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Medicare Part D Coverage in Texas

Prescription drug coverage is a valuable benefit, but Medicare Parts A and B don’t offer it. If you need prescription coverage, you need Medicare Part D coverage in Texas. This separate policy helps cover the cost of your prescriptions. You’ll likely still pay something out of pocket, however. How much depends on the policy you choose.

What Is Medicare Part D?

Medicare Part D is a separate insurance policy from Medicare Part A and Part B. You buy the policy from an independent insurance agent. Only agents sponsored by Medicare can sell these policies. Medicare Part D works alongside your Part A and Part B coverage. You also have several policies to choose from when looking at your options.

There are separate premiums and deductibles with your Medicare Part D coverage in Texas. Each plan has a different premium and annual deductible. You pay the premium monthly, directly to the insurance company. You pay toward the annual deductible every time you fill a prescription and pay out of pocket. Once you reach the deductible, your insurance benefits start. You may still have co-pays, but your out-of-pocket expenses should be lower.

Enrolling in Medicare Part D

The best time to enroll in Medicare Part D coverage in Texas is during your initial eligibility period for Medicare. This starts three months before you turn 65 years old. It continues through your birthday month and for three months afterward. If you miss this opportunity, you cannot sign up for Medicare Part D until open enrollment.

The Open Enrollment Period occurs from October 15 to December 7 every year. You can change your plans and add plans, such as Medicare Part D at this time. The coverage becomes effective January 1 of the following year.

Avoid the Medicare Part D Penalties

Even if you don’t take prescriptions now, you should consider Medicare Part D coverage in Texas when you start Medicare. If you have credible prescription coverage from another plan, you can skip this step. If you don’t, you could be subjected to a penalty if you don’t enroll in Part D right away.

The government gives you a 63-day window to be without prescription drug coverage. If you don’t have credible coverage for prescriptions beyond 63 days, you are subject to a penalty. The penalty equals 1 percent for each month you don’t have coverage. Let’s say you go three years without prescription coverage. You’ll then pay a 36 percent penalty of the average premium for Medicare Part D as long as you have coverage. This is in addition to the standard premium for your chosen Medicare Part D plan.

Choosing the Right Medicare Part D Plan

You have options for Medicare Part D coverage in Texas. Consider the following factors when choosing your plan:

  • Do you take medication now? If so, find a plan that covers the medication you take. Ask the provider for the formulary list to see if your medication is on it.
  • Do you take generic prescription drugs? Generic prescription drugs cost less. However, you may even find a plan that offers tiered pricing. Some plans have no co-pay for generic drugs or very low co-pays.
  • What’s the co-pay or co-insurance? Most insurance policies have some type of co-pay or co-insurance. The amount you owe varies by policy. Know the percentage or flat co-pay amounts and determine if they are affordable.
  • What’s the deductible? You must meet the deductible before insurance starts paying for your prescriptions. Make sure you choose a plan with an annual deductible that you can afford.

Other Options for Prescription Coverage

If having three Medicare policies is too confusing, you can also consider a Medicare Advantage policy. This policy includes all the Medicare Part A and Part B benefits, plus other benefits. Some plans include prescription drug coverage. With one plan, you have one premium and one deductible to meet. This could make it more affordable and convenient for you. Make sure you shop around to find the plan that works best for you.

Whether you take prescriptions now or you want to protect yourself for the future, Medicare Part D coverage in Texas is one way to do it. You’ll have to buy a policy from an independent insurance agent, so take your time shopping around. Each insurance company has to offer the same benefits within each plan, but the pricing may differ. Find the plan that offers the benefits you need at the prices that you can afford.

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