Medicare Advantage Plans and Prescription Drug Plans – Type, Costs, Provider Choices & More

Medicare Advantage plans offer coverage to Texas residents with services provided by network health care providers including hospitals, doctors, clinical labs and some preventive screenings.

A person possessing a Medicare Advantage plan will get help to cover medical expenses by paying the plan’s monthly premium. Even if a plan’s monthly premium costs $0, you would have no choice but to pay the Original Medicare Part B premium and Part A premium, if applicable. Part A covers inpatient hospital-related costs and covers the necessary medical facilities while Part B covers a portion of non-hospital related medically necessary services such as doctor’s visits and additional services.

Medicare Parts C and D may play a role in your coverage. Part C is known as a Medicare Advantage Plan. Part C allows Medicare beneficiaries to enroll in a private health care plan (like an HMO or PPO) and receive a variety of medical services from a private provider. Part D is an optional program that allows Medicare beneficiaries in exchange for a monthly fee.

In 2019, nearly 37 percent of Medicare beneficiaries in Texas were enrolled in a Medicare Advantage (Medicare Part C) plan and more surprisingly, there were 2,778 different Texas Medicare Advantage plans that came into effect in 2019.

Last year, the average Medicare Advantage plan premium in Texas rounded up to $5 per month. Overall in 2019, 1,312 different Texas Medicare Advantage plans were issued that charged $0 monthly premiums.

• Here is the breakdown:
• $5 – average monthly premium cost in 2019
• $4,290 – average in-network, an out-of-pocket spending limit
• $164.081- average deductible in 2019

It’s vital to note that Medicare Advantage plan premiums, deductibles, and out-of-pocket costs vary significantly based on your location and the plan you subscribe to. Further in this article, we provide you with crucial information regarding the Medicare Advantage plans in Texas.

If a Medicare Advantage plan is awarded four or more stars, it is regarded as a top-rated plan. Currently, 1,003 top-rated 2019 Medicare Advantage plans in Texas have four or five stars.

Following are some of the rating criteria of Medicare Advantage plans:

• Preventive care and health maintenance (lab tests, vaccines, screenings, etc.)
• Chronic disease management (CDM)
• Member rating and health insurance status of the plan
• Member complaints, for example; problems receiving services and member retention, and
• Customer service

The Centers for Medicare Services (CMS) awards star ratings after considering several types of information, including Medicare’s daily monitoring activities along with member surveys.

In the case of the Medicare Advantage plans, offered by different Medicare-approved private companies who offer a list of plans to Texas residents as another way to get your Medicare coverage. Despite several insurance companies offering Medicare Advantage plans in Texas, each plan’s availability depends on the area where the individual resides. On the other hand, private insurance companies offer Medicare Advantage plans unique to the area mentioned in the plan. A licensed insurance agent can educate you on a range of insurance carriers available to you and help you get a plan that suits your needs.

Likewise, Texas Medicare Solutions is an independent insurance agency where local licensed insurance agents work with Medicare Advantage plans, prescription drug plans, hospital indemnity insurance, life insurance, etc. They can help you compare the Medicare Advantage plans from various insurance companies serving your area, and help you enroll in the right plan.

So when you’re shopping for a Medicare Advantage Plan Texas, be careful. Compare plans from different insurance providers to determine the advantages and disadvantages of each. Read up on reviews and testimonials from customers to assess a company’s overall reputation, and explore the company’s Medicare plans.

In short, do everything that helps you decide on the most suitable Medicare Advantage plan and provider. If you’re confused and would like some help, consult with us, we feel that we have the best people to advise you on Medicare in Texas. They will help you gain a deep understanding of different plans.