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Medicare Part D Plans in Texas

How Medicare Part D plans work in Texas

Original Medicare (Part A and Part B) generally does not offer coverage for prescription drugs. The program may pay for some medications, like immunosuppressive drugs after an organ transplant, but Original Medicare won't cover a majority of prescriptions. This may leave a fairly significant gap in your health insurance coverage.

To fill this gap, many Medicare beneficiaries may use a Medicare Part D plan. These are private insurance plans that cover some of the costs of your prescription medications. With a Part D plan, you pay a monthly premium in exchange for this coverage.

A Medicare Part D plan in Texas can be useful even if you've already purchased a Medicare Supplement plan. Medicare Supplement plans never pay for prescription drugs, and so Original Medicare beneficiaries may wish to join a stand-alone Prescription Drug Plan (PDP) in order to be covered.

Another way to obtain prescription drug coverage is through a Medicare Advantage Prescription Drug plan (MAPD), which combines health benefits with the Part D drug benefit.

Medicare Part D plan facts for Texas

As of 2013, there are 32 Medicare Part D plans offered by 17 companies throughout Texas. This is a fairly significant drop from 2010 when there were 50 Part D plans available. The least expensive 2013 Part D plan cost $15.00 a month, while the most expensive plan premium was $108.00. The average cost for Part D is just under $40.

12 of the 32 Part D plans are eligible for a low-income subsidy. 11 plans also offer some coverage during the Part D donut hole. This is a coverage gap found in the Part D program where Medicare plans will temporarily stop coverage once the cost of your medications reaches $2,970. From there until your prescription cost hits $4,700, you pay the complete drug cost out of your own pocket.

In 2012, 39% of the statewide Medicare population was enrolled in a Part D plan.

##Comparing Medicare Part D plans in Texas

Understand that every county has its own Medicare Part D market, so not all plans are available in every area. Plans can also charge different monthly premiums depending on where you live.

As you consider your options for enrolling in a Medicare Part D plan , it is recommended that you read through drug formularies for each plan. A plan's drug formulary lists what prescriptions are covered and at what cost you pay. These drugs are placed in different tiers depending on whether they are brand-name or generic, and may require different out-of-pocket costs: the lower the tier, the less expensive your copayment. Ideally, your plan would cover all of the prescriptions you take at a low cost to you.

Data provided by the Kaiser Family Foundation.

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