It’s said that everything is big in Texas and that holds true for the divide between rural and metropolitan Counties when it involves a choice of Texas Medicare plans.
The story is the same in many States across the Country. If you live in a rural County your chances of having a big selection of Medicare Advantage plans is not too great.
This article will focus on Medicare Advantage plans and how you can choose one that is best for you. If you are interested in a Medigap policy or a Part D plan the playing field is a little more level. But when it come to Texas Medicare Advantage plan options there is a disparity of choices.
Texas Medicare plan choice – your Counties population matters
The most popular types of Medicare Advantage plans include:
- Health Maintenance Organization (HMO)
- Health Maintenance Organization – Point of Service (HMO-POS)
- Preferred Provider Organization (PPO)
- Regional Preferred Provider Organization (RPPO)
- Private Fee-For-Service plans (PFFS)
Your County’s population will generally determine which types of plans are available and predominant. A Medicare HMO, HMO-POS and to a lesser degree a PPO require a credible network of providers.
Plans negotiate rates with providers and providers need to know that a large group of Medicare Advantage members will potentially become clients and make it worth their while.
If you live in a heavily populated County like Harris County or Dallas County there is a good chance that you will have many plans to choose from including many HMO, HMO-POS and PPO plan options. For 2013 Harris County has 40 Medicare Advantage plans available 29 of which include Part D coverage.
If on the other hand you live in Webb County you will find far less of a choice when it comes time to compare Texas Medicare plans. There are only 8 plans that include Part D coverage. Of these 4 are PFFS plans which many people consider less desirable.
Comparing Texas Medicare Advantage plans
If you are in a more populated County you will need to take a look at the network for each plan that you may be considering. This can be less of a concern with PFFS plans especially in more rural Counties.
But after the network question is resolved you need to focus on five key pieces of information.
- Compare plan premiums
- Delve into the plan’s Summary of Benefits (Most important document!)
- Review the plan’s formulary if Part D is included
- Compare out-of-pocket costs – copays, coinsurance and any deductibles
- Determine if the plan has the extra benefits that you find important
The Annual Enrollment for Texas Medicare Advantage plans begins on October 15th and ends at midnight on December 7th. Plans will be effective January 1st.
Start shopping early and cover as much ground online as possible. you can visit plan websites or visit the Medicare website to locate plans in your County.