Medicare Advantage in Tarrant County

Medicare Advantage Made Easy

Medicare Advantage in Tarrant County

Medicare Advantage in Tarrant County is funded by the government for those who are 65 years and older. Medicare consists of Part A, or hospital insurance, and Part B, or medical insurance. Medicare Part C is a Medicare Advantage Plan which combines Part A and Part B and in some cases Part D. Medicare Part C is managed by insurance companies which are Medicare-approved. These plans cover the necessary medical services, and have co-payments, coinsurance, and deductibles which vary. Medicare Part D provides assistance in covering prescription drugs and can prevent high costs in the future. Like Medicare Part C, the coverage depends on the plan.

There are many people who are enrolled in some of the best Medicare Advantage plans in Tarrant County Texas. If you have recently enrolled in Medicare Part A and Part B or if you will be eligible soon, you might want to join them and look into Medicare Advantage plans in Texas yourself. It’s possible to just stick with Original Medicare (Medicare Part A and Medicare Part B) but opting for a Medicare Advantage plan can help you significantly reduce your out-of-pocket expenses and can provide you with some extra perks.

Ashford Insurance offers Medicare Advantage Plans in Texas, (the Part C of Medicare).

Tarrant County Medicare Advantage

The name implies that this plan can give you more coverage than others or do something for you that other healthcare plans may not be able to do. That’s absolutely correct, as Advantage plans are designed to offer powerful coverage in a way that is specialized and personalized to fit the needs of different kinds of people.

The Medicare Advantage plans all come with the same basic coverage, and Medicare has created and designed that coverage, even though it is not the one selling the plans. Medicare simply oversees Advantage plans and ensures they are being sold and marketed properly. The insurance companies that sell these plans are allowed to add some coverage on top of the basic plans and create a lineup that offers what their customers might want.

Texas Medicare Advantage plans, often called Medicare Part C, combine Medicare Parts A & B (Original Medicare) into one plan. However, instead of receiving the benefits of Parts A & B through Original Medicare, Medicare Advantage plans are offered through private insurers.

Medicare Advantage Plans in Texas combine coverage for hospital (Part A) and doctor (Part B) visits all in one plan and are required to offer all the benefits included in Original Medicare (except hospice care which continues to be covered by Part A). However, many Medicare Advantage (Part C) plans also include prescription drug coverage and routine eye and dental care coverage not offered by Original Medicare.

Many Texas Medicare Advantage (Part C) plans include prescription drug, vision, hearing, and dental coverage not offered by Original Medicare (Parts A & B). Additionally, each Medicare Advantage plan is required by law to feature an annual maximum cap on out-of-pocket costs, meaning once that limit is reached you will pay nothing for additional covered medical services.

You can get your Texas Medicare benefits through Original Medicare, or you can choose a Medicare Advantage Plan. With Original Medicare, the government pays for your Medicare benefits when you get them. Medicare Advantage Plans are offered by private companies that have been approved by Medicare. Medicare pays these companies to administer your Medicare benefits.

If you join a Texas Medicare Advantage Plan, the plan will provide all your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage. They are completely different than a Medicare Supplement Insurance (Medigap) policy.

Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan. Your Medicare services aren’t paid for by Original Medicare. Below are the most common types of Medicare Advantage Plans.

Health Maintenance Organization (HMO) plans:

In most HMOs, you may only go to doctors, other health care providers, or hospitals that are in the plan’s network, except in an emergency or urgent situation. You probably also need to get a referral from your primary care doctor for diagnostic tests or to see other doctors or specialists.

Preferred Provider Organization (PPO) plans:

With a PPO, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. You generally pay more if you use doctors, hospitals, and providers outside of the network.

Private Fee-for-Service (PFFS) plans:

PFFS plans are similar to Original Medicare in that you can generally go to any doctor, other health care provider, or hospital as long as they agree to accept the plan’s payment terms. The plan will determine how much it will pay doctors, other health care providers, and hospitals, and how much you must pay when you get care.

Special Needs Plans (SNPs):

SNPs provide specialized and focused health care for specific groups of people, like those who have both Medicare and Medicaid, live in a nursing home, or have certain chronic medical conditions.

HMO Point-of-Service (HMOPOS) plans:

These are HMO plans that may allow you to get some services out-of-network for a higher co-payment or coinsurance.

Medical Savings Account (MSA) plans: These plans combine a high-deductible health plan with a bank savings account. Medicare will deposit money into the account (usually less than the deductible). You can use the money to pay for your health care services throughout the year. MSA plans do not offer any Medicare drug coverage. If you want drug coverage, you have to join a Medicare Prescription Drug Plan, Part C of Medicare.

To be eligible to enroll in a Texas Medicare Advantage plan you must have both Medicare Parts A and B and live in the plan’s service area. People with End-Stage Renal Disease (permanent kidney failure) generally cannot enroll in a Medicare Advantage Plan.

You must continue to pay your Part B premium and generally pay one monthly premium for the services included in a Medicare Advantage Plan. Each Medicare Advantage Plan has different premiums and costs for services, so it’s important to compare plans in your area and understand plan costs and benefits before you join. Some may have a $0 premium.

Texas Medicare Advantage Plans must cover all the services that Original Medicare covers except for hospice care. Original Medicare will cover hospice care even if you are in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, you will always be covered for emergency and urgent care. Medicare Advantage Plans must offer emergency coverage outside of the plan’s service area (but not outside the U.S.). Many Medicare Advantage Plans also offer extra benefits such as dental care, eyeglasses, or wellness programs.

Most Medicare Advantage Plans include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you usually pay one monthly premium for both the plan’s medical and prescription drug coverage.

Remember, plan benefits can change from year to year. Make sure you understand how a plan works before you join.

Confused? Many People Are. It can seem overwhelming when trying to plan your future coverage and sort through the many options, especially since the choices you make can have a significant effect on your health care and your financial well-being.

Whether an “all-in-one” Medicare Advantage plan or a standalone Part D plan suits you, Ashford Insurance can help. Get a quote for prescription drug plans online now at no cost to you. Or, let one of our licensed agents review your options and find the best drug insurance plan for your unique needs. Just give us a call today at 817-952-3153.