Living in Texas and preparing for that stage in your life where you have to tend to the special healthcare needs of your parents, spouse or loved ones as they advance in age can be tasking, but necessary. As people advance in age, they get more susceptible to illnesses and they don't recover as fast as before.

Having a Medicare plan in place helps you cover healthcare services and manage the costs. In this article we discuss what Medicare is, the Medicare advantage plans in Texas available to you.

Medicare and the Plans Available to you

Medicare is a healthcare insurance program initiated by the federal government in the year 1965 under the social security administration. Its goal is to assist with healthcare services for aging Americans who are 65 and above.

Studies indicate over 18% of the US population as being covered by Medicare services, with Texas having one of the largest percentages of individuals aged 65 or older.

Best Medicare Plan in Texas

There are two segments of Medicare plans. The first segment focuses on original Medicare plans and it is divided into two categories: Plan A and B.

The second segment focuses on private companies that offer the best Medicare advantage plans in Texas, USA. It covers health insurance and medical insurance. Some companies include drug prescriptions coverage and Special Needs Plan (SNPs). They are offered by medicare approved companies.

This plan is available for your loved ones who have previously enrolled in the original medicare. It combines all of the benefits found in the original medicare plans and goes on to deliver extra benefits in two categories namely: Plan C and D.

Let us examine the various Medicare plans below:

Plan A

This plan deals with the hospital insurance cover health care costs for admitted patients in a hospital or skilled nursing facilities. The services covered include:

Services Rendered in the Hospital

This includes hospital supplies, general care, acute care, and meals used to care for the patient. It can include access to long-term care and a semi-private room.

Home Health Care

This care is rendered by expert nurses at the home and it includes a recovery plan for your loved ones. This does not however mean 24/7 health coverage at home as your Medicare plan has to cover it. However, it covers for nurses who are tasked with aiding the speedy recovery of your loved ones.

Skilled Nursing Facilities

An inpatient may enjoy the services of a skilled nursing facility for a limited time if the inpatient meets the following conditions:

● The illness requires a hospital stay.

● If the minimum number of three days is met

● If you're passed as an inpatient due to a certain illness spotted

● An order from the doctor after immediate discharge from the hospital

While a few skilled nursing facilities are located at a hospital unit, the majority of them are privatized. Some conditions that requires skilled nursing care may include:

● Heart failure,

● Renal failure,

● Kidney and urinary tract infection, and

● Pneumonia, etc

Palliative and Hospice Care

Both palliative and hospice care offer similar benefits by aiming to reduce pain, discomfort and offer individualized care, according to the studies conducted by the National Institute of Aging (NIA). The only difference being that:

● Palliative care prioritizes on the continuity of treatment for serious ailments.

● Hospice care focuses on terminal illnesses, one usually associated with the end of life.

Medicare covers everything needed for this process including transportation, medication etc.

Plan B

Plan B covers doctor services, outpatient care, emergency services etc. It is the part of Medicare that provides medical insurance and also offers coverage for preventive services.

These services may include:

● Ambulance services

● Cardiac rehabilitation

● Clinical laboratory services

● Cardiovascular screenings

● Diabetes screenIngs

● Defibrillator (Implantable)

● Mental health care

● Physical therapy

● Transplant and Immunosuppressive drugs

● Flu shots etc

Medicare Advantage Plans in Texas

In this segment, private companies are contracted to provide coverage in gaps that might not be covered by Plan A and Plan B. In addition to filling in the gaps, Conniehealth Medicare advantage plans provide all the benefits your loved ones would originally get from subscribing to Medicare Plan A and B.

We briefly discuss the coverage below.

Plan C

Plan C is referred to as Medicare advantage plan. In this plan, private companies are contracted to provide the services not covered by the original Medicare plans. This plan also covers all the services you'd receive under Medicare plan A and B.

This coverage includes:

● Dental

● Hearing

● Prescription drugs

● Home meal delivery

● Gym membership etc.

Can Your Loved Ones Access Medicare Plan C?

Your loved ones can access any Texas Medicare advantage plans if they have already had Medicare A and B.

In 2021, a law passed by Congress allowed for people with loved ones suffering end stage renal disease (ESRD ) to access Medicare advantage plans. Before this time, Medicare advantage plans were limited to a special needs plan (SNP) for people with ESRD.

Enrollment Period for Medicare

Getting your loved ones to enroll for Medicare advantage plans in Texas should begin:

● Three months before they turn 65

● On the month they turn 65

● Or three months after they turn 65

Should you miss the initial enrollment period, open enrollment period begins October 15th and closes on the 7th of December yearly.

Plan D

This covers the prescription of drugs. It is an insurance policy covering the cost of drugs to be used. It can operate as a stand-alone policy or as an added benefit to your loved ones who enroll in the Medicare advantage plan.

Plan D also covers most vaccines, in case needed by your loved ones in Medicare.

Some examples of drugs covered by Plan D may include:

● Anticancer drugs

● Antidepressants drugs

● HIV/AIDS treatment

● Antipsychotic drugs etc

Texas Medicaid Application

The Medicaid plan gives healthcare services to the vulnerable percentage in American society at a much subsidized rate. Both federal and state governments are responsible for funding the medicaid plan. While it is administered by the state government of Texas in line with federal regulations.

This plan gives healthcare coverage to people like:

● Low income earners

● Pregnant woman

● People with disabilities

● The elderly

● Children etc.

Medicaid Eligibility in Texas

For the children 's medicaid program, the young child must be 18 and below. (Having a form of disability). Older Texas residents have to be low income earners and above age 65.

Conclusion

You can begin plans for Medicare the moment your loved ones are about to hit 65. There are many plans to choose from. The original Medicare plans can cover the special healthcare needs for your loved ones. While the Medicare advantage plan combines the original Medicare plans with some added features to ensure your loved ones are well taken care of.

Medicare Plans For Your Loved Ones - 2022