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.