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Texas Medicare Plans - Frequently Asked Questions

Who is Consumer Benefits Group, LLP?

We are a family-owned independent insurance agency specializing in Texas Medicare supplements, Texas Medicare Advantage plans and Texas Part D prescription drug plans. Read more about our experience and certifications on the About Us page of this website.

What is the charge for your services in helping me select a Texas Medicare plan?

There is no charge whatsoever. In Texas, independent Medicare insurance agents  are compensated by the Medicare insurance carrier with whom you choose to apply. The premium that you pay for any policy has a built-in commission charge that is paid to the insurance agent who assists you with your application. This commission is paid so that the agent will provide service to your policy not only at application time, but also ongoing in the future.( If you do not use an agent, you still pay this commission charge regardless, but you now have no agent to assist you with your ongoing needs.)

If you choose a Medicare Advantage plan with no premium, then the insurance company still compensates the agent for referring you to that company's plan.

Does the Texas Medicare policy insurance carrier charge me a higher premium for using an agent?

Absolutely not. The premium you pay to the insurance company you choose is EXACTLY the same, whether you work with an agent or whether you apply directly with the insurance carrier. However, if you apply directly with the carrier, you still pay the commission charge but now you have given up your right to a dedicated insurance agent to represent you at claim time. It is in your best interest to choose an agent who will service and support your policy and represent your interests in the future when claims questions may arise.

I'm new to Medicare and trying to understand the differences between Medicare Supplements and Medicare Advantage plans. Can you help me?

Yes. As licensed insurance agents specializing in Medicare-related insurance products, we are happy to conduct what we call "Medicare 101" with you, either in person or by telephone. We can explain what your original Medicare covers, what it doesn't, and what your options are. During this conversation, rest assured that we will not try to sell you anything. We consider it our job to help consumers understand their options. If we earn your trust by helping you understand, then we hope that you will want us to be your agent whenever you are ready to select a policy.

Which plan is better for me - a Medicare supplement or a Medicare Advantage plan?

This is a very personal decision, and the answer will vary based on your individual needs, concerns and budget. Medicare supplements work very differently from Medicare Advantage plans. Often we find that determining which type of plan is best for you will depend on your age, where you live, how much travelling you do, and your level of desire to control your own medical spending. You may also need to evaluate cost savings versus potential out-of-pocket costs for each plan. Finally, it's important to find out which types of plans are accepted by your preferred medical providers, so that you can be sure the plan you select allows you to continue treating with those providers, if that's important to you.

Does a Medicare supplement pay for things that Medicare does not?

Yes and no. Supplements are designed to fill in the gaps that Medicare does not cover, such as deductibles and copayments that you are responsible for under original Medicare. However, Medicare supplements generally do not pay for things that are outside the realm of Medicare-covered services - such as cosmetic procedures, dental, vision, etc.

Your Medicare supplement will only pay after Medicare first pays it's share of any claim. If Medicare denies a claim, the supplement is not allowed to cover any cost of that claim either.

What is Medigap?

Medigap is just another term for a traditional Medicare supplement.

Why do different insurance companies charge different prices for the same Medicare supplement plan?

Although Congress standardized Medicare supplements back in the 90's to eliminate consumer confusion, each insurance company still gets to choose which of the standardized plans it will offer to the public, and what rates they will charge for each plan. Some carriers have better rates than others. This is why working with an independent insurance agent who is not employed by any one insurance company can benefit you.

As an independent Texas insurance agency, we shop numerous carriers to compare rates for you so that you can select an insurance company that offers not only the plan you want, but offers it at a reasonable price.

In addition, each year as the inevitable rate increases occur with each carrier, you can call us for help to shop your policy and determine whether applying elsewhere might help you to save premiums.

I am over age 65 and I missed my open enrollment window. Can I still get a traditional Medicare supplement?

Yes, with certain restrictions. After your open enrollment period has passed, you will generally have to answer health questions on your Medicare supplement application, unless you have a special circumstance such as just now leaving an employer group health plan. The underwriter at the insurance company will review your answers to the health questions and your medical records to determine whether they will choose to offer coverage. You can be turned down for coverage by the insurance company if the underwriter feels you represent certain risks. Some insurance companies have more health questions than others, so we can help you determine which companies might represent your best chance for coverage.