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Your Guide to MACRA

What is MACRA?

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) changes some of the Medicare supplement plans people new to Medicare can purchase.

The rule says that as of January 1, 2020, newly-eligible Medicare beneficiaries won’t be able to purchase Medicare supplement plans that cover the Part B deductible. These are Medicare supplement Plans C, F, High-Deductible F and Minnesota and Wisconsin Part B deductible coverage.

For MACRA purposes, “newly-eligible” people are those who become eligible for Medicare on or after January 1, 2020.

How does this affect you?

If you’re Medicare-eligible before January 1, 2020


Your plan options covering the Part B deductible don’t change. That is, Medicare supplement Plans C, F and High-Deductible F will still be available to you where offered.

If you currently have a Medicare supplement insurance plan:

  • Your policy benefits don’t change
  • Your Medicare supplement Plan C, F or High-Deductible F will continue paying your Part B deductible
  • Your policy will continue as long as premiums are paid on time

If you’re eligible for Medicare on or after January 1, 2020


When you select Original Medicare for your health care coverage, you’ll be able to choose from many Medicare supplement plans available where offered. Benefits will vary, but no plan will cover the Medicare Part B calendar-year deductible ($185 in 2019).

Information provided by Mutual of Omaha.

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Medicare Insurance, MACRA Info, Medigap, Supplement Insurance Plans, Services, Costs and Quotes in East Texas

By choosing the right Medicare Supplement Insurance Plan you will have:

  • No Deductibles
  • No Co-Pays
  • No Network
  • No Referrals Necessary
  • No Complicated Claim Forms
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A Guide to Comparing Medigap Policies

Choosing the right Medicare Supplement (Medigap) plan is a critical decision for ensuring comprehensive healthcare coverage. With various options available, understanding how to compare policies effectively is key. Here’s a guide to help you navigate the process.

Understanding Standardized Medigap Plans

Medigap policies are standardized, meaning that each plan (designated by a letter, such as Plan G or Plan N) offers the same basic benefits regardless of the insurance company selling it. For example, a Plan G from one company provides the same medical coverage as a Plan G from another. This standardization simplifies the comparison process, allowing you to focus on other important factors.

While the benefits for each plan letter are the same, it's important to note that Massachusetts, Minnesota, and Wisconsin have their own standardized Medigap plans.

Key Factors for Comparing Medigap Policies

When comparing Medigap plans, consider the following:

  • Premiums: While the coverage is standardized, the premiums charged by different insurance companies can vary significantly for the exact same plan. It is crucial to compare quotes from multiple providers to find the most competitive rate.
  • Company Reputation and Service: Look into the reputation of the insurance company. Consider factors such as their financial stability, customer service ratings, and history of rate increases. A company with a strong track record can provide peace of mind and reliable support.
  • Your Healthcare Needs: Assess your current and anticipated healthcare needs. While a comprehensive plan like Plan G may be suitable for many, your individual health status and budget will influence the best choice for you.
  • Eligibility and Enrollment: Remember that your ability to purchase a Medigap policy is guaranteed during your Medigap Open Enrollment Period. This six-month window begins on the first day of the month in which you're 65 or older and enrolled in Medicare Part B.

How Emerson Insurance Can Help

Navigating the complexities of Medigap can be challenging. At Emerson Insurance, we specialize in helping individuals find the right Medicare Supplement plan for their unique needs and budget. We can provide you with:

  • Free, No-Obligation Quotes: We'll help you compare rates from top-rated insurance companies.
  • Expert Guidance: Our experienced agents will answer your questions and help you understand the differences between plans.
  • Personalized Recommendations: We'll work with you to identify the Medigap policy that offers the best value and coverage for your situation.

Contact us today at 903-592-8100 or toll-free at 800-533-0653 to get started. You can also request free quotes online.

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Medigap Plans

Note: The Medigap policy covers coinsurance only after you've paid the deductible (unless the Medigap policy also pays the deductible).

Compare Medigap plans side-by-side

The chart below shows basic information about the different benefits Medigap policies cover.
No = the policy doesn't cover that benefit
% = the plan covers that percentage of this benefit
N/A = not applicable

Medigap Benefits Medigap Plans
A B C D F* G K L M N
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
Part B coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%***
Blood (first 3 pints) 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Part A hospice care coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Skilled nursing facility care coinsurance No No 100% 100% 100% 100% 50% 75% 100% 100%
Part A deductible No 100% 100% 100% 100% 100% 50% 75% 50% 100%
Part B deductible No No 100% No 100% No No No No No
Part B excess charges No No No No 100% 100% No No No No
Foreign travel exchange (up to plan limits) No No 80% 80% 80% 80% No No 80% 80%
Out-of-pocket limit** N/A N/A N/A N/A N/A N/A $5,880 $2,940 N/A N/A

* Plan F also offers a high-deductible plan in some states. If you choose this option, this means you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount determined by Medicaid, before your policy pays anything.  

** For Plans K and L, after you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.

*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission. 

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The 2003 Medicare Modernization Act

Due to the 2003 Medicare Modernized Act, which went into effect in June 2010, there were some changes regarding the standardized Medicare Supplement Plans. These changes did not affect Medicare beneficiaries who are already enrolled in a Medigap Plan prior to that date, and only apply to people who enrolled effective June 1, 2010 and after.

Learn More About The 2003 Medicare Modernization Act