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Posts Tagged ‘texas medicare part d precription drug plans’

Texas Medicare Part D Prescription Drug Plan: In’s and Out’s

Tuesday, November 1st, 2011

In Texas, there are only two ways to get Medicare drug coverage- through a Medicare Prescription Drug Plan (PDP) or through a Texas Medicare Advantage Plan. Medicare Prescription Drug Plans, or Part D, are offered to everyone with Medicare and sold through private insurance companies. Basically, Part D is prescription drug coverage that is added to your Original Medicare. Understanding these plans can be a bit tricky and many Texans just like you are confused as to eligibility, enrollment, costs and coverage. Take the time to learn a few in’s and out’s of Texas Medicare Part D and make the right decisions concerning your health care coverage.

Eligibility and Enrollment

To be eligible for a Medicare Part D drug plan, you must live in the area that your network serves and you must be enrolled in Original Medicare. The best time to enroll in a Medicare Part D plan is when you are first eligible. You can join anytime during the 7 month period of time beginning three months before the month you turn 65 and ending three months after you turn 65. If you choose not to enroll in Part D when you are first eligible and decide to enroll later, you will most likely be charged a late enrollment penalty.

“Open enrollment” is different from your 7 month eligibility period. It is the specific timeframe when everyone else can join, switch or drop a Medicare Drug Plan. For 2011, the open enrollment period is October 15 through December 7. During this time only, anyone can make changes to their Medicare drug plan. The end date of December 7 ensures that any changes made will take effect by January 1st. It’s important to remember that the open enrollment period is not the same as when you are first eligible.

If you are disabled, you can join a Medicare drug plan starting three months before your 25th month of disability and ending three months after your 25th month of disability. However, if you currently receive extra help, you may join, switch or drop a Medicare drug plan anytime. There are also special enrollment periods that take into consideration if you live in a nursing home, move out of the coverage area or lose other credible prescription drug coverage.

Costs and Coverage

With any Medicare Prescription Drug Plan, you can expect to pay a monthly premium as well as other out-of- pocket expenses including deductibles, copayments and coinsurance. In some cases, if you enrolled late, you may have to pay a late enrollment penalty. However, the actual cost for a drug plan varies and is based on several factors including the plan you choose, whether or not you use a pharmacy in the plan’s network, the specific drugs you use and if your plan covers them.

While prices vary considerably between insurers, coverage does as well and each plan has a list of the specific drugs that they cover. This list is called a formulary and it is why it is so important to make certain that your provider covers the drugs that you need.

Cost is a definitely a factor to consider when comparing drug plans between insurance companies. However, it’s not the only factor as dependability and reliability are important as well. When choosing your insurance provider, choose trustworthy companies that have earned a reputation with Texans for providing credible, dependable Part D coverage for decades.

For more information on Texas Medicare Part D prescription drug plans visit our Texas Medicare Supplement website.

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