| The Medicare Project a consumer's guide to Texas Medicare programs, Medicare Part D Prescription Drug Reimbursement and Coverage topics: Medicare Prescription Drug Help, Medicare coverage, Medicare Advantage prescription drug programs, supplement insurance, what is Medicare? help |
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Texas Medicare, Texas Medicare Prescription Drug Coverage
Answers and information about Medicare, prescription drug coverage and health insurance
involves searching through hundreds of pages at government and private websites. To help seniors and caregivers get started
in their search, our editors have compiled this digest of Texas Medicare help and information
resources. |
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Medicare Web Page: Prescription Drug Coverage source:TexasMedicareRx (Texas Health and Human Services Commission) languages: English and Spanish "Through this website, the Texas Health and Human Services Commission hopes to provide information that helps dual eligible Texans - those who are Medicare-eligible and also receive assistance from Medicaid - make a successful transition to the new Medicare Rx program..." TRS-ActiveCare Medicare Prescription Drug Coverage source:Teacher Retirement System of Texas file size: 3 pg. languages: English (September 19, 2005) Eligibility, costs, and coverage details directed to members of the TRS of Texas. Medicaid Prescription Drug Coverage Primer source:Texas Institute For Health Policy Research file size: 8 pg. languages: English Thorough presentation of Medicare Part D questions and answers The Medicare Coverage Gap (The Doughnut Hole) languages: English A directory of web sites, articles, and publications that helps explain what and how the Prescription Drug Coverage Gap works. Medicare Web Page: (Texas) Medicare Supplement Insurance Handbook and Rate Guide source:Texas Department of Insurance languages: English (July 2006) Various topics are covered, including: Key Changes in Medicare Supplement Insurance... Medicare and Medicare Supplement Insurance... Medicare Basics... Medicare Supplement Insurance and others also from Texas Department of Insurance: Medicare Web Page: Medicare Advantage Plans languages: English "Medicare prescription drug coverage (Medicare Part D) pays some of the costs for prescription drugs at participating pharmacies in your area. Everyone with Medicare is eligible for this coverage, regardless of income and resources, health status, or current prescription expenses. The program is voluntary and can be especially helpful for people who have high drug costs and no drug coverage..." Medicare Web Page: Health Information Counseling & Advocacy Program of Texas languages: English "...health insurance counseling for older and disabled Texans...The Texas Department of Insurance partners with the Texas Legal Services Center and the Texas Department of Aging and Disability Services to provide information about both public benefits and private health insurance...." Medicare Web Page: Covering the Cost of Medicare languages: English (Revised June 2006) "If you cannot afford the additional expense of purchasing a Medicare supplement policy to supplement your Medicare coverage, there are a couple of programs you should be aware of. The Medicaid-sponsored Medical Savings Programs may pay Medicare premiums, deductibles, and coinsurance amounts for eligible Medicare beneficiaries. These programs allow you to better direct your savings to cover health care expenses..." (Medicare Prescription Drug Plan Finder source:Medicare: The Official U.S. Government Site for People with Medicare languages: English Find and compare plans for all states, including Texas Medicare Prescription Drug plans HEALTHCARE RIGHTS OF OLDER TEXANS source:THE LEGAL HOTLINE FOR TEXANS languages: English "...discusses several different laws concerning health care which may provide assistance to Texans sixty years of age or older and persons eligible for Medicare..." Texas Medicare Drug Plan Ratings source:AARP file size:5 pg. languages: English "...This AARP rating tool contains information about “stand-alone” Medicare plans in your state that cover only prescription drugs...." Texas: Medicare Prescription Drug Plan (PDP) Premiums, 2007 source:Kaiser Family Foundation / statehealthfacts.org languages: English from the web page: "...Beneficiaries can join a prescription drug plan (PDP) for drug coverage only and get their other Medicare