Aetna® Medicare in Texas

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Aetna Medicare Insurance in Texas

With all its rolling hills, wide open spaces, and warm temperatures, people from all over are heading to the Lone Star State for their retirement years. That may explain why the great state of Texas sits just behind Florida with the third highest number of people enrolled in Medicare. In fact, in 2018 Texas had over 4 million Medicare beneficiaries living within its borders.

Over 3.6 million Texans enrolled in Medicare plans.*

If you want to find out more about your Medicare options in Texas, you’re in the right spot. Speak with a friendly, licensed agent today for more information about Aetna Medicare plans in Texas.

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Types of Medicare Plans in Texas

While coverage varies depending on where you live, Medicare-eligible folks, including those in Texas, have a wide range of health coverage options to choose from. You can choose a federally funded Medicare plan, such as Original Medicare, or you can select a Medicare Advantage plan sold through a Medicare-approved private insurance company.

Speak with a licensed agent today to find out what kind of Texas Medicare plan you may be eligible for.

Types of plans include:

Original Medicare (Parts A and B) plans

Original Medicare is made up of two parts: Part A and Part B. Medicare Part A, also known as “hospital insurance,” covers your inpatient care at hospitals, skilled nursing facilities, or hospices. Medicare Part B, on the other hand, is sometimes called “medical insurance” and helps pay for your Medicare-approved outpatient care. This includes medical services and supplies such as doctor’s visits, physical therapy, and preventative care. It also covers durable medical equipment (DME) that you may need, such as oxygen pumps, walkers, and wheelchairs. Original Medicare is funded and administered by the federal government.

Medicare Advantage (Part C) plans

Medicare Advantage plans are regulated by the federal government but are sold by private insurance companies. By law, all Medicare Advantage plans must provide all the same coverage as Original Medicare, but most plans offer additional coverage, too. This may include things like prescription drug coverage, vision, dental, hearing aids, health and wellness programs, or gym memberships.

Medicare Part D (prescription drug) plans

If you’re eligible for Medicare Parts A or B, you can choose to purchase a Medicare Part D separately. Medicare Part D helps pay for the cost of your prescription drugs and medications. Coverage for specific drugs varies based on what’s called a Medicare “formulary,” a list of drugs separated into “tiers” according to price. Note, Medicare Part D coverage may be included in some Medicare Part C (Medicare Advantage) plans. These plans are called Medicare Advantage with Prescription Drug (MAPD) plans.

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Am I eligible for Medicare in Texas?

If you’re 65 years or older, you’re eligible to receive Medicare benefits, no matter where you live in the country, though coverage varies according to where you live. Medicare benefits are also available to younger folks who suffer from certain medical conditions, such as end-stage renal disease (ESRD) or kidney failure and amyotrophic lateral sclerosis (also known as ALS or Lou Gehrig’s disease).

In order to qualify for a Medicare Advantage plan, you must have both Medicare Part A and Part B (Original Medicare) and not have ESRD. To find out which Medicare plan you’re eligible for, talk to an agent licensed to enroll people in Medicare in the state of Texas.

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When can I enroll?

If you’re enrolling in Medicare for the first time you qualify for both Part A and Part B of Medicare, you can enroll in a Medicare Advantage plan during your Initial Enrollment Period. Your Initial Enrollment Period begins three months before the month of your 65th birthday and ends three months after your birth month.

If you’re already on Medicare and want to enroll in a Medicare Advantage plan, you can do so during the Annual Enrollment Period, which starts October 15 and ends December 7 every year.

Under some circumstances, you may be able to enroll in an Aetna Medicare Advantage plan during a Special Enrollment Period. For example, if you’ve recently moved or if you’re currently living in a nursing home. Talk to one of our licensed agents today to see if your life circumstance applies.

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Other Medicare Resources in Texas

Navigating your coverage as a Medicare beneficiary can be really complex and confusing. The state of Texas offers a number of resources to help.

Texas Medicare Savings Programs

If you’re on Medicare and you’re struggling to pay for your health care, Texas’s Medicare Savings Programs may help cut your costs by offering financial assistance for expenses like deductibles, copayments, and coinsurance. Assistance is based on your income, so contact the Texas Department of Health and Human Services to learn more.

Texas State Health Insurance Counseling and Assistance Program (SHIP)

Sometimes, you just need someone to sit down with you and explain things in plain English. Health Information Counseling & Advocacy Program of Texas (HICAP) is the Texas branch of SHIP. HICAP’s mission is to help provide senior or disabled citizens statewide with free health insurance counseling, so you can get all the information you need to make wise decisions regarding your health care.

Texas Department of Insurance

The Texas Department of Insurance publishes lots of helpful informational materials for seniors and other Medicare recipients, including information about long-term care and how to avoid becoming the victim of insurance fraud.

Texas Department of Aging and Disability Services

First established in 2004, the Texas Department of Aging and Disability Services (DADS) is the location of the Lone Star State’s Aging and Disability Resource Center, which provides a broad range of resources and services for Texas Medicare beneficiaries, including personal counseling.