If you are living in Texas and qualify for Medicare coverage, you have a few options available to you. Medicare is available to all citizens over the age of 65, those under 65 who have permanent disabilities, or those with end-stage renal disease. When selecting a Medicare plan, you can choose between Original Medicare , Medicare Advantage, or Medicare Supplement plans. Each of these plans is associated with different benefits and has different associated costs as well. There is also a specific time you must be apply for Medicare coverage in order to avoid extra fees.
What Medicare Plans are Available for Texas Residents?
Original Medicare
The most common Medicare option is Original Medicare, which includes Part A and Part B. Medicare Part A is primarily responsible for inpatient care. This is meant to cover inpatient procedures, overnight hospital stays, stays in skilled nursing facilities, hospice care, or home health care.
On the other hand, Part B covers outpatient expenses, which can include any care to treat disease or prevent it. These types of services include clinical research, mental health care, durable medical equipment, and ambulance services. In addition, Part B is responsible for annual checkups or physician visits and may also cause physical therapy visits, required lab work, and any diagnostic imaging testing that must be completed.
Medicare Part D
In addition to Parts A and B, Part D coverage is also available for Medicare recipients. Part D is designed specifically for prescription drug coverage. This is especially useful for those with chronic conditions or that use daily medications to maintain their general health and wellbeing. Many Medicare recipients enroll in Part D when they are first eligible to avoid paying late enrollment penalties later.
Medicare Advantage Plans
For those living in Texas, similarly to other states, you are also able to get Medicare benefits through Medicare Advantage plans. Medicare Advantage plans include the same Medicare benefits as Part A and Part B, but they are offered through private insurance companies. This means that these plans carry different copayments, deductible amounts, and premium payments. In addition, these plans can include a variety of other benefits that are not usually offered in Original Medicare. Some of these benefits can include dental services, vision care, drug coverage, and others.
Medigap, or Medicare Supplement, Plans
Medigap plans are yet another option for Texas residents looking to gain Medicare coverage. Medigap plans are also known as Medicare Supplement plans, and these options help to limit the out-of-pocket costs associated with Medicare plans. There are various requirements for these plans and 10 different Medigap plans available, all of which include different benefits.
They all offer various levels of cost sharing and are used in conjunction with Original Medicare plans. However, it is important to note that Medigap plans do not include drug coverage, which must be purchased separately if desired.
Applying for Medicare
If you become eligible for Medicare at the age of 65, and you are able to apply for care during the Initial Enrollment Period, which starts three months before your birthday, includes your birthday month, and lasts for three months after your birth month. If you do not apply for Medicare during this seven-month period, you may be forced to pay additional enrollment fees.
If you are currently on disability, you may qualify for Medicare before your 65th birthday. In this case, your Initial Enrollment Period will begin three months before your 25th month of receiving benefits, and it will end three months after your 25th month.
You may also be able to enroll at a different time if you are still working at the time you turn 65. If you are working at a company with more than 20 employees and are receiving healthcare from your employer, you are able to request an extension on your enrollment period. This will allow you delay accepting Medicare until after you retire and prevent you from needing to pay for multiple policies simultaneously.
Related articles:
Can Enrolling in a Medicare Advantage Plan Save Me Money?(Opens in a new browser tab)
Retiring under the age of 65? Understanding Your Medicare Benefits(Opens in a new browser tab)