Filling the Gaps: What To Know About Medicare Supplement Insurance (Medigap)
For many Texans, Original Medicare (Parts A and B) is a big part of how they get health care coverage. But it doesn’t cover everything. You still have to pay things like copays, coinsurance, and deductibles which can add up. That is where Medicare Supplement Insurance, also called Medigap, steps in. It helps cover some of those extra costs so you can avoid surprise bills and better plan your healthcare expenses.
At Rollo Insurance, we want to help you understand how Medigap works and whether it might be a good fit for you.
What is Medicare Supplement Insurance?
Medigap is a private insurance policy you buy to fill in the “gaps” left by Original Medicare. Here is how it works. Medicare pays its share first, and then your Medigap policy kicks in to cover some or most of the rest.
Some Medigap plans even help with care when you travel outside the U.S., which Original Medicare does not cover.
Important Things to Keep in Mind
- Medigap only works with Original Medicare and does not replace it. So, you cannot have both a Medigap plan and a Medicare Advantage plan at the same time.
- You will pay a monthly premium for your Medigap policy, on top of the Medicare Part B premium.
- Each policy covers just one person, so couples each need their own.
- Medigap policies are guaranteed renewable. As long as you keep paying premiums, your insurer cannot drop you because of health issues.
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Do You Really Need Medigap?
Original Medicare covers a lot, but you are still responsible for part of the costs. For example, Medicare Part B covers 80 percent of doctor visits, leaving you with 20 percent. If you have big medical bills, that 20 percent can be a lot.
Medigap helps make those costs more predictable so you do not get hit with unexpected bills. It also lets you see any doctor or hospital that accepts Medicare anywhere in the country without networks or referrals. This flexibility can be important if you travel or have preferred doctors.
What About If You Have Medicaid Too?
If you qualify for full Medicaid, you probably do not need Medigap. Medicaid usually covers the costs that Medicare does not, including copays and deductibles. Insurance companies generally will not sell Medigap to people with full Medicaid because it would overlap.
If you have both Medicare and Medicaid, called “dual eligible,” it is a good idea to talk to an expert who knows both programs to make sure you are getting the coverage you need without paying for something extra.
What Does Medigap Cost in Texas?
Medigap costs vary quite a bit based on:
- The type of plan you choose. Some offer more coverage than others. Plan G is popular for its broad coverage.
- Your age. Premiums usually go up as you get older.
- Where you live in Texas. Costs can vary by county or ZIP code.
- Which insurance company you choose. Even for the same plan, prices can differ.
- When you apply. If you wait past your initial enrollment window, you might face higher premiums or be turned down due to health issues.
To give you a rough idea, a 65-year-old in Texas might pay anywhere from $100 to $300 a month for common plans. Some high-deductible plans start lower, maybe around $50, but you would pay a big deductible yourself before coverage kicks in.
Getting personalized quotes is the best way to find the right fit and price for you.
Is Medigap Premium Tax Deductible?
Sometimes it can be, but it depends on a few factors:
- You usually have to itemize deductions on your tax return.
- Your total medical expenses need to be more than 7.5 percent of your adjusted gross income.
- If you are self-employed and your business makes a profit, you may be able to deduct your premiums without meeting the 7.5 percent rule, as long as you do not have other health coverage through an employer.
Tax rules can be tricky, so talking with a tax professional is always a good idea.
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Planning Your Healthcare with Confidence
Medigap is one way to bring more certainty to your healthcare costs in retirement. At Rollo Insurance, we are here to help Texans understand their options and choose the Medigap plan that fits their needs best. Reach out to us anytime for a consultation and let us make sure you have the coverage you need for peace of mind.
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