benefits through the fee-for-service program, as the majority of people with Medicare currently do. Alternatively they can join a Medicare Advantage (MA) plan..." A Consumer's Guide to Getting and Keeping Health Insurance in Texas source:healthinsuranceinfo.net file size: 42pg. languages: English from GEORGETOWN UNIVERSITY HEALTH POLICY INSTITUTE. from the publication: "...As a Texas resident, you have rights under federal and state law that will protect you when you seek to buy, keep, or switch your health insurance, even if you have a serious health condition. This guide describes your protections as a Texas resident." What Medicare Covers & How Much You Will Pay source:Medicare Rights Center languages: English Charts of premiums, deductables, and other information for medicare coverage under Part A, Part B, and Part D Texas HIV Medication Program - Medicare Part D (Medicare RX) Information & Updates source:Texas Department of State Health Services languages: English The nationwide introduction and rollout of Medicare Rx (Medicare Part D) for Medicare recipients has impacted those THMP clients concurrently covered by Medicare in a variety of ways. Your Medicare Rights and Protections source: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services 44pp languages: English Fairly detailed explanations and descriptions about your Medicare rights and protections. Medicare brochure or publication: State Pharmacy Listing - Aetna Medicare RxSM Plans - Texas Aetna Medicare Landscape: Texas Medicare Advantage, Cost Plans, and Demonstrations source:CENTERS FOR MEDICARE & MEDICAID SERVICES file size:92 pg. languages: English "Texas 2007 Medicare Advantage, Cost, and Demonstration Data as of September 29, 2006. Includes all contracts/plans regardless of 2007 approval status. PACE, Special Needs Plans, and Employer sponsored plans (800 series) are excluded." Medicare brochure or publication: Landscape: Texas Stand-Alone Prescription Drug Plans source:CENTERS FOR MEDICARE & MEDICAID SERVICES file size:3 pg. languages: English "Texas 2007 Medicare Part D Stand-Alone Prescription Drug Plans Data as of September 12, 2006. Includes all contracts/plans regardless of 2007 approval status. Employer sponsored plans (800 series) are excluded." |
| Texas Prescription Drug Plans This list is to familiarize you with Medicare Prescription Plans available in your state, and to provide you with contact information to specific carriers. Check with the insurance provider or medicare.gov for information about coverage options, annual deductibles, approved drugs, and other limitations. Do NOT use this web page as the basis for any decision or action. (All data is subject to change. Check with medicare.gov or the insurance provider for latest data.) | ||||||
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| Plan Name and ID Numbers |
Company (w. link to plan web site) |
Coverage in the Gap About the gap |
Contact Service Phones |
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| Humana PDP Standard | Humana Insurance Company | No gap coverage | Members 1-800-706-0872 TTY Users should call: 1-877-833-4486 Members 1-800-281-6918 TTY Users should call: 1-800-281-6918 |
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| Humana PDP Enhanced | Humana Insurance Company | No gap coverage | Members 1-800-706-0872 TTY Users should call: 1-877-833-4486 Members 1-800-281-6918 TTY Users should call: 1-800-281-6918 |
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| AdvantraRx Value | Coventry AdvantraRx | No gap coverage | Non-Members 1-800-882-3822 TTY Users should call: 1-800-508-9548 Members 1-866-823-5177 TTY Users should call: 1-866-823-5177 |
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| WellCare Signature | WellCare | No gap coverage | Non-Members 1-888-423-5252 Members 1-888-550-5252 TTY Users should call: 1-888-550-5252 |
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| MedicareRx Rewards | Unicare | No gap coverage | Non-Members 1-866-892-5335 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| Texas HealthSpring Prescription Drug Plan | Texas HealthSpring Prescription Drug Plan | No gap coverage | Non-Members 1-800-846-2098 TTY Users should call: 1-877-893-1504 Members 1-800-280-8888 TTY Users should call: 1-800-280-8888 |
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| Blue Medicare Rx - Standard | HISC - Blue Cross Blue Shield of Texas | No gap coverage | Non-Members 1-888-579-9373 TTY Users should call: 1-888-579-9375 Members 1-888-579-9373 TTY Users should call: 1-888-579-9373 |
