Medicare FAQs for the Texas Hill Country

Navigating Medicare can feel overwhelming. These quick answers cover the most common questions we hear in Dripping Springs and the Hill Country. If you want help comparing your options, book a no-cost consultation.

Short answer: Most people enroll during their Initial Enrollment Period—the 7-month window from 3 months before to 3 months after your 65th birthday month. If you have qualifying employer coverage, you may delay Part B without a penalty.
More detail: We’ll confirm if your coverage qualifies and map the exact dates for you.
 

Short answer: Medicare Advantage (Part C) replaces Original Medicare with a private plan that bundles hospital, medical, and often drugs; Medigap is a separate policy that helps pay Original Medicare’s out-of-pocket costs.
More detail: Networks, referrals, and costs work differently—let’s compare based on your doctors and prescriptions.

Short answer: If you take Original Medicare (with or without Medigap), you usually need a Part D plan to avoid gaps and potential late penalties. Many Medicare Advantage plans already include drug coverage.
More detail: We’ll check your medications to find plans with the lowest total cost.

Short answer: It depends on the plan. Advantage plans have networks; Original Medicare + Medigap typically allows any provider who accepts Medicare.
More detail: We’ll run a provider check for your preferred doctors and clinics.

Short answer: If your employer coverage is creditable, you can delay Part B (and Part D if drug coverage is creditable) without penalties.
More detail: We’ll verify “creditable coverage” and plan the best timing for you.

Short answer: Yes. The main window is Oct 15–Dec 7 (AEP) for next-year coverage. Jan 1–Mar 31 (OEP) allows one switch if you’re already in Medicare Advantage. Special situations can trigger SEPs.

Short answer: IRMAA is an income-related surcharge that can raise Part B and Part D premiums for higher-income beneficiaries.
More detail: We’ll review current thresholds and help you understand potential adjustments or appeals.

Short answer: Coverage and copays vary by plan formulary and pharmacy.
More detail: We’ll run a medication analysis to estimate your annual drug costs and find savings.

Short answer: No. Our services are provided at no cost to you. We’re paid by the plan you choose, and your premiums are the same as if you enrolled on your own.
More detail: Our job is to simplify decisions and support you year-round.

Short answer: Your Medicare card (or enrollment notice), list of medications/doses, preferred doctors, and your pharmacy.
More detail: If transitioning from employer coverage, bring your plan details and any Medicare letters.

Short answer: We compare plans across carriers, check doctors and prescriptions, estimate total costs, and handle enrollment—locally in Dripping Springs and the Hill Country.
More detail: We’re your ongoing resource whenever things change.