Texas Medicare Rx Program
Non-Full Dual Eligible Beneficiary
Your selection indicates you are a Medicare beneficiary and have been receiving assistance from Medicaid that does not include prescription drug coverage.
The information presented in this section of the Web site addresses your specific situation as it relates to the Medicare Part D prescription drug program. More detailed information is available at the website for the Texas Department of Aging and Disability Services.
Once you become eligible for Medicare, you will be offered a choice of prescription drug plans through the Medicare Part D prescription drug program. It is important for you to look at what these plans have to offer, then choose and enroll in the plan that covers the medications you need.
What does this mean for me?
If you do not currently have prescription drug coverage, Medicare Part D will provide that for you.
What do I need to do?
For now, watch your mail and look for information about Medicare Part D and the various drug plans available in the program. Three months before you become eligible for Medicare, you should receive an enrollment packet, “Welcome to Medicare.” This packet will explain how to enroll in a Medicare Part D plan. Your opportunity to enroll in one of the Medicare prescription drug plans will begin when you receive the “Welcome to Medicare” packet in the mail. If, after three months, you have not enrolled in a prescription drug plan, Medicare will assign you to one. Regardless of when you enroll in Medicare Part D, you can change your prescription drug plan at any time. Medicare has a website that can help you find out the plan you’ve been assigned to if you get assigned to a prescription drug plan.
Will there be out-of-pocket costs?
If you currently get help from Medicaid in covering your Medicare costs, you will automatically receive extra help for payment of your Medicare Part D prescription drug plan. You will not have to pay a monthly premium or an annual deductible, but you will pay a small co-pay for each prescription drug you receive.
Which plans are "basic-level" plans?
Each year, the basic-level plans available in each state may change. The list of plans for the coming year in Texas will be updated in the fall. It's important that people with both Medicare and Medicaid review this list each fall to see if the plan they are on will be available for the coming year. If it is not, they will need to pick a new plan. If you pick a plan that is not a basic-level plan, you will have to pay a portion of the monthly premium.
Basic-level Medicare Part D prescription drug plans available in Texas
What is covered under Medicare Part D prescription drug coverage?
Medicare Part D will cover most of your necessary prescriptions. Specific information on the prescription medicines each drug plan covers is available from the plan itself. All Medicare Part D prescription drug plans must cover “all or substantially all” drugs in key categories such as antidepressants, antipsychotics, anticonvulsants, anticancer, immunosuppressants, and HIV/\AIDS categories of drugs. There are certain categories of drugs Medicare Part D will not cover including over-the-counter medications, barbiturates (sedatives), and benzodiazepines (anti-anxiety agents).
How can I get more information?
You may receive additional information in the mail from Medicare Part D prescription drug plans in your area. You may also receive mail from companies promoting their Medicare-affiliated drug plans. It is important you review this information carefully and make sure the drug plan you choose covers the prescription drugs you need.
In the meantime you can also:
- Visit the Texas Department of Aging and Disability Services (DADS) website
- Use the Medicare Prescription Drug Plan Finder
- Call 1-800-MEDICARE (1-800-633-4227)
- TTY users call 1-877-486-2048