Why You Need Medicare Supplement Insurance

Medicare is a federal program to help older Americans and some disabled Americans pay for the high cost of health care. However, Medicare was never intended to cover all your health care costs. So even if you’re covered by Medicare, you are still responsible for a large portion of your health care costs.

What Medicare Doesn’t Cover

Medicare does not cover all health care costs. Medicare coverage consists of Part A (which covers hospital and skilled nursing facility care), and Part B (which covers doctor bills and other medical expenses).

Even with Medicare Part A and Part B coverage, you’re responsible for some out-of-pocket expenses including:

• Part A Hospital deductible ($1,024)
• Copayments for hospital stays over 60 days
• Care in a skilled nursing facility after 20 days
• Part B deductible ($135)
• Twenty percent coinsurance for doctor bills and other Part B medical expenses

Without Medicare Supplement insurance, your out-of-pocket costs could add up to more than $49,600 this year alone.

Supplementing Medicare

Private insurers offer Medicare Supplement insurance to help fill in the gaps for hospital and medical expenses Medicare does not pay.

By law, Medicare Supplement insurance is standardized into 12 plans (Plans A through L). That means Plan F from one company must include the same benefits as plan F from another company. While the benefits must be the same, each company’s rates, reputation, membership features and quality of service can vary.

Will You Be Eligible for Medicare Soon?

If you’re a Texas resident nearing your 65th birthday, it’s time to start planning for your new health care coverage needs.

 Three to six months before your 65th birthday:

• Become familiar with Medicare, what it covers and what it doesn’t cover.
• Research the Medicare Supplement insurance plans that can help fill the cost gaps in Medicare.
• Make sure your doctor participates in Medicare.

One to three months before your 65th birthday:

• Enroll in Medicare: Although enrollment in Medicare Part A is automatic, it’s a good idea to apply by calling your local Social Security office.
• You can apply for Medicare as early as three months before your 65th birthday.
• Your application can be taken at your local Social Security office, over the phone or online.
• Medicare Part B is optional*, but you should not turn it down unless you have primary insurance from another source.
• Consider which Medicare Supplement insurance plan you will choose to help cover Medicare’s cost gaps; then you should have a solid program in place by your 65th birthday.

*Part B is required for Blue Cross and Blue Shield of Texas Medicare Supplement insurance.

On your 65th birthday

Celebrate! If you’ve followed these simple steps, you’ll have solid health care protection in place to help keep you secure and reduce your out-of pocket expenses.

Medicare Disabled Plan (Plan A)

If you are under age 65 and Medicare Disabled, Blue Cross and Blue Shield of Texas has an option for you. To be eligible for coverage, you must be under age 65, reside in Texas and have Medicare Parts A and B. You must also apply within six (6) months of your Medicare Part B effective date, or qualify as an Eligible Person. If you meet these conditions, Plan A is Guaranteed Issue. For more information, please call us at 1-800-654-9390.