MEDICARE PART B PLANS AND COSTS IN TEXAS

Medicare Part B plans are available to eligible applicants who need medical coverage in Texas. Texas Medicare Part B includes coverage for medical expenses, home health care services, clinic laboratory services, outpatient hospital treatments, durable medical supplies and equipment. Additionally, Medicare Plan B covers preventative health services, exams, shots and health screenings. Patient Medicare Part B Costs include premiums, deductibles, copayments and coinsurance. Qualifying applicants can apply for Medicare Plan B coverage online, by telephone or in-person.

Below, Medicare Part B applicants can find information about enrolling in Plan B:

  • What is Medicare Part B?
  • How to get Medicare Plan B/medical insurance in Texas
  • Medicare Part B eligibility requirements in Texas
  • How much do Medicare Part B plans cost in Texas?
  • Texas Medicare savings programs

What is Medicare Part B?

Medicare Part B provides medical coverage to qualifying candidates in Texas. Medicare Part B plans provide coverage for two different types of medical services: Medically-necessary services and preventative services. Medically-necessary Medicare Part B services include supplies and services needed to treat or diagnose a medical condition. Medicare Part B preventive services are services used to prevent illnesses such as the flu.

Additionally, Medicare Part B plans cover services such as clinic research, ambulance services, durable medical equipment, inpatient and outpatient mental health services and limited outpatient prescription drugs. Medicare Part B plans also allow a patient to seek a second opinion before undergoing surgery.

How to Get Medicare Plan B/Medical Insurance in Texas

Texas Medicare Part B applicants who are 65 years of age or are already receiving Railroad Retirement, disability benefits or Social Security benefits may be automatically enrolled in Part B coverage. Other individuals need to manually enroll in Medicare Part B three months before turning 65.

Medicare Part B plans may be purchased without having to purchase Part A plans. However, applicants may only sign up for Medicare Part B plans during selected enrollment periods. An applicant’s initial Medicare Part B enrollment period begins three months before turning 65 and ends three months after turning 65.

If an applicant chooses not to enroll in Medicare Part B during that timeframe, he or she can apply during the general enrollment period which takes place from January through March. Medicare Plan B coverage begins on July 1 of the same year. However, Medicare Part B monthly premiums increase by ten percent for each year-long period that an applicant was eligible for medical insurance but did not enroll.

To enroll in Medicare Part B plans, applicants must submit an enrollment application online, by telephone, or in-person at a Texas Social Security office.

Medicare Part B Eligibility Requirements in Texas

Medicare Plan B applicants must be at least 65 years of age, be U.S. citizens or have lived in the U.S. for at least five years. Medicare Plan B applicants who are eligible to receive Medicare Part A benefits are also eligible to receive Plan B coverage. However, all applicants must pay Medicare Plan B monthly premiums, even if they do not need to pay a monthly premium for Plan A.

Additionally, Medicare Part B plans are available by purchase for petitioners who are not eligible for Part A benefits. Medicare Plan B applicants can purchase Part B without having to purchase Part A.

How Much Does Medicare Part B Cost in Texas?

Medicare Part B plans charge applicants premiums each month. Medicare Part B applicants with higher incomes will need to pay a higher monthly premium than applicants with lower monthly incomes. Many Medicare Plan B applicants will pay a standard premium amount; however, candidates with adjusted gross incomes over a certain amount will be subject to pay an Income Related Monthly Adjustment Amount (IRMAA). An IRMAA is an extra charge on the Medicare Part B monthly premium.

In 2017, Medicare Plan B standard monthly premiums are $134. Medicare Part B premiums will be larger for higher incomes. However, Medicare Plan B prices may vary depending on Social Security benefits and whether a candidate has Medicaid or not. Additionally, Medicare Part B costs include deductibles and coinsurance costs. Medicare Plan B deductible costs are $183 in 2017. Medicare Plan B coinsurance costs are typically 20 percent after the deductible has been met. Medicare Part B plans may have limited coverage on speech language pathology, physical therapy and occupational therapy in the 2017 year.

Texas Medicare Savings Programs

Qualifying Medicare Plan B applicants may also be eligible to receive state assistance with paying for monthly Medicare premiums. Available Medicare Part B savings programs include the following: Qualified Medicare Beneficiary Program (QMB), Specialized Low-Income Medicare Beneficiary Program (SLMB), the Qualified Individuals Program (QI) and the Qualified Disabled Working Individuals Program (QDWI).


What are benefits for Texas residents?

The State of Texas offers a wide array of benefits and services to the residents of Texas at home and abroad. These benefits include health care, housing assistance, unemployment assistance and a variety of programs for families to assist with food and health expense. Many individuals and families qualify for several of these programs. Complete the survey and download our guide to find helpful information on all of Texas Benefits along with details about eligibility and instructions for how to apply here.


Who is eligible for Texas benefits?

The State of Texas extends benefits to those who qualify. Families, individuals who have lost their job, persons with disabilities and elderly residents are usually those who will benefit the most from Texas’s social welfare programs. For a comprehensive list of the requirements for each of Texas’ programs please complete the survey and download our guide.