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New to Medicare - Turning 65

New to Medicare - Turning 65

Did you just turn 65, or are you about to? Are you new to Medicare and trying to understand your options? Entering in to Medicare can be a very confusing and daunting task if you do not have some on your side that can help. Do you have the right Medicare Parts (A, B, C, and/or D)? Which Medigap Insurance Plan is the best for me (Plans A, B, C, D, F, G, K, L, M, or N)? What is the difference between a Medigap Insurance Plan and a Medicare Advantage Plan? This is where Texas Healthcare Specialists, Inc. can help by having an agent on your side to help you understand the rules and best possible routes to go when making sure that you are covered the right way with Medicare.

Helpful points to keep in mind when buying Medigap Insurance

  • Purchase a Medigap Plan during your Open Enrollment. The best time to purchase a Medigap policy is during your Medicare Open Enrollment Period, which start the 1st day of the month your Medicare Part B effective date begins and last for 6 months (this can either be when you turn 65 or older if your Part B starts at a later date), or the Guaranteed Issue Period. By doing this, companies cannot refuse you coverage because of pre-existing conditons.
  • Use an independent agent that has an insurance portfolio of more than just a few policies. True independent agents or agencies will make sure to offer their clients many choices that are available, and do side by side comparisons of price and benefits. Even though all Medigap insurance plans are standardized, prices for the same plan can vary between insurance companies.
  • Financial Stability - When choosing a Medicare supplement insurance company, always look in to the financial stability, as well as the number of complaints of the insurance company. Always ask or do research on the A.M. Best Financial rating and other rating companies. You can usually get this information from your state department of insurance.

During your Open Enrollment Period or Guaranteed Issues Period, which by definition is 6 months before and after your effective date of you Medicare Part B, an insurance company is not allowed to medically underwrite your policy. This means the insurance company cannot do any of the following:

  • Refuse to sell you any Medigap policy it has available
  • Make you wait for your coverage to start
  • Charge you more for a Medigap policy because of any health conditions

The insurance companies cannot make you wait for your coverage to begin, but they may be able to make you wait for coverage of a pre-existing condition. A pre-existing condition is a health condition you have before your Medigap insurance policy starts. In certain cases, the insurance company can refuse to cover your out-of-pocket costs for these pre-existing health problems for up to 6 months. This is called a "pre-existing condition waiting period." Coverage for a pre-existing condition can be excluded from your Medigap policy if the condition was treated or diagnosed within 6 months before your new Medigap policy begins.

If you buy a Medigap policy during your Medigap Guaranteed Issue Period and you recently had certain kinds of health coverage in place that offers a "Creditable Coverage" Letter, it is possible to avoid or reduce waiting periods for pre-existing conditions. Creditable Coverage is generally any other health coverage you had before applying for a Medigap policy. Make sure you do not wait more than 63 days to find and become effective on your Medicare supplement, this will keep Medigap insurance companies from making you wait before it covers your pre-existing conditions.

If you buy a Medigap policy during a Guaranteed Issue Period (also called "Medigap Protection"), the insurance company cannot use a pre-existing condition waiting period at all.

Contact an agent today with Texas Healthcare Specialists, Inc. to learn more about your Medicare insurance coverage options and please fill out our free, no-obligation Texas Medicare Supplement Quote Form to receive a side-by-side comparison of affordable Medicare supplement plans in your area.

    Texas Healthcare Specialists, Inc. is not connected with or endorsed by the United States Government or Federal Medicare Program. We do not offer every plan available in your area. Any information we provide is limited to those plans we provide is limited to those plans we do offer in your area. Please contact or call 1-800-MEDICARE to get information on all your options.

    Texas Healthcare Specialists, Inc.
    1530 Sun City Blvd, Suite #140 Georgetown, TX 78633

    Direct: 512-868-4469


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