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.

8 Responses to Texas Medicare Supplemental Insurance – A Brief Look

  • Desiree Granger says:

    Hi, i am currently pregnant and i would like an appliction to apply for medicaid.
    I cannot find the website to fill out an application.
    Would you please give me the wesite to do so, or send me an application.

    Thank you

  • Mary Mendez says:

    I have a mother who is 88 years old and has resided in a nursing home for the last 8 years. She is medicare/medicaid recipient. She own a home but will not be returning to it anytime soon. My mom does not walk at all. My question is as her daughter can I sell the home for my mother (she is right state of mind) and could probably sign. Where would the proceeds to the house go to? I am very confused as of what to do since her house is needing alot home repairs, especially the roof.

    Could you please advice me on a solution to this matter? I would really appreciate it.

  • admin says:

    Desiree,

    You could visit http://www.hhsc.state.tx.us/Programs/how_to.html for help completing the Medicaid application in Texas.

    Good luck and Congratulations on your pregnancy!

  • admin says:

    Hello Mary,

    First of all, my heart goes out to your situation. I know how tough it must be to have a parent living in a nursing home and have to take care of major business decisions like the sale of a home.

    Unfortunately, I don’t really have any advice for you. My recommendation is that you seek out an attorney in your area who specializes in the area. He or she would be the best person to provide the answer you are looking for.

    I’m sorry I wasn’t able to help more. Good luck with your situation and take care of your Mom.

  • Linda Bernard says:

    Hi, I am currently living in Florida and am considering moving to Texas. I am on SSD and SSI and have medicare and medicaid. I do not have to pay any premiums except my co-pays for my meds. 1.00 for generic and 3.10 for name brand meds. My question is, will this all change if I move to Texas? What are the guidelines for disability? I cannot give up my medical coverage because I am recovering from breast cancer and am worried it may come back, God forbid. I would appreciate your input. Thank You, Linda

  • sarah ortis says:

    I became disabled Jan 5th 2009. I am now on Medicaid and they only pay for part of my perscriptions. I received only 690.00 from disability and 4.00 from ssi. This after paying my rent and food I am left with very little. With the this I cannot afford most of my perscriptions. Is there any more help I can possibly get form the government. I have tried all other routes and they are all exhausted. I cannot even get into section 8 housing with the unemployment as it is they have a 5 years waiting period to lower my rent so I might afford my perscriptions. also someone told me that after being on disability for 2 years you are put on meidcare. Ther is no way I can afford to pay this what shall I do.

  • Barbara Davis says:

    My elderly Mom is visiting in Indiana. She has Medicare and Medicaid from Texas. She is unable to care for herself as she has a benign tumor on her spinal column and Aorta. She could function better if she was not in pain. In Texas they just gave her oral pain medication which is not working well. While in Indiana what can I do for her? I want her to see a pain specialist. Will Texas Medicaid help to pay Medical bills here in Indiana or will she be responsible?
    Thank You.
    Barbara

  • Jillian says:

    I moved from New Jersey to Texas nearly five months ago and have been getting the run around from everyone concerning my ssi medicaid benefits I am too young to receive ssdi so i get ssi and with that I was getting medicaid in NJ but was denied by the local office here because i should get it from ssi i have contacted ssi several times and am getting nowhere I desperately need to see a doctor does anyone have any idea what I can do to get my insrance back I still get my ssi benefits so I should still get medicaid I just don’t know what to do

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