Medicare Plans in San Marcos, Texas
A number of factors influence what Medicare coverage options you have available to you, such as your age and what county you live in. Medicare enrollees in San Marcos have access to Medigap, Medicare Advantage, and Part D plans.
However, Medicare plan availability and premium rates vary depending on where an enrollee resides, so Hays County residents may note differences in plan prices and availability as compared to options in surrounding counties.
Read on to learn more about your options when it comes to Medicare plans in San Marcos, Texas. And if you would like to receive guidance when it comes to choosing a Medicare plan, reach out to us here at Medicare Plans Direct. We can answer all of your Medicare questions and help you find the right plan for you.
Medicare Supplement Plans in San Marcos
Medigap plans are one option that you have when it comes to setting up your Medicare health insurance coverage. These policies can be purchased to supplement your Original Medicare benefits and work by filling in the “gaps” left over by Original Medicare.
The best time to enroll in Medigap coverage in San Marcos is during your Medigap OEP, which occurs when you first become eligible for Medicare and are enrolled in Part B. This period lasts for six months, and during this time, you will be allowed to enroll in a Medigap plan without having to undergo medical underwriting.
San Marcos Medicare beneficiaries have access to all Medigap plans. However, if you are a Medicare enrollee under the age of 65 who qualifies for coverage because of a disability, you only have the option to enroll in one of the following policies: Plan A, B, C, D, F, G, or N.
Texas law only grants guaranteed issue rights for disability beneficiaries when it comes to enrolling in Plan A, and this protection is only offered during an enrollee’s Medigap OEP.
If you are under the age of 65 and want to enroll in a plan other than Plan A, or try to enroll outside of your Medigap OEP (and don’t qualify for another guaranteed issue right), you will likely have to undergo medical underwriting. This means that insurance companies reserve the right to deny you coverage and charge you higher premiums.
What you have to pay for your Medigap monthly premium in San Marcos depends on a number of factors, such as your age, gender, smoking status, and when you enroll. For example, a 65-year-old female non-smoker in San Marcos could pay between $72 and $280 for Plan N coverage in 2021 (before any household discounts were applied), while a male non-smoker with the same age and ZIP Code faced monthly premium rates of between $82 and $316 for the same plan.
As you can see, there are a number of variables that impact how much your Medigap coverage will cost you, and premiums vary significantly based on which insurance company you choose.
That’s why we always recommend that you consult with a knowledgeable insurance agent, like a team member at Medicare Plans Direct, before deciding on a plan. We can shop multiple insurance companies for you very quickly, saving you time and energy. That way, you’ll ensure that you are getting the best value plan for you.
Medicare Advantage Plans in San Marcos
Medicare Advantage plans are another way to get your Original Medicare health care coverage. These plans do not replace your Part A and Part B coverage, but rather they become primary to your Original Medicare Coverage. Medicare Advantage policies often include extra benefits, such as drug coverage, hearing coverage, vision coverage, dental coverage, and more.
In 2021, over 40% of Medicare beneficiaries in Hays County were enrolled in Medicare Part C, and the average monthly premium for Texas Medicare Advantage enrollees in 2022 is $10.68. Some plans in this area even offer a Part B Giveback, meaning that money will be applied to your Social Security check to help pay for your Part B premium.
Medicare beneficiaries in San Marcos can choose between 56 plans in 2022. Among these plan options there are various types of Special Needs Plans (SNPs) available to qualifying beneficiaries. Your individual situation will determine which type of plan you qualify for.
There are SNPs available for people who have both Medicare and Medicaid. There are also SNPs available for people who have chronic conditions, such as diabetes, mellitus, or coronary artery disease, among others.
Many Medicare Advantage plans include prescription drug coverage. Make sure you are aware of whether the plan you are signing up for includes prescription drug coverage, as some Medicare Advantage policies, like HMO and PPO plans, don’t allow you to sign up for a separate drug plan once you are enrolled.
Certain Medicare Advantage plans limit coverage options to the plan’s provider network, meaning that only doctors and hospitals within your policy’s network will be covered. It is important to consult with an experienced insurance agent before choosing a Medicare Advantage plan to ensure that your preferred medical providers will be covered.
The following types of Medicare Advantage plans are available in San Marcos in 2022:
- Special Needs Plans (Dual Eligible Medicare/Medicaid)
- Special Needs Plans (Chronic Conditions)
- Medicare Advantage without drug coverage
To make sure that you are selecting the type of plan that meets your needs, contact us today for a free analysis and plan review.
It is important to note that Medicare Advantage plans can not be combined with Medicare Supplement plans. So, for example, you can’t have a Medigap Plan G and a Medicare Advantage PFFS plans at the same time. Now let’s take a look at Medicare Part D drug plans.
Medicare Part D Plans in San Marcos
If you want help paying for your prescription medications, it is important that you enroll in a Medicare Part D drug plan. There are 26 stand-alone drug plans available to San Marcos Medicare beneficiaries in 2022.
Some Medicare Advantage plans offer coverage for your prescription drug expenses, but individuals who are enrolled in Original Medicare and/or Medicare Supplement Insurance will need to enroll in Part D if they want help paying for prescription medications.
You should be aware that even if you don’t require prescription medications when you first become eligible for Medicare, you may want to consider enrolling in a prescription drug plan. Failing to sign up for Part D when you first become eligible could cause you to face late enrollment penalty fees in the future (unless you have other prescription drug coverage that Medicare considers to be creditable).
If you are a San Marcos resident who is about to become eligible for Medicare, don’t hesitate to reach out to us for a free Medicare consultation. Here at Medicare Plans Direct, our mission is to help seniors navigate their Medicare enrollment journeys and find the best possible coverage options for them.