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).