Benefits of Getting Medicare Advantage Plans in Texas

Medicare Advantage Plans in Texas provides an alternative way of getting Medicare Part A and B coverage from a private, Medicare-approved health insurance company. Remember, Medicare is a federal government program. Automatic enrollment means getting Original Medicare benefits.

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Meanwhile, Medicare Advantage Plans (Part C) includes Original Medicare benefits. Moreover, it incorporates additional benefits which you won’t get from Original Medicare. Further, most Medicare Plans in Houston include additional benefits. For example, dental, vision, and prescription drug coverage.

In fact, there are various types of Medicare Part C plans in Texas. Such as, Medicare Plans in San Antonio and Medicare Plans in Dallas. Also, there are some Medicare Part C plans which operates around specific illnesses. These plans are known as Medicare Special Needs Plans (SNPs). Moreover, it sets up your coverage, drug formularies, provider networks and focuses those with specific health conditions.

 

An Overview on Medicare Parts A, B, and D

Anyway, let’s have a brief review on the Medicare. Again, Medicare is a federal health insurance program that serves people who are 65 or older. Also, it serves younger people with certain disabilities. Basically, Medicare has four parts: Medicare Part A, B, C, and D.

Original Medicare

This is what you get when you become eligible for Medicare. Thereupon, it covers 80% of a senior’s medical costs. Moreover, it has two parts: Part A Medicare (Hospital Insurance) and Part B Medicare (Medical Insurance). Refer to the table below to see the comparison between Part A and Part B benefits.

What do Parts A & B Cover?
Part A Medicare (Hospital Insurance) Part B Medicare (Medical Insurance)
·         Hospital Care

·         Skilled Nursing Facility Care

·         Short-term Nursing Home Care

·         Home Health-Care Services

·         Hospice

·         “Welcome to Medicare” exam prevention visit*

·         Annual “Wellness” visits every 12 months*

·         Laboratory tests (blood test, x-rays)

·         Medical Equipment (hospital beds, wheelchairs)

·         Orthotics and prosthetics

·         Mental healthcare

·         Ambulance services

*Note: If, you need additional tests or services, you will have to pay coinsurance. Then, Part B deductibles may apply.

Part D Medicare

Also known as Medicare Prescription Drug Coverage, this provides outpatient prescription drug coverage. Further, you can only get this through private insurance companies that have contracts with the government. Especially, you must choose Part D plans that work with Medicare benefits. For example, you must opt for a stand-alone Part D plan (PDP) if you already have Original Medicare.

 

Introducing Medicare Advantage Plans (Part C)

Basically, Medicare Advantage Plans in Texas covers all Medicare benefits. Furthermore, they offer extra coverage such as vision, hearing and dental coverage. They provide important coverage more than Part A and B coverage. In some cases, they also include prescription drugs. However, not all private insurance companies offer prescription drug coverage.

Moreover, Part C is not a separate benefit because it is a Medicare policy which allows private health companies to provide Medicare benefits. In fact, you can get Medicare coverage through Part C instead of Original Medicare.

Although, Part C plans offer benefits with their own rules, costs and coverage restrictions. Henceforth, there are different kinds of Medicare Part C. Moreover, here are key facts about Medicare Part C:

  • Each Part C plan charge different out-of-pocket costs and rules regarding specialists or choice of hospital
  • Also, plans may be from PPOs, HMOs, PFFS, SNP, and MSA
  • Further, Part C incorporates Original Medicare benefits and additional benefits. But, with specified rules, coverage and costs.
  • Sometimes, Part C plans include prescription drug coverage
  • Usually, these plans feature physicians and hospitals that are in their networks which you can go to for medical care

How does Medicare Advantage Plans in Texas work?

Meanwhile, Part C plan may not cover costs that are not medically necessary. Thus, you can check with your provider before getting the services you want or need. Furthermore, study the table below which explains how Part C works with Original Medicare.

Original Medicare Medicare Advantage Plan
Hospital and Medical Coverage ·         Hospital stays up to 9 days per benefit period

·         Skilled nursing facility

·         Inpatient mental health care

·         Home health care

·         Hospice care

·         Clinical laboratory services

Original Medicare with additional benefits:

·         Dental, vision and hearing care

·         Wellness programs

·         Prescription drug coverage

·         Preventive care services

·         Mail order pharmacy benefits

·         Additional hospital stay

·         Coverage during foreign travel

Premium Over 100.00/month Under $50.00/month
Deductible Part A: Deductible per benefit period

Part B: Annual deductible

Nevertheless, deductibles modify by plan and could be lower or higher than OM
Co-payments / Co-insurnace ·         Hospital benefits for days 61-90

