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

Who Offers Texas Medicare Prescription Drug Plans? Medicare Texas help & articles The Medicare Project (Home) Texas MEDICAID help
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Texas Medicare, Texas Medicare Prescription Drug Coverage
Medicare Help & Information, Medicare Part D In Texas, Medicare help

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.
 

Texas Medicare; TX; Medicare Part D in Texas

Texas Medicaid: Medicaid assistance and Texas Medicaid help Were you looking for Texas Medicaid instead of Texas Medicare? This link provides a directory of Medicare web sites, articles, publications, brochures
 
Texas Health Insurance Articles, help, brochures about health insurance and HMO's in Texas. Texas HSA (Health Havings Accounts) articles, brochures, help
 

Texas Medicare Coverage, Prescription Drug Plans
Texas Medicare Help Articles & Resources

Information from varied resources about Medicare in Texas
Important advice about how to use this data: This Web Site links you to other Web Sites on the Internet. We cannot take responsibility for information found on third party Web sites outside our control. While we attempt to provide links only to Web Sites that comply with all applicable laws and regulations and appear to have responsible information, please understand that the content on these third-party Web Sites is subject to change without notice to us. We therefore cannot be responsible for, and accept no liability for, any information or opinion contained in any third-party Web Site. Nothing on this Web Site should be construed as the giving of advice or the making of a recommendation and it should not be relied on as the basis for any decision or action.

 
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medicaid
 
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..."
.
Medicare brochure or publication:
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.
.
Medicare brochure or publication:
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
.
Medicare Web Page:
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 Web Page:
(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
.
Medicare brochure or publication:
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..."
.
Medicare brochure or publication:
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...."
.
Medicare Web Page:
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..."
.
Medicare brochure or publication:
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."
.
Medicare Web Page:
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
.
Medicare Web Page:
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.
.
Medicaid brochure or publication:
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
.
Medicare brochure or publication:
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."

How to get more information about Texas Medicare Prescription Drug Programs

Medicare.gov has summary information about the plans offered by the companies listed in the tables above. The data sheets are called "Landscapes".
  1. The Landscape of Local Plans is a list of all plans available in your area. You can get answers to important questions for people with Medicare based on what matters to them, including:
    • Cost (premiums, deductibles and payments)
    • Coverage (important issues around what and how drugs are covered)
    • Convenience (pharmacy and mail-order options)
  2. Medicare.gov has an important help page that explains how to read and interpret the information in both Medicare Prescription Drug Plan "Landscapes. You can access the help page through this link: How to read the Medicare Prescription Drug Plans Landscape
  3. We have provided links to the landscape documents for this state in the list of publications above. 
.
.


 

Medicare prescription drug coverage plans offered in Texas, Medicare Advantage Plans

Important advice about how to use this data: The data for the table below came from www.medicare.gov, "The Official U.S. Government Site for People with Medicare", in December, 2006, and is subject to change at any time. To check for changes and the newest data, you should visit www.medicare.gov. Your state insurance administrator might have different data; be sure to check with them before making any decisions. Nothing on this Web Site should be construed as the giving of advice or the making of a recommendation and it should not be relied on as the basis for any decision or action.

 
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.)
Plan Name and
ID Numbers
Company
(w. link to
plan web site)
Coverage in
the Gap
About the gap
Contact Service
Phones
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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

 
 
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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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