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| Blue Medicare Rx - Value | HISC - Blue Cross Blue Shield of Texas | No gap coverage | Non-Members 1-888-579-9373 TTY Users should call: 1-888-579-9375 Members 1-888-579-9373 TTY Users should call: 1-888-579-9373 |
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| PacifiCare Saver Plan | UnitedHealthcare | No gap coverage | Non-Members 1-800-943-0399 Members 1-800-797-9794 TTY Users should call: 1-714-825-3600 |
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| SierraRx | SierraRx | No gap coverage | Non-Members 1-866-789-0565 TTY Users should call: 1-866-789-0572 Members 1-866-789-1522 TTY Users should call: 1-866-789-1522 |
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| AARP MedicareRx Plan | UnitedHealthcare | No gap coverage | Non-Members 1-888-867-5564 TTY Users should call: 1-877-730-4192 Members 1-888-867-5575 TTY Users should call: 1-888-867-5575 |
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| Elder Health PDP Texas | Bravo by Elder Health | No gap coverage | Non-Members 1-888-225-0026 TTY Users should call: 1-800-964-2561 Members 1-800-935-7197 TTY Users should call: 1-800-935-7197 |
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| Aetna Medicare Rx Essentials | Aetna Medicare | No gap coverage | Non-Members 1-800-445-1796 TTY Users should call: 1-800-628-3323 Members 1-877-238-6211 TTY Users should call: 1-877-238-6211 |
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| SilverScript | SilverScript | No gap coverage | Non-Members 1-866-552-6106 TTY Users should call: 1-866-552-6288 Members 1-866-235-5660 TTY Users should call: 1-866-235-5660 |
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| Advantage Star Plan | RxAmerica | No gap coverage | Non-Members 1-877-279-0370 Members 1-800-429-6686 TTY Users should call: 1-800-429-6686 |
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| Prescription Pathway Bronze Plan Reg 22 (S5597-087) |
Pennsylvania Life Insurance Company | No gap coverage | Non-Members 1-800-765-8900 TTY Users should call: 1-866-222-3904 Members 1-800-698-8394 TTY Users should call: 1-850-432-1700 |
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| United Medicare MedAdvance | UnitedHealthcare | No gap coverage | Non-Members 1-888-556-6657 TTY Users should call: 1-888-556-7065 Members 1-888-556-7047 TTY Users should call: 1-888-556-7047 |
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| MedicareRx Rewards Plus | Unicare | No gap coverage | Non-Members 1-866-892-5335 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| YOURx PLAN | Medco YOURx PLAN | No gap coverage | Non-Members 1-800-758-3605 TTY Users should call: 1-800-716-3231 Members 1-800-758-4574 TTY Users should call: 1-800-758-4574 |
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| Advantage Freedom Plan | RxAmerica | No gap coverage | Non-Members 1-877-279-0370 Members 1-800-429-6686 TTY Users should call: 1-800-429-6686 |
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| AdvantraRx Premier | Coventry AdvantraRx | No gap coverage | Non-Members 1-800-882-3822 TTY Users should call: 1-800-508-9548 Members 1-866-823-5177 TTY Users should call: 1-866-823-5177 |
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| CIGNATURE Rx Value Plan | CIGNA HealthCare | No gap coverage | Non-Members 1-800-735-1459 Members 1-800-222-6700 TTY Users should call: 1-800-222-6700 |
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| UA Medicare Part D Prescription Drug Cov | United American Insurance Company | No gap coverage | Members 1-866-524-4169 TTY Users should call: 1-866-524-4170 Members 1-866-524-4169 TTY Users should call: 1-866-524-4169 |
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| CIGNATURE Rx Plus Plan | CIGNA HealthCare | No gap coverage | Members 1-800-735-1459 Members 1-800-222-6700 TTY Users should call: 1-800-222-6700 |
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| Scott & White Health Plan Texas RX Basic | Texas Rx Plan | No gap coverage | Members 1-866-334-3141 Members 1-866-334-3141 TTY Users should call: 1-254-298-3141 |
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| Prescription Pathway Silver Plan Reg22 | Pennsylvania Life Insurance Company | No gap coverage | Members 1-800-765-8900 TTY Users should call: 1-866-222-3904 Members 1-800-698-8394 TTY Users should call: 1-850-432-1700 |
