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Ashford Insurance

Roanoke Medicare Advantage

Texas Medicare Advantage Made Easy

Roanoke Medicare Advantage

Welcome! We Know Medicare is Confusing! Let Us Help! Ashford Insurance is an independent insurance agency specializing in the Medicare market. As an independent agency, we have the freedom to offer any Supplement or Medicare Prescription Drug product from any company. After reviewing all your doctors and prescriptions, we can give you a true and unbiased opinion.

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.

There are many people who are enrolled in some of the best Medicare Advantage plans in Roanoke 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 investigate 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 rewards.

Roanoke Medicare Advantage

Medicare Advantage (Part C) combines Part A & Part B coverage into one plan. Many come with built-in prescription drug coverage. Ashford Insurance offers Roanoke Texas Medicare Advantage Plans (Part C of Medicare).

You can get your Roanoke, 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 Part C, the Medicare Advantage program, gives you a way to get your Part A and Part B benefits through a private insurance company that contracts with Medicare.
  • Under Medicare Part C, you get all your Part A and Part B benefits (except hospice care, which you still get through Part A).
  • Most Medicare Advantage plans under Part C also include prescription drug coverage. This is something that you don’t get through Original Medicare except in certain cases (for example, in a hospital or clinic). Original Medicare doesn’t cover most medications you’d take at home.

Many 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.

There are several types of Texas 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 like Original Medicare in that you can generally go to any doctor, other health care provider, or hospital if 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.

Most Medicare Advantage plans use a combination of deductibles, co-insurance, and co-pays to share the cost of the services you use. Cost-sharing usually applies to all the services the plan covers.

You need to read the details of each individual Medicare Advantage plan to get the full story on its costs. Most plans have network doctors and pharmacies that may offer plan members discounted pricing.

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

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.