Medicare Part D in Texas: Your Guide to Drug Plans in 2025
Finding the perfect Medicare Part D plan in Texas can be tough. You've got premiums, deductibles, and formularies to sort through, but don't worry, we've got your back. With 17 Medicare Part D Texas plans available in 2025, we'll help you narrow it down to the one that fits your health needs and budget.
We'll explain everything you need to know so you can make a confident, informed decision about your Medicare Part D coverage options.
Basic Medicare Part D Plans
Basic Medicare Part D plans offer essential drug coverage with lower premiums but may have higher out-of-pocket costs for certain medications. The following table links to all basic benefit Part D plans in Texas.
| Plan Name | Premium/Mo | Deductible | Rating* | |
|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC | $76 | $590 | ||
| Blue Cross MedicareRx Basic | $101 | $590 | ||
| Cigna Healthcare Assurance Rx | $61 | $590 | ||
| Clear Spring Health Value Rx | $0 | $590 | ||
| Humana Basic Rx Plan | $62 | $590 | ||
| SilverScript Choice | $45 | $590 | ||
| Wellcare Classic | $3 | $590 | ||
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- Essential Drug Coverage: Basic plans cover a narrower range of medications, focusing on essential, lower-cost drugs. Ensure that your prescriptions are included in the plan’s formulary, as Basic plans may exclude higher-cost or specialty medications.
- Lower Monthly Premiums: Basic plans typically offer lower monthly premiums, making them a cost-effective choice if your medication needs are minimal or if you are primarily taking generic drugs.
- Higher Deductibles and Cost-Sharing: Expect higher deductibles and out-of-pocket costs with Basic plans, especially for drugs not on the preferred list. If your medication needs increase, these costs could add up quickly.
Enhanced Medicare Part D Plans
Enhanced Medicare Part D plans provide broader drug coverage, often at a higher monthly premium. The following table links to all enhanced benefit Part D plans available in Texas.
| Plan Name | Premium/Mo | Deductible | Rating* | |
|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC | $89 | $0 | ||
| Blue Cross MedicareRx Choice | $61 | $590 | ||
| Blue Cross MedicareRx Value | $117 | $590 | ||
| Cigna Healthcare Extra Rx | $94 | $175 | ||
| Cigna Healthcare Saver Rx | $20 | $590 | ||
| Clear Spring Health Premier Rx | $72 | $590 | ||
| Humana Premier Rx Plan | $125 | $0 | ||
| Humana Value Rx Plan | $43 | $573 | ||
| Wellcare Medicare Rx Value Plus | $102 | $590 | ||
| Wellcare Value Script | $0 | $590 | ||
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- Broader Drug Coverage: Enhanced plans generally offer more extensive coverage, including a broader range of brand-name and specialty drugs. This can be crucial if you require medications not covered by Basic plans.
- Higher Monthly Premiums: Enhanced plans may have higher monthly premiums, reflecting the broader coverage and additional benefits. Ensure that the increased premium aligns with your medication needs and overall budget.
- Lower Out-of-Pocket Costs: Although the premiums are higher, Enhanced plans often offer lower deductibles and reduced copayments or coinsurance for certain drugs. This could lead to overall savings if you require several medications.
Extra Help Medicare Part D Plans
Extra Help Medicare Part D plans significantly reduce prescription costs for eligible beneficiaries, offering lower premiums, deductibles, and copayments. This program is not part of Medicare Advantage plans. The following table shows all Extra Help Part D plans available in Texas.
| Plan Name | Premium/Mo | Deductible | Rating* | |
|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC | $89 | $0 | ||
| AARP Medicare Rx Saver from UHC | $76 | $590 | ||
| Blue Cross MedicareRx Basic | $101 | $590 | ||
| Blue Cross MedicareRx Choice | $61 | $590 | ||
| Blue Cross MedicareRx Value | $117 | $590 | ||
| Cigna Healthcare Assurance Rx | $61 | $590 | ||
| Cigna Healthcare Extra Rx | $94 | $175 | ||
| Cigna Healthcare Saver Rx | $20 | $590 | ||
| Clear Spring Health Premier Rx | $72 | $590 | ||
| Clear Spring Health Value Rx | $0 | $590 | ||
| Humana Basic Rx Plan | $62 | $590 | ||
| Humana Premier Rx Plan | $125 | $0 | ||
| Humana Value Rx Plan | $43 | $573 | ||
| SilverScript Choice | $45 | $590 | ||
| Wellcare Classic | $3 | $590 | ||
| Wellcare Medicare Rx Value Plus | $102 | $590 | ||
| Wellcare Value Script | $0 | $590 | ||
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- Significant Cost Savings: Extra Help plans are designed to lower your prescription drug costs, including premiums, deductibles, and copayments. Compare how much you can save with each plan, as some might offer more substantial reductions based on your specific medications.
- Coverage During the Coverage Gap: With Extra Help, you might receive continued drug coverage through the coverage gap (donut hole). This means your out-of-pocket medication costs could remain consistent throughout the year, providing more predictable expenses.
- Formulary and Drug Tiers: Even with Extra Help, reviewing the plan's formulary and drug tiers is essential to ensure your medications are covered and to understand any potential out-of-pocket costs. LIS plans might still have variations in copayments depending on the tier of your medications.
- Pharmacy Network Access: Some plans may offer lower copayments at preferred pharmacies. Verify that your regular pharmacy is included in the plan's network, or consider switching to a preferred pharmacy to maximize your savings.
