HOW TO GET MEDICARE PART D IN TEXAS

TX Medicare Part D provides qualifying applicants with prescription drug coverage. Any applicant who receives Medicare Part A or Part B is eligible to receive Medicare Part D in Texas. However, additional Medicare Part D costs will apply. TX Medicare Part D candidates with larger monthly incomes will pay higher monthly premiums than applicants who have a lower monthly income. Additionally, Medicare Plan D enrollment penalty fees may apply to applicants who do not join a prescription drug plan when they first become eligible.

Below, Medicare Plan D applicants can find information on applying for prescription drug coverage benefits in Texas:

  • What is Medicare Part D in Texas?
  • What do Medicare Part D plans offer in Texas?• How to get Medicare Part D plans in Texas
  • What does Medicare Part D cost in Texas? •Medicare Plan D TX coverage rules
  • What is Medicare Part D in Texas?

Texas Medicare Plan D offers prescription drug coverage to candidates who have Medicare Part A and/or Medicare Part B coverage. Medicare Part D plans are voluntary benefits that pay for the cost of brand-name and generic drugs. Medicare Plan D can be a helpful policy for applicants who have no current drug coverage and have high drug costs.

There are several Medicare Plan D policies to choose from; however, policies vary by location. Candidates should find a TX Medicare Part D plan in their area to learn more about each specific plan and the costs of each prescription drug plan.

What Do TX Medicare Part D Plans Offer?

In addition to offering prescription drug coverage, Medicare Plan D policies also provide vaccine coverage for commercially available vaccines used to prevent illnesses such as shingles. However, Medicare Part D plans in Texas do not cover vaccines that are already covered under Medicare Part B. Additionally, Medicare Part D plans may cover drugs offered in hospital outpatient services that Medicare Part B does not cover. However, Medicare Plan D petitioners may need to pay for these drugs out-of-pocket and then submit a claim to the drug plan to request a refund for the drugs.

How to Get Medicare Part D Plans in Texas

Medicare Part D plans are available three months before a candidate turns 65 or during annual enrollment periods. Newly eligible Medicare applicants may apply for Medicare Plan D three months before turning 65 and three months after turning 65.

Open enrollment for Medicare Part D plans begins on October 15 and goes through December 7. Medicare Plan D coverage begins on January 1 of the next year. However, Medicare Plan D penalty fees will apply to applicants who were eligible for prescription drug coverage but did not apply right away. The cost of the Medicare Plan D late enrollment fee will vary depending on how long the applicant went without prescription drug coverage. To enroll in a Medicare Part D plan, applicants should contact Medicare directly.

What Does Medicare Part D Cost in Texas?

Medicare Part D costs vary by plan and by the income amount of the applicant. Medicare Part D costs are based on IRS tax returns from the previous year and two years prior.

A Medicare Plan D applicant with a higher monthly income will be expected to pay a higher monthly premium or an income-related monthly adjustment amount in addition to the plan’s monthly premium. In addition to premium TX Medicare Part D costs, additional fees for deductibles, co-pays and coinsurance costs vary depending on the plan.

Medicare Part D costs vary depending on the types of drugs a patient uses and which drug plan the patient is enrolled in. Medicare Part D costs also depend on whether the applicant goes to a pharmacy in his or her network. Additionally, Medicare Part D costs will be lower for applicants with lower incomes who receive state help to assist with their Medicare fees.

Medicare Plan D TX Coverage Rules

TX Medicare Part D coverage includes several important rules that applicants should be aware of. These coverage rules include the following:

  • Medicare Plan D candidates must receive prior authorization from the drug plan before filling certain drugs. Applicants or the prescriber must contact the Medicare Plan D policy directly to receive authorization before filling the prescription. Only drugs deemed medically necessary are covered by the plan.
  • Medicare Part D has a quantity limit that only allows patients to fill a certain number of prescriptions at one time.
  • Medicare Plan D applicants must try less expensive drugs before the plan can cover higher cost drugs.However, Medicare Part D petitioners may be able to ask their plan for an exception to any of these rules.

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.