In this blog post, we will discuss Medicare coverage options in Austin, Texas, as well as some popular hospitals and Medicare plans that you might want to consider.
What type of Medicare coverage is available?
Medicare in Austin will cover hospitalization, medical expenses, and other health care services. There are several different types of Medicare coverage available to choose from.
Original Medicare
This is the standard Medicare program that everyone pays into throughout their working lives. It consists of Medicare Part A and Medicare Part B.
If you have worked for ten years or forty quarters, you are eligible to receive Medicare Part A for free. If you have not paid into Medicare throughout your working life, then you’ll need to pay a premium for Medicare Part A.
Medicare Part A is considered your “hospital insurance.” It covers inpatient care, hospice care, and some limited home health services.
Medicare Part B does come at a monthly premium of $148.50 in 2021. This premium can increase if you have a high income.
Medicare Part B is considered your “medical insurance.” It covers medical expenses like doctor visits, outpatient services (like lab work), preventative benefits (including physicals), and durable medical equipment.
Medicare Advantage Plans
Medicare Advantage is also called Medicare Part C. If the particular Advantage plan offers prescription drug coverage, it is also referred to as a Medicare Advantage Prescription Drug Plan, or MAPD for short.
Medicare Advantage plans are plans offered by private companies that contract with Medicare. It combines Medicare parts A and B, and it also provides additional benefits such as dental coverage or vision services at no extra cost. If you choose to go this route, your primary care physician will be the one to coordinate all of your healthcare needs.
Medigap Plans
Medicare Supplement plans, or Medigap for short, are available to supplement your Original Medicare coverage. There are ten different Medicare supplements that can help you pay out-of-pocket costs like copays and coinsurance when you’re in the hospital or receiving medical services from a doctor.
Unlike Medicare Advantage plans, Medigap plans do not combine your Original Medicare, Parts A and B, into one plan. A Medigap plan is a separate policy. If enrolled in a Medigap plan, individuals will also need to purchase a separate Dental, Vision, and Hearing policy, as well as prescription drug coverage (also known as Medicare Part D).
- Medicare in Austin will cover hospitalization, medical expenses, and other health care services.
Which Medicare plans are available in Austin, Texas?
Original Medicare is available across the United States. However, there are specific MAPD, Medigap, DVH, and Part D plans available depending on where you live. Let’s discuss your Medicare options in Texas.
Medicare Advantage Plans
Medicare Advantage plans are an excellent choice for residents of Austin, Texas. They are widely accepted throughout the state and each county has many options to choose from.
The current list of carriers and plans is much too long for a single post. There are approximately 270 Medicare Advantage Prescription Drug plans in Texas.
Some of the most popular MAPD plans are as follows:
- Erickson Advantage Champion (HMO-POS C-SNP)
- Erickson Advantage Freedom (HMO-POS)
- KelseyCare Advantage Rx+Choice (HMO-POS)
- United HealthCare Nursing Home Plan (PPO I-SNP)
- AARP Medicare Advantage Plan 1 (HMO-POS)
Medigap Plans
There are approximately 69 carriers offering Medigap plans to Austin, Texas residents in 2021. These carriers include all major insurance companies, as well as smaller ones unique to Austin.
These carriers will all offer the ten standardized plans of Medigap. Of the ten plans, Plan F, Plan G, and Plan N are the most popular and comprehensive.
Dental, Vision, and Hearing Plans
Dental, Vision, and Hearing plans are available all over the United States. There are multiple carriers and coverage levels. If you currently have a dentist, optometrist, and audiologist, you may want to find out which carriers they accept payment from.
Some popular Dental, Vision, and Hearing carriers are:
- Aetna
- Manhattan Life
- Medico
- Mutual of Omaha
- Nat Gen
Part D Prescription Drug Plans
If individuals choose not to enroll in an MAPD plan, they will need to purchase a separate Part D prescription drug plan.
There are several carriers for these plans. Individuals will need to understand how their current medications are covered under each plan to find the one with the most value.
The current Part D carriers in Texas are:
- AARP
- Amerivantage
- Blue Cross
- Cigna
- Clear Spring Health
- Elixir
- Exemplar
- Express Scripts
- Humana
- Mutual of Omaha
- SilverScript
- WellCare
Each of these carriers offers several plans to choose from and will vary by county.
Which hospitals in Texas accept Medicare assignments?
There are 595 hospitals in Texas, and most of them accept Medicare Assignment. Of course, you will likely want to seek care from the one closest to you in Austin, but the following six rank highest in the care provided.
- Ascension Seton Medical Center: Austin, TX
- St. David’s Medical Center: Austin, TX
- Arise Austin Medical Center: Austin, TX
- Houston Methodist Hospital: Houston, TX
- UT Southwestern Medical Center: Dallas, TX
- Baylor St. Luke’s Medical Center: Houston, TX
If you are a resident in Austin, Texas, and looking for ways to decrease your medical costs, give us a call. We’d be happy to review your needs and compare them to the available plans.
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