New online tool helps seniors sort through the best Medicare Part C Plans in Texas by comparing benefits, copays, and Medicare 5-star ratings.
With more than 30 Medicare Advantage plan available in most Texas counties, there have never been so many health plan choices. On one hand more choices offer better deals. On the other hand, it creates more headaches for Texas seniors, as comparing plans is more challenging than ever. That's where a new plan finder tool by MedicareWire comes in.
Texas seniors can use the plan finder tool, located at https://medicarewire.com/medicare-advantage/state/texas/, to compare the best Medicare Advantage plans in Texas and download a summary of benefit document for each plan that interests them. Each summary of benefits PDF document details the copays, coinsurance, premiums, deductibles, and other out-of-pocket costs plan members will pay when they use various health services.
Medicare Advantage plans are private health plans from a variety of national and local companies. Each plan has a monthly premium that the plan sets based on the benefits included. Many plans have a zero dollar premium, however, they are free. When a beneficiary joins a plan they must continue paying their Medicare Part B premium.
Most Medicare Advantage plans include a Part D plan for prescriptions. In addition to the copays and other costs plan members pay when they use health services, the Part D plan component has its own costs, including deductibles, copays, and coinsurance when a member picks up their prescriptions.
The Part D component of a Medicare Advantage plan makes comparing plans particularly difficult because each medication is organized into one of several pricing tiers, and each plan creates its own tiers. Generally speaking, 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 highly recommended.
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 regular medications are expensive, some enhanced benefit plans give you extra benefits when you reach the coverage gap (aka, “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. You can use a site like GoodRx to find additional savings. This helps people with high-cost medications save their Part D dollars for their costly medications while saving a few dollars on the lower-cost prescriptions.
In addition to pharmacy benefits, many Advantage plans bundle vision, hearing, dental, and telehealth benefits, as well. As with stand-alone vision and dental plans, most Medicare Advantage 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.
Plan shoppers should take note that the MOOP only applies to out-of-pocket costs on health services, including copays at the doctor's office and coinsurance when you are hospitalized. It does not include monthly premiums, deductibles, or prescriptions.
If you have Medicare, it pays to look at your plan choices every year, even if you're happy with the plan you already have. Doing so could save you a substantial amount of money and help ensure that you're able to afford the care you need to stay healthy. Medicare's Annual Election Period (AEP), which runs from October 15 through December 7, is your chance to make plan changes for the new year.
For more information about Texas Medicare Advantage plans, and how to find a plan that will work for your particular situation, visit the link above.
