Blue Cross Blue Shield of Texas Medicare Part D Formulary

Medicare Prescription Drug Plans in Texas

Original Medicare offers many benefits, but it doesn't cover prescription drugs. You'll need to purchase a Medicare Part D plan to help with prescription drug costs or choose a Medicare Advantage Plan with prescription drug coverage.

Texas has several options for Medicare Part D plans, some with a low monthly premium. Learn more about Texas Medicare Part D prescription drug plans:

• All Texas Medicare recipients have access to a Medicare prescription drug plan in 2022.
• There are 28 Part D prescription drug plans available in Texas in 2022.
• Eight Part D prescription drug plans in Texas participate in the Part D Senior Savings Model, which offers lower out-of-pocket insulin costs than other plans.
• The lowest 2022 Part D prescription drug plan monthly premium in Texas is $6.90.

Read on to learn about enrollment, cost, and benefits of Medicare Part D plans in Texas.

Medicare Part D Plans in Texas

Note: A.M. Best, BBB, NCQA, and J.D. Power ratings assess the insurance company as a whole or Medicare Advantage Plans, which often include prescription drug coverage.

What Medicare Part D Plans Cover

Medicare Part D plans offer prescription drug coverage. Each plan has a formulary, which is the plan's list of covered drugs. Typically, Part D plans have drug tiers, which indicate the drug's cost.

Part D Formularies

A Medicare Part D formulary is a list of all the drugs covered by the plan. All Medicare Part D plans are required to cover a wide range of prescription drugs for people with Medicare, with at least two drugs per drug category.

If your specific drug is not on a plan's formulary, it should have a similar drug available. You can ask for an exception if you need a drug that's not on a plan's formulary.

Part D Tiers

Usually, Medicare Part D plans categorize drugs in tiers, with each tier charging a different copayment amount. For example:

Medicare Part D Plan Eligibility and Enrollment

You can enroll in a Medicare Part D prescription drug plan if you're enrolled in Medicare Part A and/or Part B, or a Medicare Advantage Private Fee-for-Service (PFFS) Plan that doesn't offer prescription drug coverage. You must be enrolled in Medicare Part A and B to join a Medicare Advantage Plan.

It pays to enroll in prescription drug coverage during your initial enrollment period, even if you don't take prescription medications. If you don't enroll during this period and have no creditable drug coverage, you'll have a 1% penalty for each month you don't enroll, which will be added to your Part D monthly premium.

Part D enrollment is available during specific enrollment periods:

There are multiple ways to enroll in Medicare Part D prescription drug plans:

• Enroll on the Medicare Plan Finder or on the plan's website.
• Complete a paper enrollment form.
• Call the plan.
• Call us at 1-800-MEDICARE (1-800-633-4227). TTY: 1-877-486-2048.

When you join a Medicare drug plan, you'll give your Medicare Number and the date your Part A and/or Part B coverage started. This information is on your Medicare card.

What Medicare Part D Costs in Texas

You'll pay a monthly premium and be subject to an annual deductible and copays for each prescription with a Medicare Part D plan.

• Lowest Part D monthly premium in Texas: $6.90
• Maximum annual deductible: $480
• Copays: As low as $0 for preferred generic in the initial coverage phase

The initial coverage phase starts when you meet your deductible and ends when you and your plan have spent $4,430. You then enter into the coverage gap phase (also known as the "donut hole") until your out-of-pocket spending reaches $7,050. You pay a small amount for prescription drugs for the remainder of the year while you are in the catastrophic coverage phae.

If you have limited resources, you may be able to get financial assistance through Medicaid, Extra Help, or Pharmaceutical Assistance Programs in your state.

How to Choose a Medicare Part D Plan in Texas

Medicare Part D Resources in Texas

Need help choosing a Part D plan or help paying for your prescription drugs? Counselors in Texas can help you find the best Part D coverage for your needs. They can also help if you're having trouble getting an exception approved or have a denied claim. Get in touch with these Medicare resources in Texas:

Certified Senior Advisor (CSA)Ⓡ

As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor® credential from the Society of Certified Senior Advisors.

Blackwell contributes to the University of Colorado-Anschutz blog and has been published in "The Human Touch" distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote "Dying Is" for Pathways Hospice.

A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She's passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She's equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.

As a CSAⓇ, Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.

Learn More From Our Sources

• A.M. Best | Health Insurance Industry | Last accessed July 2022
• BBB | Last accessed July 2022
• CMS | Medicare Fact Sheet 2022 | Last accessed July 2022
• J.D. Power 2021 U.S. Medicare Advantage Plan Ratings | Last accessed July 2022
• Medicaid | Last accessed July 2022
• Medicare | Costs for Medicare drug coverage | Last accessed July 2022
• Medicare | Extra Help | Last accessed July 2022
• Medicare | How to get prescription drug coverage | Last accessed July 2022
• Medicare | Joining a Health or Drug Plan | Last accessed July 2022
• Medicare | Part C and D Performance Data | Last accessed July 2022
• Medicare | Pharmaceutical Assistance Programs | Last accessed July 2022
• Medicare | Plan Finder | Last accessed July 2022
• NCQA | Health Plan Ratings | Last accessed July 2022

gleasontander.blogspot.com

Source: https://www.medicareplans.com/medicare-part-d-plans-texas/

Share this post