Medicare Advantage in Texas

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Beneficiaries have two options for Medicare coverage: Original Medicare and Medicare Advantage. Medicare Advantage, often called Medicare Part C, is an alternate method to get Medicare coverage. With Medicare Advantage, you’ll get a bundled package of health benefits from a private insurance company—much like you’re probably used to with employer-sponsored health plans.

Eighteen insurers sell Medicare Advantage plans in the state of Texas,1 offering a combined total of 137 plans.2 However, availability of Medicare Advantage plans depends on where you reside in Texas. Currently, 37% of Texas beneficiaries are enrolled in some type of Medicare Advantage plan.3

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Click to Call: 833-241-9711

Medicare call center hours: 8:30 a.m.–5 p.m. MT Mon–Fri

Speak to a licensed agent

Call: 833-241-9711

Medicare call center hours: 8:30 a.m.–5 p.m. MT Mon–Fri

Medicare Advantage plan benefits

Medicare Advantage plans cover everything Original Medicare (Parts A and B) covers, but many Medicare Advantage plans in Texas pay for a lot more. These are a few of the most common extra benefits covered by Medicare Advantage plans:

If you have a chronic illness in Texas, you may be able to buy a Medicare Advantage plan that covers other services that could improve your well-being, such as meal delivery, non-medical transportation, home modifications, and pest control.4

Medicare Advantage plan costs in Texas

Medicare Advantage premiums depend on where in Texas you live and which plan you enroll in. You might even be able to find plans with $0 premiums in Texas. However, the chart below shows the average monthly premium for a Texas Medicare Advantage plan is just under $45.

Average annual cost $6,602.68
Average monthly premium $44.73
Average drug deductible $193.64
Annual max out-of-pocket $5,872.23

Table created from data at https://www.healthmarkets.com/content/medicare-advantage-costs-index. Data as of 6/2/2020.

Medicare Advantage insurers in Texas

There are 18 insurance providers that provide Medicare Advantage plans in Texas:

  • Imperial Health
  • KelseyCare Advantage
  • Lasso Healthcare
  • Memorial Hermann Health Plan
  • Mutual of Omaha
  • Oscar
  • Scott and White Health Plan
  • UnitedHealthcare
  • WellCare

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Top-rated Medicare Advantage providers

top rated provider icon stars

The Centers for Medicare and Medicaid Services (CMS) rates Medicare Advantage plans each year on a 5-star scale (5 stars is best). Only 20 of the 400 Medicare Advantage plans rated nationwide were awarded the prestigious 5-star CMS rating.5

Two of these 5-star Medicare Advantage plans can be found in Texas. The first, provided by Kelsey-Seybold Medical Group, is available in 13 counties and boasts 34,967 enrollees.5 The second, provided by UnitedHealth Group, is available in 53 counties and boasts 256,417 enrollees.5 However, the UnitedHealth Group 5-star plan is a Special Needs Plan, available only to beneficiaries who are eligible for both Medicare and Medicaid.6

The CMS doesn’t rate every Medicare Advantage plan in Texas. Some are too new to be measured. Others don’t have enough data. But of the plans that receive ratings, Texas’ Medicare Advantage plans receive an average of 3.5–4 stars.5

Find the Medicare Advantage plan that fits you best

HMO
Low premiums
Must stay in-network
Must choose a primary care physician
Referrals required to see a specialist
PPO
Pay more expensive premiums
Can go out of network at a higher cost
Don’t need to choose a primary care physician
Don’t need referrals to see a specialist
Typically have a smaller network with local PPO
Typically have a larger network with regional PPO
PFFS
May or may not have a network
In-network expenses lower than out-of-network
Plan is accepted by any doctor who agrees to the plan’s terms
Need written acceptance for coverage before each service
MSA
Similar to a health savings account (HSA)
Accompanied by high-deductible health plan (HDHP)
Money accumulated in savings rolls over each year
Cannot deposit personal funds into an MSA

Texas is a big state with a quantity of Medicare health plans to match its size. In total, there are 80 local HMO plans, 46 local (and 4 regional) PPO plans, 4 PFFS plans, and 3 MSA plans.2

If you're looking for a Texas Medicare Advantage plan, give us a call. A licensed Medicare insurance agent can help you find the best plan for your area—and your health needs.

Local resources in Texas

  • Texas Department of Insurance: Regulates Texas’ insurance industry and protects consumers with regulations and a portal for customer complaints.

Speak to a licensed agent
Call: 833-241-9711


Content on this site has not been reviewed or endorsed by the Centers for Medicare & Medicaid Services, the United States Government, any state Medicare agency, or any private insurance agency (collectively "Medicare System Providers"). Eligibility.com is a DBA of Clear Link Technologies, LLC and is not affiliated with any Medicare System Providers.