·         “lifetime reserve” days in the hospital

·         Days 21-100 in a skilled nursing facility per benefit period

·         20% Medicare-approved costs for inpatient and outpatient medical/doctor services which includes durable medical equipment

·         45% of Medicare-approved costs for outpatient mental health care

·         Co-insurance or co-pay for most outpatient hospital services

Co-payments and Co-insurance costs differ by plan. They could be lower or higher than OM. Typically, the charges include:

·         Doctor visits

·         Hospital stays

·         Emergency care

·         Outpatient hospital care

·         Prescription drugs

·         Medical equipment

 

Medicare Advantage Plans in Texas Cities and Counties

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Anyway, there are different Medicare Advantage Plans in Texas that are readily available. Further, here is a list of counties with Medicare Part C. Moreover, these counties are from Houston, San Antonio and Dallas.

Medicare Plans in Houston

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Nevertheless, here is a list of Houston, Texas counties that have Medicare Part C:

  • Harris County
  • Fort Bend County
  • Montgomery County
  • Brazoria County
  • Galveston County
  • Liberty County
  • Waller County
  • Chambers County
  • Austin County

Medicare Plans in Dallas

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Accordingly, here is a list of Dallas, Texas counties that have Medicare Part C:

  • Collin County
  • Dallas County
  • Delta County
  • Denton County
  • Ellis County
  • Hood County
  • Hunt County
  • Johnson County
  • Kaufman County
  • Parker County
  • Rockwall County
  • Somervell County
  • Tarrant County
  • Wise County

Medicare Plans in San Antonio

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Moreover, here is a list of San Antonio, Texas counties that have Medicare Part C:

  • Bexar County
  • Medina County
  • Comal County

(Other) Texas Counties with Medicare Advantage Plans

Anderson Coke Garza Jim Hogg Menard San Augustine Wharton
Andrews Coleman Gillespie Jim Wells Midland San Jacinto Wheeler
Angelina Collingsworth Glasscock Jones Milam San Patricio Wichita
Aransas Colorado Goliad Karnes Mills San Saba Wilbarger
Archer Comanche Gonzales Kendall Mitchell Schleicher Willacy
Armstrong Concho Gray Kenedy Montague Scurry Williamson
Atascosa Cooke Grayson Kent Moore Shackelford Wilson
Bailey Coryell Gregg Kerr Morris Shelby Winkler
Bandera Cottle Grimes Kimble Motley Sherman Wood
Bastrop Crane Guadalupe King Nacogdoches Smith Yoakum
Baylor Crockett Hale Kinney Navarro Starr Young
Bee Crosby Hall Kleberg Newton Stephens Zapata
Bell Culberson Hamilton Knox Nolan Sterling Zavala
Blanco Dallam Hansford Lamar Nueces Stonewall
Borden Dawson Hardeman Lamb Ochiltree Sutton
Bosque Deaf Smith Hardin Lampasas Oldham Swisher
Bowie DeWitt Harrison La Salle Orange Taylor
Brazos Dickens Hartley Lavaca Palo Pinto Terrell
Brewster Dimmit Haskell Lee Panola Terry
Briscoe Donley Hays Leon Parmer Throckmorton
Brooks Duval Hemphill Limestone Pecos Titus
Brown Eastland Henderson Lipscomb Polk Tom Green
Burleson Ector Hidalgo Live Oak Potter Travis
Burnet Edwards Hill Llano Presidio Trinity
Caldwell El Paso Hockley Loving Rains Tyler
Calhoun Erath Hopkins Lubbock Randall Upshur
Callahan Falls Houston Lynn Reagan Upton
Cameron Fannin Howard McCulloch Real Uvalde
Camp Fayette Hudspeth McLennan Red River Val Verde
Carson Fisher Hutchinson McMullen Reeves Van Zandt
Cass Floyd Irion Madison Refugio Victoria
Castro Foard Jack Marion Roberts Walker
Cherokee Franklin Jackson Martin Robertson Ward
Childress Freestone Jasper Mason Runnels Washington
Clay Frio Jeff Davis Matagorda Rusk Webb
Cochran Gaines Jefferson Maverick Sabine Wharton

Compare Part C Plans

Of course, the key points when comparing Medicare Advantage Plans in Texas. Also, try comparing the costs of Part C to its list of benefits. So, contact Inzur agents to ensure you get the best Part C plan. Further, they can help you find the plan that fits your medical conditions, budget and other factors. Call 1-888-999-0089 for more information on Medicare, Dental and Life Insurance.