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Numerous senior citizens in the US rely on government-backed programs to financially protect them whenever they come face to face with a medical emergency. Several surveys reveal that 41% of working-age US citizens – almost 72 million people – are currently dealing with medical debt and owe more than $10,000.

Medical debt isn’t limited to a single demographic but equally affects every single US citizen who is afflicted with a chronic ailment or has disabilities.

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Medicare Options in Texas

Every person enrolling in Medicare must choose between one of the following Medicare programs.

Original Medicare

Original Medicare, also known as traditional Medicare is regulated by federal law and is one of the most popular healthcare options among the people of Texas.

The Original Medicare plans consist of two parts: Part A and Part B.

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Private Fee-For-Service (PFFS)

This Medicare Advantage health plan is offered by State-licensed organizations that have contracts with the Centers for Medicare & Medicaid Services (CMS).

The PFFS plan pays in-network providers on a fee-for-service basis so the providers aren’t on the brink of financial risk. This service also does not restrict the member’s choices among the providers that have the lawful authorization to offer their services.

Any provider who agrees to the terms and conditions of Medicare is eligible for these Medicare benefits. Prescription medication coverage is included in most plans but you can also sign up for a drug plan separately.

PCP and a specialty referral are not required and there are higher premiums when opting for an out-of-network provider.

Special Needs Plan (SNP)

The special needs plan only allows membership to people who have been diagnosed with specific chronic conditions and characteristics. This plan includes tailored healthcare benefits, drug formularies, and provider choices that have been specifically chosen to meet the special needs of these individuals.

To become eligible, you need to be enrolled in Medicare Part A or Part B plans or have a chronic condition like AIDs/HIV, diabetes mellitus, cancer, auto-immune disorders, cardiovascular diseases, or a neurological disorder.

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Medigap Supplement – Supplemental Healthcare

Medigap or Medicare Supplement plans are a secondary health insurance plan that is funded by private insurance companies.

The Original Medicare only provides coverage for 80% of the inpatient and outpatient care. This is why many people in Texas like to purchase Medigap to get coverage for any gaps left in the Original Medicare plan.

Each policy in this program is labeled from A to N. To become eligible for Medigap you;

  • Must already be enrolled in the Original Medicare plan
  • Must be 65 years old or older
  • Under 65 and regularly receiving disability benefits from Social Security or the Railroad Retirement Board
  • Under 65 but diagnosed with amyotrophic lateral sclerosis
  • Under 65 and diagnosed with end-stage renal disease(ESRD)

Medigap provides all the basic benefits of the traditional Medicare plan including additional coverages like coverage for Part A and Part B deductibles, hospice care copayments and coinsurances, Medicare preventive care deductibles, and three pints of blood.

Medigap also pays for any foreign travel medical emergencies, skilled nursing facility deductibles, Part B excess charges, and out-of-pocket yearly limit.

Medigap insurers use three methods to set their premiums.

Issue Age Rating

This method for calculating premiums depends on the enrollee’s age and is less costly for younger buyers. The overall costs are never affected by the individual’s age.

Attained-Age Rating

In this approach, the premiums get higher as the person advances in age. These premiums are less costly for younger subscribers and many insurance companies tend to use this method to set premiums.

Community Rating

This method has been mandated in 8 US states while many insurers tend to avoid it. Premiums do not get affected by the enrollee’s age.

When going through the lengthy process of signing up for Medicare, it’s not uncommon for many people to feel overwhelmed and intimidated. But our Medicare insurance agents are dedicated to simplifying this process for you. We make sure to go the extra mile for our clients and help them devise the most efficient healthcare plans that are within their budget and meet all of their needs.

To learn more about the different Medicare plans available in Texas, you can go through our resources and find comprehensive guides on how to sign up for Medicare. You can also use our Medicare plan finder tool to check out all the Medicare Advantage plans available in your area.

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Medicare Enrolment in Texas

Medicare immediately registers you to receive healthcare benefits if you have received at least four payments from the Railroad Retirement Board or Social Security before your 65th birthday. If your registration has been delayed, you can always reach out to your local Social Security office and apply online.

You can apply for Medicare in the following time frames.

Initial Enrolment

The initial enrolment period starts three months prior to and ends three months after your 65th birthday. You can initiate your application process during this time frame, or change and upgrade your current plan.

General Enrolment

If you missed the initial enrolment period, you can sign up for Medicare during the general enrolment period which begins on January 1st and ends on March 31st. During this time, you can opt for Part A, Part B, Medicare Advantage, Medigap, and Part D plans.

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Why Choose Medicare Hope Insurance at Integrity Now Insurance Brokers?

Our Medicare insurance agents at Integrity Now Insurance Brokers are certified, high-qualified, and have years of experience when it comes to helping clients land well-rounded health insurance plans.

Our independent Medicare insurance agents offer free of charge assistance and will guide you line by line through every insurance policy to help you find the one that is best suited to your needs and requirements.

With our access to top-rated Medicare insurance providers, we assure you that you are in safe hands. You can rely on us to connect you with the best insurance agencies that are right for you.

Book a one-on-one consultation today by giving us a call and our representative will help you compare quotes and provide you with all the details that you require.

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