- Impact on Plan Choice: If you qualify for Extra Help, it might influence which plans are most beneficial for you. Plans with higher premiums or deductibles that may not be affordable without assistance could become viable options under LIS, offering more comprehensive coverage.
Essential Facts About Medicare Part D Plans
Medicare Part D plans are all about helping you afford your prescription medications. It's a separate program from Original Medicare; private insurers call the shots. But don't worry; the Medicare program sets the rules.
In Texas, the average Part D deductible this year is $495. But here's the silver lining: 2 plans offer a zero-dollar deductible, which could save you a good amount upfront, depending on your prescriptions.
A Closer Look at How Medicare Part D Plans Work
Every Medicare Part D plan covers a wide array of medications through a list known as a formulary. A formulary is a catalog of all the drugs a particular plan covers. Since formularies can vary from plan to plan, it’s important to review yours to ensure it includes the prescriptions you rely on.
Each formulary is divided into different "tiers," categorizing medications by cost. Typically, drugs in lower tiers have lower copayments, while those in higher tiers have higher out-of-pocket expenses.
For instance, Tier 1 might include generic drugs with the lowest copayments, while Tier 2 could feature preferred brand-name medications at a slightly higher cost. Tiers 3, 4, and 5 usually encompass brand-name and specialty drugs with steeper prices.
Out-of-pocket costs can fluctuate based on several factors, including the plan you select, the tier your medications fall under, and which coverage phase you’re in—such as the deductible or initial coverage phase.
What to Consider When Choosing a Medicare Part D Plan
Finding a Medicare Part D plan in Texas that aligns with your needs requires carefully reviewing various factors. This ensures that your plan provides the right coverage while minimizing out-of-pocket costs.
Monthly Premium
The monthly premium is what you pay each month to keep your Medicare Part D plan active, like a subscription. While it may be tempting to choose the plan with the lowest premium, it’s crucial also to consider deductibles, copayments, and the extent of coverage.
Lower premiums often come with higher deductibles or more limited coverage, so finding a plan that balances affordable premiums with the coverage you need is important. This will help you avoid surprises later.
Annual Deductible
The annual deductible is the amount you must pay out of pocket for your prescriptions before your Medicare Part D plan starts contributing.
If you take regular medications, selecting a plan with a lower deductible can save you money over time. However, a higher deductible plan could be more economical if you rarely need prescriptions.
Drug Formulary
Carefully check the plan’s formulary (list of covered medications) to ensure your drugs are on it. Since plans often change their formularies throughout the year, reviewing it during the Annual Enrollment Period is good practice to confirm that your medications are still covered.
Pay special attention to your drug’s tier placement, as this directly impacts the price you'll have to pay.
Pharmacy Network
Most plans have preferred pharmacy networks offering reduced medication prices, potentially saving you significant money. Check that the pharmacies you prefer are in the plan’s network and explore if mail-order pharmacy services are an option. This can be particularly beneficial for maintenance medications.
How Texas Part D Plans Work with Other Parts of Medicare
Medicare Part D provides prescription drug coverage, but you may wonder, "How does this fit with my other Medicare benefits?" Let's break it down for you:
Medicare Part A and Part B (Original Medicare)
With Original Medicare, Part A covers hospital stays, and Part B covers doctor visits and other medical services, including medications administered during a visit. Part D is designed to cover the cost of prescription drugs you take at home, rounding out your overall coverage and ensuring you're protected on both fronts.
Medicare Supplement Plans
Medicare Supplement plans, or Medigap, help fill in the gaps left by Original Medicare, covering some copayments, coinsurance, and deductibles. However, they don’t cover everything.
One notable exclusion is prescription drugs. You must enroll in a stand-alone Part D plan for medication coverage.
Combining a Medicare Supplement plan with a Part D plan can be especially beneficial if you take multiple prescriptions. Though you’ll pay separate monthly premiums for both, the combined coverage can help provide peace of mind, ensuring that your medical and drug costs are well-covered.
Medicare Advantage Plans
Part D works a little differently if you have a Medicare Advantage plan, also known as Part C. Most Medicare Advantage plans include prescription drug coverage, which means your medical and drug coverage are combined under one plan.
However, some Medicare Advantage plans don’t include drug coverage, allowing you to pair the health plan with a separate Part D plan.
Whether you choose Original Medicare with a standalone Part D plan or a Medicare Advantage plan with built-in drug coverage, the key is to find the best fit for your needs. Consider your current prescriptions and budget to help guide your decision and ensure you have health coverage.
Key Dates for Enrolling in a Medicare Part D Plan
Medicare has specific enrollment periods for signing up or making changes. Here are the key ones to know:
- Initial Enrollment Period (IEP) – Starts three months before your 65th birthday and continues for seven months.
- Annual Enrollment Period (AEP) – From October 15th to December 7th, annually, for making changes to coverage.
- Medicare Advantage Open Enrollment Period – Runs annually from January 1st to March 31st for those with Medicare Advantage.
To learn more, read our Medicare Enrollment Periods Guide
.Getting Assistance with Medicare Part D Enrollment in Texas
Navigating and comparing Medicare Part D plans can sometimes be overwhelming, but help is just a phone call away. The experienced, licensed insurance agents at HealthCompare can assist you by phone at 1-833-748-3201 (Mon-Fri 5am-6pm, Sat 6am-5pm PST).
HealthCompare is ready to answer your questions, compare plans, and guide you through the enrollment process step by step.
Plans Offered Through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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