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Medigap Supplement Insurance

Shopping Wisely for Medicare Supplement Insurance

  • Buy during open enrollment. The best time to buy a Medicare supplement policy is during your Medicare open enrollment period because companies must sell you any plan they offer without looking at your past or present health conditions.
  • Shop around. Prices can vary considerably. Use the rate guide section of this handbook to compare the company prices for the plans that interest you.
  • Consider other factors. Price should not be your only consideration. You can learn a company´s complaint record and A.M. Best financial rating by calling TDI´s Consumer Help Line. Both are important indicators of the service you can expect from a company. Your family and friends are other sources of information about a company´s customer service. Ask them if they have had any experiences with the companies you are considering.
  • Consider your needs. Although it is illegal to sell you more than one Medicare supplement policy, insurers may offer other policies with benefits that work differently than Medicare supplement coverage. These include cancer, specified disease, hospital indemnity, and long-term care policies. Any duplication of benefits must be disclosed in writing. In general, duplicate coverage wastes money because you are paying twice for the same coverage.
  • Look into Medicare Part D prescription drug coverage. If you have a Medicare supplement plan that includes prescription drug coverage, consider getting a stand-alone Medicare prescription drug plan. The prescription coverage in Medicare supplement H, I, and J plans are not as good as a stand-alone, Part D Medicare drug plan.

Protect Yourself

  • Make sure the agent and company are licensed. You can verify company and agent licenses by calling TDI´s Consumer Help Line.
  • Try to buy from an agent you know and trust. Ask friends or family for recommendations.
  • Ask questions and take notes when you talk to an agent. These could help you later if there is a dispute over what you were told about a policy.
  • Don't buy a policy on the agent's first visit. Invite someone you trust to be present during the second visit. An agent shouldn't object.
  • If an agent tries to rush you, be suspicious. Tell the agent you need more time.
  • Read what you are asked to sign before you sign it. Never sign a blank application form.
  • Obtain the names and addresses of the agent and the insurance company. Know how to contact the agent and the company if you have questions.
  • Answer all questions on the application accurately. If an agent helps you complete the application, make sure the information is correct and complete before you sign. Leaving out information or lying could cause the company to deny your claims or cancel your policy.
  • Do not pay cash or make a check out to an agent. Always pay by check or money order so you have a clear record of payment. Make checks payable only to the insurance company. Ask for a receipt on the company's letterhead that the agent has signed.
  • Before making a lump-sum payment, ask the agent or company about reimbursement of unearned premium. This is especially important during the open enrollment period when you have the right to change companies.
  • Read your policy carefully when you receive it. You can return a policy for any reason within 30 days and receive a full refund.

Unfair Practices

Agents and companies who engage in any of the following activities are breaking the law:

  • Knowingly making misleading statements to encourage you to drop a policy and buy a replacement from another company. This is called twisting.
  • Using high-pressure tactics, including the use of force, fright, or threat to pressure you into buying a policy.
  • Obtaining sales leads through advertising that hides the fact that an agent or company may try to sell you insurance. This is called cold lead advertising.
  • Using misleading advertisements made to look like mail from the government by using eagles or similar graphics or a return address with a name that sounds like an official government agency or bureau.
  • Acting as a representative of Medicare or a government agency.
  • Selling you a Medicare supplement policy that duplicates Medicare benefits or health insurance coverage you already have. An agent is required to review and compare your other health coverages.
  • Suggesting that you falsify an application.

If you believe that an agent or company has engaged in unfair and illegal practices, file a complaint with TDI.

How to Use the Rate Guide 

The companies in the rate guide are licensed to sell their Medicare supplement plans in Texas. The Medicare Select companies, however, only sell only in certain areas of the state.

For information about a company’s plans, call the company at the toll-free number listed in the guide or call an agent. Check your phone book for the phone numbers of agents in your area. If a company has a website, the address is included in the guide.

The rate guide includes only companies that are actively selling Medicare supplement plans. If you can’t find your plan in the guide, your company may no longer be selling the plan you purchased.

Organization of the Rate Information

The rate guide is organized into separate rate tables for each of the 10 Medicare supplement plans. The tables include an alphabetical listing of the companies selling that particular plan, along with policy information and rate estimates for people of various ages.

The last table shows rate and policy information for companies that sell Plan A for people under age 65 with disabilities. The number of companies selling each plan varies. All companies must offer Plan A, but they do not have to offer any of the other plans. The guide also identifies companies that offer a high-deductible option for plan F.

Information in the Rate Tables

Rates: The rates shows are estimates given to TDI by the companies. The first number in the range is the lowest estimated annual premium and the second number is the highest estimated annual premium. Your premium should fall somewhere within the range.

The exact premium you will pay will likely vary from the estimates and will be based on your individual circumstances. Rates also vary if you pay monthly or quarterly. The rates listed assume that you pay your annual premium in one lump sum. To learn the exact premium you would pay, call your agent or the company.

If you have an issue-age policy, your premiums are based on your age at the time you buy. Companies may increase issue-age policy premiums once during your first year of coverage. After that, the company may not increase the premium for 12 months. If you have an attained-age policy, your premium could increase within the first 12 months and will increase on your birthday. Few, if any, companies in Texas offer community rated policies, which charge the same rate to all policyholders.

Some companies base rates on the ZIP code where you live. Medicare supplement rates are set by insurance companies, and are subject to approval by TDI. Companies can obtain approval for rate increases at any time during the year.

Age: Rates are shown for people buying a plan at ages 65, 70, and 75. You should compare costs at different ages. For people under 65 with disabilities, only one rate estimate is given.

Preexisting conditions: In most cases, an insurance company may impose a waiting period of up to six months before it covers preexisting medical conditions. The number of months you must wait before a policy covers preexisting conditions is shown in the column labeled “Preex Wait” in the rate tables.

If you move from one Medicare supplement policy to another, the time you were covered under your prior policy will be credited toward your preexisting condition waiting period. If you have had a policy for at least six months, your new policy will not have a waiting period for preexisting conditions. If you are 65 or older, had an employer health insurance plan for at least six months, and purchase a Medicare supplement policy within 63 days of leaving your employer plan, you should not have a waiting period for preexisting conditions.

Group plans: You must be a member of a group, association, or organization to get group insurance coverage. In general, rates for group coverage are lower than rates for individual policies. Group plans in the rate guide are listed by plan letter after the individual policies.

Disability under age 65 and other plans: This table lists companies that offer additional plans to people under age 65 with disabilities. Since Texas law requires companies selling Medicare supplement policies to offer Plan A, people with disabilities must meet a company’s guidelines to be eligible for any of the additional plans the company offers. 

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