Medicare Hints and Tips

• All Texas Medicare Supplements are guaranteed renewable. A company cannot cancel your policy or refuse to renew it unless you made intentional false statements on your application or you failed to pay your premium. However, the amount of the premium is not guaranteed. An insurance company may raise your premium as often as once a year on a class basis. In addition, if you have an attained-age policy, a company may raise your premium on your birthday.

• Medicare Supplement Claims - Your doctor and other health care providers must submit Medicare claims to the appropriate carrier or fiscal intermediary for you. In most cases, the carrier or intermediary will send your Medigap claim directly to your insurance company. You should not receive a bill from your provider! Texas law requires insurance companies to pay claims promptly. If your Medigap company refuses to pay a claim for a Medicare approved charge or delays payment of your claims, you or your provider may file a complaint with the Texas Department of Insurance.

• Texas Medicare supplements allow you to choose any doctor and any hospital anywhere in the US. Unlike HMO's, you do not need a referral or pre-authorization to see a doctor or to be admitted to a hospital. They allow you to be in charge of your health care.

• When you first receive Part B of Medicare you have a six-month period called "Open Enrollment". During this time you can purchase Texas Medigap insurance plans without having to answer heath questions.

• All companies offering Medicare supplements in Texas have automatic claims filing. You should not have to worry about filing a claim with Medicare or your insurance company.

• Medicare has an annual deductible of $198 in 2020 for Part B charges. Some policies pay this deductible but you may pay more than $198 in additional premium each year if you select a policy that provides this benefit.

• Typically Medicare does not pay for routine Nursing Home Care. Be sure you thoroughly understand the Skilled Nursing Benefit in Part A of Medicare.

• All Medicare supplement insurance companies will pay your claims. Medicare must first approve your claim. If Medicare does not approve your claim your Texas Medicare Supplement Policy will not pay.

• Check with your doctors to see if they "Accept Assignment".  If all of your doctors "Accept Assignment" you may not need to spend the extra money for Plans that pay for Excess Charges.

• If you currently have a Texas Medicare supplement policy and switch to a different policy or a different insurance company there cannot be a waiting period imposed for pre-existing conditions. You may, however, have to answer health questions on the application. If you cannot answer the questions successfully the company will not issue the policy.

• For a Medicare supplement insurance plan in Texas, you have a 30 - Day Free Look period. You can return your Medigap insurance policy within 30 days and get your money back with NO questions asked.  Be sure to keep a record of the date you received the policy.  Read the policy as soon as you get it.  If you return the policy to the company, use certified mail with a return receipt to prove that it was returned within the 30 day time limit. 

• Insurance agents work on straight commission. The more expensive the policy is that they sell you, the more money they make. Make sure the agent has your best interests in mind, not the amount of commission they will make.