Medicare Supplement Plans in Texas: Guaranteed Issue Explained

Medicare is a federal program that offers health insurance to the elderly and disabled. However, some federal laws allow states to make changes. The guaranteed issue rights for Medicare supplements are different from state to state, including Texas.

About Medicare Supplements

• A Medicare supplement is better known in the insurance industry as a Medigap policy. This is designed to fill some of the gaps in coverage in standard Medicare. Plans are available at different levels, assigned by the letters A through N. Each level has different benefits at a different cost.

Federal Guaranteed Issue Rights

• According to federal law, only those 65 years of age and older are guaranteed the right to purchase a Medigap, which is called guaranteed issue. They have guaranteed issue rights for the first six months following their 65th birthday and Part B enrollment for 63 days following any qualified loss of insurance coverage.

Texas Guaranteed Issue Amendments

• States are allowed to expand on the federal guaranteed issue rights. Texas requires insurance companies to extend these rights to Medicare beneficiaries under 65 years of age for the Medigap policy Plan A only.

Considerations

• While those under 65 may not be guaranteed the right to purchase a Medigap, that does not mean that an insurance company will not sell them a plan.