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| Prescription Pathway Silver Plan Reg 22 | Marquette National Life Insurance Company | No gap coverage | Members 1-800-845-2551 TTY Users should call: 1-866-222-3904 Members 1-800-698-8395 TTY Users should call: 1-800-698-8395 |
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| Aetna Medicare Rx Plus | Aetna Medicare | Generic Only | Members 1-800-445-1796 TTY Users should call: 1-800-628-3323 Members 1-877-238-6211 TTY Users should call: 1-877-238-6211 |
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| PacifiCare Select Plan | UnitedHealthcare | No gap coverage | Members 1-800-943-0399 Members 1-800-797-9794 TTY Users should call: 1-714-825-3600 |
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| MedicareRx Rewards Premier (S5960-092) |
Unicare | Generic Only | Non-Members 1-866-892-5335 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| Blue Medicare Rx - Plus | HISC - Blue Cross Blue Shield of Texas | No gap coverage | Non-Members 1-888-579-9373 TTY Users should call: 1-888-579-9375 Members 1-888-579-9373 TTY Users should call: 1-888-579-9373 |
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| WellCare Complete | WellCare | No gap coverage | Non-Members 1-888-423-5252 Members 1-888-550-5252 TTY Users should call: 1-888-550-5252 |
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| AdvantraRx Premier Plus | Coventry AdvantraRx | No gap coverage | Non-Members 1-800-882-3822 TTY Users should call: 1-800-508-9548 Members 1-866-823-5177 TTY Users should call: 1-866-823-5177 |
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| PacifiCare Comprehensive Plan | UnitedHealthcare | Generic Only | Non-Members 1-800-943-0399 Members 1-800-797-9794 TTY Users should call: 1-714-825-3600 |
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| CIGNATURE Rx Complete Plan | CIGNA HealthCare | Generic Only | Non-Members 1-800-735-1459 Members 1-800-222-6700 TTY Users should call: 1-800-222-6700 |
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| WellCare Premier (S5967-125) |
WellCare | No gap coverage | Non-Members 1-888-423-5252 Members 1-888-550-5252 TTY Users should call: 1-888-550-5252 |
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| Prescription Pathway Gold Plan Reg 22 | Pennsylvania Life Insurance Company | No gap coverage | Non-Members 1-800-765-8900 TTY Users should call: 1-866-222-3904 Members 1-800-698-8394 TTY Users should call: 1-850-432-1700 |
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| Prescription Pathway Gold Plan Reg 22 | Marquette National Life Insurance Company | No gap coverage | Non-Members 1-800-845-2551 TTY Users should call: 1-866-222-3904 Members 1-800-698-8395 TTY Users should call: 1-800-698-8395 |
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| Scott & White Health PlanTexas RX Enhanced | Texas Rx Plan | No gap coverage | Non-Members 1-866-334-3141 Members 1-866-334-3141 TTY Users should call: 1-254-298-3141 |
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| Sterling Prescription Drug Plan | Sterling Life Insurance Company | No gap coverage | Non-Members 1-888-909-1713 TTY Users should call: 1-888-858-8567 Members 1-866-865-0664 TTY Users should call: 1-866-865-0664 |
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| Aetna Medicare Rx Premier | Aetna Medicare | Generic Only | Non-Members 1-800-445-1796 TTY Users should call: 1-800-628-3323 Members 1-877-238-6211 TTY Users should call: 1-877-238-6211 |
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| Humana PDP Complete S5884-050 | Humana Insurance Company | Generic and Brand | Non-Members 1-800-706-0872 TTY Users should call: 1-877-833-4486 Members 1-800-281-6918 TTY Users should call: 1-800-281-6918 |
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| SilverScript Plus | SilverScript | No gap coverage | Non-Members 1-866-235-4582 TTY Users should call: 1-866-552-6288 Members 1-866-235-5660 TTY Users should call: 1-866-235-5660 |
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| Prescription Pathway Platinum Plan Reg 22 | Marquette National Life Insurance Company | No gap coverage | Members 1-800-845-2551 TTY Users should call: 1-866-222-3904 Members 1-800-698-8395 TTY Users should call: 1-800-698-8395 |
