Senior couple happy with Medicare Part D in Texas

Medicare Part D in Texas

Part D in Texas – There is no shortage of Part D plans in Texas, so you’ll have plenty of options to choose from. But before you enroll, you’ll need to know exactly what Part D is, when you can enroll, and which plans are available in your area.

What is Medicare Part D?

Part D includes prescription drug coverage, nothing else. Prescription medications are the only things covered in Part D plans. You can enroll in an individual plan, or you may have Part D rolled into your Medicare Advantage (Part C) plan.

No matter the route you take to get Part D coverage, they always work the same. Part D plans consist of the following aspects.\

Premium: The monthly cost of having the plan. If your drug coverage is included in your Medicare Advantage plan, there is not an extra premium.

Drug formularies: The list of medications covered by the plan.

Drug Tiers: Categories of drugs that dictate coverage and price.

Deductible: The amount you pay before coverage begins.

Copays/Coinsurance: Your cost for a prescription.

Pharmacy Networks: The best prices are found at preferred pharmacies, but there will also be coverage if you use a standard pharmacy.

Part D Plans in Texas

Now that you have an idea of how drug plans work let’s discuss Part D in Texas. Premiums, drug formularies, coinsurance costs, and pharmacy networks will vary among plans, so you’ll need to consider each aspect when choosing a policy.

As of 2022, there are 26 stand-alone Part D plans available in Texas. In addition, there are 312 Medicare Advantage plans that include Part D drug coverage. (These are abbreviated as MAPD plans.) Fortunately, you won’t have quite that many to sort through. Your zip code will narrow down the plans available in your area.

As far as the stand-alone Part D plans in Texas, these are the available carriers:

  • AARP MedicareRx
  • Blue Cross Medicare Rx
  • Humana
  • Cigna
  • Mutual of Omaha
  • SilverScript
  • Wellcare
  • Elixir
  • Amerivantage
  • Clear Spring Health
Having Meeting with Insurance Agent Medicare Part D in Texas
Choosing a Part D plan requires time and research if you try to do it alone.

How do I choose a Part D plan in Texas?

Choosing a Part D plan requires time and research if you try to do it alone. If you aren’t using an agent to help you find a plan, there are a few steps to take when browsing for coverage.

First, pay attention to the drug formulary and find a plan that includes coverage for all of your current medications.

Next, look at the total estimated cost. This is the amount that you will pay for the year if you refill all of your medications as directed.

Third, make sure you know which pharmacies are preferred. You can use your Part D plan at a standard pharmacy, but you’ll pay more out-of-pocket for your prescriptions. If you want the option to use mail order, make sure that it is also offered by the plan.

When should I enroll in Part D?

The best time to enroll in Part D is as soon as you are eligible. That will mean one of two things for every Medicare beneficiary: either during your Initial Enrollment Period or a Special Enrollment Period.

You Initial Enrollment Period (IEP) starts three months before your 65th birthday. During that time, you can enroll in all aspects of Medicare, including Medicare Part D. If you want to postpone enrollment, you can do so. However, you should only do this if you have credible coverage in place. Having credible coverage will ensure you do not pay a late enrollment penalty later.

Credible coverage for Part B and Part D have different standards, so make sure you check both before choosing to postpone enrollment.

If you did decide to delay coverage and you have credible insurance in place, you’ll be eligible for a Special Enrollment Period when you lose that coverage. In most cases, you’ll have 63 days to get enrolled in a Medicare plan.

Not taking prescriptions? Enroll anyway! Most people assume that if they aren’t taking prescriptions, they don’t need to enroll in Part D. That would make sense, but the problem is that you will be penalized later when you do decide to enroll. What’s worse, you’ll pay that penalty for the rest of your life! There are very low-cost plans that you can choose to avoid the penalty.

Choosing a Medicare prescription drug plan sounds complicated, but it doesn’t have to be. In fact, our agents specialize in Medicare products, and we can help you choose and enroll in a Part D plan with no hassle at all. There is no cost to use our services, and you’ll have peace of mind knowing you have the coverage you need. Give us a call today to speak with one of our licensed insurance agents.