply weighing your options. Our agents work with the best insurance companies in the country. So, they can provide you with a free comparison of all available plans in your area. We will go over your medical and financial needs and help you find a plan that works for you. To get started, simply enter your zip code in the bar below or give one of our licensed agents a call at 877-670-3602.
