Which Medicare insurance is offered in Texas?

Medicare includes parts A, B, C, D, and Medigap. Here is an explanation for each of these elements of Medicare coverage in Texas and tips for finding the coverage that works for you.

Medicare Part A

Medicare is divided into specific parts that cover different services. Original Medicare is composed of Part A and Part B.

Medicare Part A is hospital coverage. In Texas as in the rest of the country, Part A is free for most people. This means that you do not have to pay a monthly premium to have coverage. In Texas, you are eligible for premium-free Medicare Part A if:

• you are age 65 or older and you or your spouse worked and have paid Medicare taxes for at least 40 quarters during your lifetime
• you are under age 65 and receive benefits from Social Security or from the Railroad Retirement Board, and have received those benefits for at least 24 consecutive months
• you have ESRD or ALS

Even people who do not meet any of these requirements can get Medicare Part A for a monthly out-of-pocket premium once they are 65 years old.

Medicare Part B

Medicare Part B is medical coverage. If you are eligible for Medicare Part A, you are also eligible for Medicare Part B. This part of Medicare is not premium free.

The cost of Medicare Part B in Texas is comparable to the rest of the country. That is because what you pay for Medicare Part B is determined by your or your spouse’s income history, not by your ZIP code or state.

Your Medicare Part B costs include an annual deductible and a monthly premium. Your monthly premium may be higher if you make more than a certain amount.

Medicare Part C (Medicare Advantage)

Medicare Part C (Medicare Advantage) is purchased through Medicare-approved private insurers. If you are eligible for Medicare, you are eligible for Medicare Advantage. You must, however, enroll in original Medicare before you can get a Medicare Advantage plan.

The premium and copay rates for Medicare Part C vary from insurer to insurer and from state to state.

Plans also vary in what they cover, as well as the service areas where they are available. A close friend who lives in a neighboring town may be eligible for a plan that does not cover your area and vice versa.

You can compare the cost of every Medicare Advantage plan offered in your county by using Medicare’s find a Medicare plan tool.

Some plans cover prescription drugs and others do not. Some Part C plans also cover services that original Medicare does not, such as vision and dental. There may be restrictions on the doctors you can see with a Medicare Advantage plan, so carefully reviewing the plan you are considering is important.