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Need help understanding differences in Medicare Advantage Plans versus just Medicare? Health experts explain

Traditional Medicare does not cover prescription drugs

Medicare’s annual enrollment period is here -- the time when millions of Americans will make important decisions about their health care coverage for 2021.

Whether you’re enrolling in Medicare or looking to change your coverage, the annual enrollment period is the time to do it.

Dr. Rowland Reyna, founder and CEO of HealthTexas explains why it’s important to review your Medicare plans for 2021.

Below are some key questions, answered.

How do you become Medicare Eligible?

“The most common way of becoming medically eligible is to turn 65,” Reyna said. “Whenever you get Medicare, make sure to call Social Security and sign up for Medicare. If you don’t and you miss that opportunity, you’re out of luck. The other way you can get it is, if you’re disabled for 24 consecutive months, you qualify in that regard, as well.”

Why should someone on Medicare join a Medicare Advantage Plan?

“From my standpoint and from the patient’s standpoint, the most important thing is to choose a good primary care doctor -- somebody you have confidence in and somebody who has been well trained and recognized," Reyna said.

Here are some things to consider:

  • Determine if the plan is a good fit for your budget.
  • Make sure your medications are covered in the Medicare plan.
  • Don’t forget about dental, vision and other additional benefits.
  • Confirm your preferred doctors and hospitals are available through the Medicare plan you’re considering.

What advantages does a Medicare Advantage Plan have over traditional Medicare?

A Medicare Advantage Plan covers all health and prescription coverage needs and includes added-value services such as dental, vision and hearing.

“The important thing to remember is that traditional Medicare does not cover everything,” said Glenda Pope, local sales director for United Healthcare. “Medicare Advantage Plans give you the benefit of all the things that are covered under Medicare plus options such as prescription drug plans, and many people don’t realize that Medicare does not cover prescription drugs.”

It’s easier to budget due to the reduced fixed costs and there is no extra premium.


If you need a primary care doctor, HealthTexas has 17 locations to serve the San Antonio region. All doctors are board-certified in internal medicine or family medicine. Watch the video above for more information about HealthTexas.


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