Texas Medicare Part D Drug Plans help Medicare recipients control their retail prescription drug costs. We are very lucky to have this coverage. Prior to 2006, Medicare beneficiaries did not have outpatient drug coverage under Medicare.
You can either enroll in a stand-alone Part D drug plan, or you can enroll in a Medicare Advantage plan that has a Part D drug plan included. No matter how you get a Part D plan, every plan has four stages. To learn more about Texas Medicare Part D’s four stages, check out Part D Basics.
For 2018, there are over 20 Texas Medicare Part D drug plans to choose from. It is important that all people with Part D review their coverage every year. The plan’s benefits, formulary, pharmacy network, premium and/or copayments and coinsurance may change on January 1st of each year.
Your insurance company will send you an annual notice of change around September of each year. Review it carefully to see the upcoming year’s changes.
Part D Formularies
All plans must also include at least two medications from each therapeutic class. This means that if you develop new health conditions that require medications mid-year, your doctor should be able to find drugs on the formulary to help you.
However, there are certain classes of drugs that Medicare doesn’t require Part D drug plans to cover. For example, Medicare drug plans aren’t required to include barbiturates and benzodiazepines in their formularies.
Is Part D Voluntary?
Part D is an option part of Medicare. With that said, if you choose to forgo enrolling in a Part D plan, you can be penalized for each month you go without creditable coverage. Which means, if you ever do choose to enroll in a Part D plan, you will have to pay the penalty in addition to your plan’s premium.
Every month you go without Medicare Part D, 1% of the national average Part D premium is added to your plan’s premium. Not only do you have to pay this penalty on top of your premium, but this penalty is lifelong.
Texas Medicare Part D Creditable Coverage
In order to avoid being penalized for not having Medicare Part D, you must have creditable coverage. The two most popular forms of creditable drug coverage in Texas are group health plans and VA benefits.
If you continue active work past 65 and have insurance with a drug plan through your employer, that coverage could be considered creditable drug coverage. Same goes if you have VA benefits. VA benefits act as creditable coverage for Part D. However, they are not considered creditable coverage for Part A and Part B.
For help understanding Medicare Part D, please call us or request online help here: