If you live in Texas and are looking for Medicare information ahead of open enrollment, which begins January 1 and ends March 31, it’s easy to get confused. Not only must you determine your eligibility, but you also need to find the right plan and provider for your needs.
Should you choose Part A, Part B, or both? And do you qualify for a Medicare Advantage plan? If you’re gearing up for Medicare open enrollment and looking for help choosing the right provider, here are some tips to help you make the best-informed decision.
Determining Medicare Eligibility in Texas
If you’re 65 or older, or under the age of 65 and deemed disabled by the Social Security Administration and meet certain income and resource requirements, you may be eligible for Medicare.
Non-Disabled Applicants
- Income limit: $1,133.01 minimum to $1,359 maximum per month ($1,526.01 to $1,831 for couples.)
- Resource limit: $7,970 for individuals ($11,960 for couples)
- Resources include any liquid assets that can be converted into cash within 20 days, as well as real estate holdings for any non-primary residence.
Disabled Applicants
- Income limit: $2,265 maximum for individuals and $3,052 maximum for couples
- Resource limit: $4,000 for individuals and $6,000 for couples
Understanding Medicare Part A and Part B Coverages
Although there are 10 different kinds of Medicare Supplemental plans (A, B, C, D, F, G, K, L, M, and N), original Medicare consists of Part A and Part B.
Medicare Part A
With Medicare Part A, you can choose any doctor or hospital that accepts Medicare without restrictions. Part A covers hospital-related expenses, such as care at a skilled nursing facility after a hospital stay, care in a hospital, home health care, and hospice care. You’ll be responsible for paying a monthly premium, as well as deductibles, co-pays, and co-insurance costs (unless you have plans B, C, D, F, G, or N, which pay your Part A deductible; or Parts K, L, or M, which pay a percentage of your Part A deductible).
Medicare Part B
Medicare Part B helps cover doctor visits, outpatient care, medical equipment, and preventative care screenings. Similar to Part A, you can use your Plan B coverage with any doctor or hospital that accepts Medicare, but you’ll be responsible for deductibles, co-pays, and co-insurance (unless you have Plan C or F, which pays Part B deductibles; or Part F or G, which pays for any doctor fees over the agreed Medicare-approved charges.)
Choosing a Medicare Advantage Plan Provider in Texas
If you have both Medicare Part A and Part B coverage, you may qualify for Part C, otherwise known as a Medicare Advantage plan. However, the number of providers and costs will vary depending on where you live in Texas.
For instance, heavily populated Harris County has 17 providers to choose from, with an average monthly premium of $18. Meanwhile, Reeves County only has four providers, with an average monthly premium of $49.
To choose the best provider for you, start by researching reputable reviews of Medicare Advantage plans in Texas. There are also several government resources available to help in your decision-making, including a plan comparison guide provided by Medicare.gov and consulting with experts at the Texas Medicare Helpline. Call 800-252-9240 for more information.
The Choice is Yours
After determining your eligibility, the next step is choosing which Medicare plans are the best fit for your needs. While Part A and Part B plans cover different types of care, they are universally accepted wherever Medicare is taken. When choosing a Medicare Advantage plan ahead of open enrollment, however, you’ll need to do more research to determine which providers are available in your area and accepted by your preferred doctor or hospital. You’re not alone in your search, though, as many reputable third-party reviews of plans and government services can help you make the best-informed decision.
