Medicare Part D in Texas

There are a total of 25 Medicare Part D prescription drug plans available for purchase in the state of Texas. These plans are sold and serviced by 13 different health care providers under the direction of the federal government’s Medicare program. In order to qualify for enrollment in one of these plans, you’ll need to be enrolled in Original Medicare Part A and Part B.

You may then apply for your preferred Part D plan in person at the provider company’s office. Some companies may offer online applications via their official website. Whichever application method you choose, you should apply as soon as you’re eligible. Failure to apply in a timely manner could result in penalties, higher monthly costs, and possible health audits.

Medicare Part D vs. Medicare Advantage

Medicare Part D isn’t the only prescription drug plan available in Texas. Some companies offer Medicare Advantage plans as well, some of which provide prescription drug coverage that may meet your needs. Like Part D, Advantage (sometimes called Medicare Part C) is a plan designed and sold by a third-party health care provider with Medicare’s oversight. Unlike Part D, Advantage plans don’t focus exclusively on prescription drugs, and instead provide an alternative for all of the coverage normally provided by Original Medicare Part A and Part B, plus a few plan-specific extras.

You should be aware that some Advantage plans are incompatible with Part D. This means that if you enroll in a Part D plan while also being enrolled in an incompatible Advantage plan, you will lose your Advantage coverage and you will default back to Original Medicare Part A and Part B. You should always consult with your doctors, health care providers, and health care plan administrators before making any changes to your existing plan.

When to sign up

Medicare Part D’s Initial Enrollment Period lasts for seven months. It starts three months before your Original Medicare eligibility date and concludes four months after that date. The date is determined by your birth month and your 65th birthday. It is listed in your Original Medicare documentation. If you miss the initial seven month enrollment window, you can still apply during the Annual Election Period. This period starts every October 15th and ends every December 7th. If you miss this period as well, you’ll have to enroll during one of Medicare’s infrequent Special Election Periods. These periods are designed to help people with extenuating circumstances such as the loss of prior insurance. If you delay your enrollment to a Special Election Period, you may be subject to late fees, higher monthly premium costs that constantly increase over the life of your coverage, and even health audits that may prevent you from receiving coverage.

What are my choices?

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The Medicare Part D services listed in the preceding table are provided in all Texas counties. Your county of residence may provide additional plans and services. Contact your local Medicare office for additional details.

Source: CMS.gov

Plans are subject to change as contracts are finalized.

Includes contracts/plans as of April 22, 2016. The data does not reflect information for employer-sponsored plans, Part B-only plans, or plans not offering a Part D drug benefit.

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