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Never in the history of the Medicare Advantage plan program has so many health plan choice been available to Texas seniors and other Medicare beneficiaries. This is the finding of a new MedicareWire report detailing the 2021 changes for Texas seniors. According to the report’s authors, most Texas counties average over 30 plan choices.
Texas seniors can use the MedicareWire plan finder tool, located at https://medicarewire.com/medicare-advantage/state/texas/, to compare the best Medicare Advantage plans in Texas and download summary of benefits documents. Each summary of benefits PDF file details the copays, coinsurance, premiums, deductibles, and other out-of-pocket costs members will pay when they join a plan.
Texas seniors who enroll in Medicare aren’t stuck with the same coverage forever. Rather, they can make changes to their coverage once a year during Medicare’s Annual Election Period (AEP), which runs from October 15 through December 7.
Medicare Advantage plans have a monthly premium that each plan sets. Many plans have a zero dollar premium, but this does not mean the plans are free. If they join a plan, Texas Medicare beneficiaries are required to continue paying their Medicare Part B premium, according to the MedicareWire report.
The MedicareWire report explains that most plans include a Part D prescription drug plan. In addition to the costs plan members pay when they use healthcare services, the Part D component of a health plan also has costs, including deductibles, copays, and coinsurance when a member picks up their prescriptions.
The Part D component of a health plan makes comparing plans particularly difficult because each medication is organized into one of several pricing tiers, and each plan creates its own tiers. According to the report’s authors, the best Part D plan (PDP) is the one that is most affordable for the regular prescription medications you take. Spending time making sure your medications are covered at the most favorable rate is a serious recommendation.
Even though the current Administration has signed a “most favored nations executive order” to lower Medicare drug prices, it’s still important to make sure that you find the best-cost plan. Specifically, if your medications are expensive, some enhanced benefit plans give you extra benefits when you reach the “donut hole,” while others do not.
Most Part D plans have a network of preferred pharmacies. But, PDPs also offer their members a mail-order drugs service, which could be the savings you need when it comes to getting your medications at the best price. Plus, you may find additional savings when you use a pharmacy discount card. The MedicareWire report recommends GoodRx, and further suggests comparing costs before using your Part D benefits. This helps people with high-cost medications save their Part D dollars for the costly meds while still saving a few dollars on the lower-cost prescriptions.
In addition to prescription benefits, many new Medicare Advantage plans offer vision, hearing, dental, and telehealth benefits. As with stand-alone vision and dental, most plans cap the annual benefit at a modest level.
Another big change for the new plan years is an increased maximum out-of-pocket (MOOP) limit. For the past five years the highest MOOP a plan could have was $6,700 per year. The new MOOP ceiling is now $7,550. The good news is that many Texas Medicare Advantage plans have kept their original MOOP, and some plans have lowered it.
The annual maximum out-of-pocket limit only applies to out-of-pocket costs on health services, including copays and coinsurance. It does not apply to monthly premiums, deductibles, or prescriptions.
If you have Medicare benefits, it pays to look at your Texas Medicare Advantage plan choices every year, even if you’re happy with your existing coverage. Most people find they can save a substantial amount of money by comparing plans.
But new information from the Kaiser Family Foundation shows that 57% of Medicare enrollees in Texas don’t take advantage of this option by comparing their coverage choices each year. And, due to the complexity of comparing Medicare plans, older enrollees are even less likely to review their plan options each year, with 66% of beneficiaries age 85 and older not taking advantage of AEP at all.
For more information about Texas Medicare Advantage plans, and how to find a plan that will work for you, visit the link above.
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