Medicare in Texas is a national, tax supported health insurance program for people who are 65 or older, people below 65 with certain disabilities and any individual with end-stage renal disease (ESRD). If you or your spouse have worked full time for 10 or more years, you are also probably eligible to receive Medicare Part A for free in Texas. Medicare Part B is available at a monthly rate set annually by congress which was around $121.80 in 2016 for incomes $85000 or less for an individual. While some seniors are eligible to receive the medical insurance portion part B for free depending on their income and asset levels.
All eligible Texas residents should expect the following benefits in part A Medicare in Texas.
- All inpatient hospital stays
- Care in a skilled nursing facility
- Hospice care and some home health care services
Original Medicare in Texas does have deductibles, co-pays and cost sharing requirements that can play havoc with budgets. Therefore in order to help pay these additional out of pocket expenses, many Texans purchase Medicare Supplemental Insurance plans.
Texas Medicare Supplemental plans are standardized by the federal government. They are labeled A, B, C, D, F, G, K, L, M and N. Each policy must offer the same basic benefits no matter which insurance company is selling it. The only difference between polices is usually the cost.
Plan A pays the Medicare hospital and physician coinsurance, the first three pints of blood, and 365 days of hospitalization beyond Medicare.
Plans B through N provide these benefits and add more benefits such as coverage for Medicare deductibles, excess charge, limited preventive care, and foreign travel. In Texas you can only have one supplemental plan. No one should try to sell you multiple plans unless you are looking at add on plans like the prescription drug plan (Plan D) or if you decide to switch plans.
Texas residents should expect the following benefits from their Medicare Supplemental Insurance plan:
- Medical cost – Part B coinsurance (generally 20% of Medicare-approved costs) or copayments for hospital outpatient services
- Hospitalization – per day coinsurance plus coverage for 365 additional days after medicare benefits end
- Blood – First three pints of blood each year
- Hospice – Part A coinsurance
Medicare Advantage Plans (Part C)
When you decided to go with a Medicare Advantage Plan, You actually trade your traditional Medicare benefits for these plans. Many of the advantage plans are offered to eligible individuals at little or no cost other than continued payment of their part B monthly premiums.
Medicare Prescription Drug Plans (Part D)
Prescription drug plans are available to all Medicare eligible people in Texas regardless of medical history or income levels. When a person first qualifies for Medicare, their initial enrollment period begins when you turn 65. Part D is designed to reduce drug cost and protect against catastrophic drug costs. This is a separate plan that would be needed to be added on to your supplemental insurance.
Other services not covered by Original Medicare
- Routine eye exams, eye glasses or contacts
- Help with bathing, dressing, eating and other custodial care
- Dental exams, most dental care and dentures
- Hearing aids or related exams or services
- Most care while traveling outside the United States
- Comfort items like hospital phone, TV, or private rooms
- Long-term care
- Acupuncture or other alternative treatments
- Routine foot care
Learn more about Texas supplemental insurance plans, rates and more at www.emedicare-supplemental-insurance.com/medicare-supplement-plans-texas. Our Texas insurance brokers are US based, Medicare experts! They are happy to help with pricing and opinions on what plan to get. Call today at 877-202-9248.