Texas Medicare Supplemental Insurance – A Brief Look

Medicare is the health insurance program administered by the U.S. Government, as most citizens know. Many residents are automatically enrolled in Medicare on their 65th birthday.  Certain persons less than 65 years old can be eligible for Medicare insurance according to specific disability requirements.  The Texas Medicare program offers additional benefits to its members.

Medicare Part D, the Medicare prescription drug program, is offered by both the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services. The Texas Department of Health and Human Services has created an online resource website to assist dual-eligible Texans transition to the new Medicare prescription program.

Dual-eligible Texans are those Texas citizens who receive both financial assistance from the Medicaid program and who are eligible for the Texas Medicare program.  This website is located at TexasMedicareRx.org.

The CMS (Federal Medicare agency) announced that "Medicare beneficiaries whose only Medicaid benefit is community attendant services are not automatically eligible for the low-income subsidy for Medicare prescription drug program."

In response to community attendant service recipients being ineligible for the low-income Medicare prescription drug subsidy, Texas became the only state (currently) to adopt the Medicaid 1929(b) program.  This program operates outside the Texas Medicare program and makes available community attendant services that assist elderly, low-income persons to live at home instead of in nursing homes.  If you are aware of nursing home costs, you know how much money this program can save.

To receive reduced-cost Texas Medicare prescription drug coverage, the only Medicaid assistance a Texan can be receiving is the community attendant services.  If that condition is met, the person must take the following actions to apply for Texas Medicare drug coverage at reduced prices.

First, the individual must determine if he or she meets the financial eligibility requirements.  Second, the person must prepare and file the application for the Texas Medicare low-income assistance.  Third, the person must select among the numerous Texas Medicare Part D drug plans and choose one that is suitable to his or her health situation.

The Texas Medicare program placed a deadline of May 15, 2006 for these actions to be completed.  Persons who missed this deadline should contact their local Texas Medicare professional or office or their caseworker from the Texas Department of Aging and Disability Services.

Both Federal and Texas Medicare rules and deadlines are subject to change.  Texas residents requesting coverage under the Texas Medicare program are encouraged to seek the most recent information before taking any actions.

Filed under: State Medicaid Programs,Texas Medicaid