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| 14 Medicare Special Needs Plans in Texas This list is to familiarize you with Medicare Special Needs Plans available in your state, and to provide you with contact information to specific carriers. Check with the insurance provider or medicare.gov for information about coverage options, annual deductibles, approved drugs, and other limitations. Do NOT use this web page as the basis for any decision or action. (All data is subject to change. Check with medicare.gov or the insurance provider for latest data.) | ||||||
|---|---|---|---|---|---|---|
| Plan Name and ID Numbers |
Company (w. link to plan web site) |
Special Rules for Enrolling | Contact Service Phones |
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| AMERIVANTAGE Special Needs Plan | AMERIGROUP Community Care | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-600-4441 TTY Users should call: 1-800-855-2880 Members 1-800-600-4441 TTY Users should call: 1-800-855-2880 |
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| Elder Health Select | Bravo by Elder Health | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-888-353-3789 TTY Users should call: 1-800-964-2561 Members 1-888-353-3789 TTY Users should call: 1-800-964-2561 |
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| Elder Health Select | Bravo by Elder Health | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-888-353-3789 TTY Users should call: 1-800-964-2561 Members 1-888-353-3789 TTY Users should call: 1-800-964-2561 |
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| Evercare Plan DH | Evercare Of Texas, LLC | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-866-382-4642 TTY Users should call: 1-888-685-8480 Members 1-800-393-0993 TTY Users should call: 1-888-685-8480 |
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| Evercare Plan DP-ES | SecureHorizons | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-330-1601 TTY Users should call: 1-888-685-8480 Members 1-866-288-3389 TTY Users should call: 1-888-685-8480 |
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| FIRSTCARE Advantage Select | FirstCare Advantage | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-866-245-1580 TTY Users should call: 1-800-562-5259 Members 1-866-229-4969 TTY Users should call: 1-800-562-5259 |
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| Physicians Health Choice Platinum Select | PHYSICIANS HEALTH CHOICE | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-866-550-4736 TTY Users should call: 1-866-858-0659 Members 1-866-550-4736 TTY Users should call: 1-866-858-0659 |
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| Physicians Health Choice Platinum Select | PHYSICIANS HEALTH CHOICE | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-866-550-4736 TTY Users should call: 1-866-858-0659 Members 1-866-550-4736 TTY Users should call: 1-866-858-0659 |
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| Secure Horizons Gold Plan | Secure Horizons Medicare Advantage Plan | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-385-5588 TTY Users should call: 1-800-557-7595 Members 1-800-950-9355 TTY Users should call: 1-800-387-1074 |
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| Secure Horizons Gold Plan | Secure Horizons Medicare Advantage Plan | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-385-5588 TTY Users should call: 1-800-557-7595 Members 1-800-950-9355 TTY Users should call: 1-800-387-1074 |
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| TexanChoice | SelectCare of Texas, LLC | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-888-800-0760 TTY Users should call: 1-866-338-4681 Members 1-800-718-9065 TTY Users should call: 1-866-338-4681 |
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| Texas HealthSpring Special Care | Texas HealthSpring | For people in certain long-term care facilities. | Non-Members 1-800-846-2098 TTY Users should call: 1-877-893-1504 Members 1-800-280-8888 TTY Users should call: 1-877-893-1504 |
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| Texas HealthSpring Total Care) | Texas HealthSpring | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-846-2098 TTY Users should call: 1-877-893-1504 Members 1-800-280-8888 TTY Users should call: 1-877-893-1504 |
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| Valley Advantage Select | Valley Baptist Health Plans | For people who are eligible for both Medicare and Medicaid. | Members 1-800-829-6440 TTY Users should call: 1-800-562-5259 Members 1-800-829-6440 TTY Users should call: 1-800-562-5259 |
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