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Ashford Insurance is an Independent Marketing Organization working with United HealthCare Medicare Solutions.

Texas Medicare Advantage Plans with Part D

Ashford Insurance

Medicare Insurance Made Easy

817-952-3153

Texas Medicare Advantage Plans with Part D

Medicare Advantage (MA) is a type of Medicare health plan offered by private companies that contract with Medicare. MA Plans provide all your Part A and Part B benefits and may also include Part D prescription drug coverage. In return for providing these benefits, MA plans to receive a fixed payment from Medicare.

There are many diverse types of MA plans available, so it’s important to compare plans and choose one that fits your needs and budget. You can use the Medicare Plan Finder website to compare plans in your area.

Here are some of the things to consider when choosing an MA plan:

  • Cost: MA plans have different monthly premiums and out-of-pocket costs. Be sure to compare plans carefully to find one that fits your budget.
  • Benefits: MA plans offer a variety of benefits, including prescription drug coverage, dental care, vision care, and hearing care. Be sure to choose a plan that offers the benefits you need.
  • Network: MA plans have networks of doctors and hospitals that you can use. Be sure to choose a plan that has a network that includes your doctors and hospitals.
  • Medicare Advantage Prescription Drug Plans (MAPDs): MAPDs are Medicare Advantage plans that include prescription drug coverage. If you need prescription drug coverage, be sure to choose an MAPD plan.

If you’re not sure which MA plan is right for you, talk to your doctor or a Medicare insurance agent. They can help you understand your options and choose the best plan for you.

What is Medicare Part D?

Medicare Part D is a voluntary outpatient prescription drug benefit for people with Medicare. You don’t automatically get Part D with Medicare — you need to sign up for it. Part D plans are sold by private insurance companies, but they must follow rules established by the federal government.

Part D coverage helps pay for prescription drugs. It has a yearly deductible, but after you reach that amount, you pay a copayment or coinsurance for each prescription. The amount you pay depends on the plan you choose and the drug you need.

You can join a Part D plan during the Annual Enrollment Period (AEP), which runs from October 15 to December 7 each year. You can also join a plan during a Special Enrollment Period (SEP) if you have certain life events, such as moving, losing other health coverage, or getting certain diagnoses.

If you don’t have Part D coverage and you fill a prescription, you may have to pay the full cost of the drug. This can be awfully expensive, so it’s important to sign up for Part D if you need prescription drug coverage.

Here are some of the things to consider when choosing a Part D plan:

  • Cost: Part D plans have different monthly premiums and out-of-pocket costs. Be sure to compare plans carefully to find one that fits your budget.
  • Benefits: Part D plans offer a variety of benefits, including prescription drug coverage, dental care, vision care, and hearing care. Be sure to choose a plan that offers the benefits you need.
  • Network: Part D plans have networks of pharmacies that you can use. Be sure to choose a plan that has a network that includes your pharmacy.
  • Prescription drug list (formulary): Each Part D plan has a list of covered drugs (called a formulary). Be sure to choose a plan that covers the drugs you need.

If you’re not sure which Part D plan is right for you, talk to your doctor or a Medicare insurance agent. They can help you understand your options and choose the best plan for you.

Why would someone want a Medicare Part D Plan?

There are many reasons why someone might want a Medicare Advantage plan with Part D coverage. Some of the reasons include:

  • Convenience: Medicare Advantage plans often have simpler enrollment and billing processes than Original Medicare. They may also offer additional benefits, such as dental, vision, and hearing coverage.
  • Cost: Medicare Advantage plans may have lower monthly premiums and out-of-pocket costs than Original Medicare, especially for people who need prescription drug coverage.
  • Peace of mind: Medicare Advantage plans can provide peace of mind knowing that you have all your Medicare needs covered in one place. You don’t have to worry about coordinating coverage between Original Medicare and a separate prescription drug plan.

If you’re considering a Medicare Advantage plan, it’s important to compare plans and choose one that fits your needs and budget. You can use the Medicare Plan Finder website to compare plans in your area.

What is the Penalty for not having a Part D prescription plan?

If you don’t have Medicare Part D when you’re first eligible, and you don’t have creditable prescription drug coverage, you may have to pay a late enrollment penalty. The penalty is 1% of the national base beneficiary premium for each full month you went without coverage, up to a maximum of 10%. The national base beneficiary premium for 2023 is $32.74. So, if you went 24 months without coverage, you would pay a 24% penalty. This penalty is permanent and will be added to your monthly Part D premium for as long as you have Part D coverage.

Here are some exceptions to the late enrollment penalty:

  • You had creditable prescription drug coverage.
  • You didn’t know you were eligible for Medicare.
  • You couldn’t afford Medicare Part D.
  • You were in a Special Enrollment Period (SEP).

If you’re not sure if you’re eligible for an exception, talk to your doctor or a Medicare insurance agent. They can help you understand your options and choose the best plan for you.

Need help? Call us for an appointment at (817) 952-3153

Ashford Insurance is an independent health insurance agency specializing in Texas Medicare insurance and has been helping seniors since 2005.  Ashford Insurance is here to help you understand Medicare and health insurance in simple, plain terms that anyone can grasp.  We specialize in assisting folks who are Medicare eligible to learn about the coverage options available through the Medicare Health Insurance Program. 

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Medigap Insurance

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(817) 952-3153

M-T 9:00 – 4:00
F 9:00- 12:00

Weekends & Evenings by Appointment

Address

 1245 Southridge Court Suite 101, Hurst, TX, 76053

Email 

Sonia@ashfordinsurancegroup.com

* A licensed sales agent may call or e-mail as a result of completing the information to discuss Medicare Advantage, Prescription Drug Plans or Medicare Supplement Insurance.

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