Texas Medicare Advantage (MA) plans have about 1,753,368 enrolled beneficiaries. Austin alone has 37.57% of its Medicare beneficiaries enrolled in MA plans.
Medicare Advantage plans in Texas
Private insurance companies provide Medicare Advantage plans in Texas. Enrolling in a Medicare Advantage plan leaves the federal Medicare program to join a private insurance plan.
Currently, there are 39 MA plans available. However, depending on the carrier, each program will have different benefits and costs. For example, some Medicare Advantage plans provide Medicare Part D coverage.
Medicare Advantage plans available
The primary difference between MA and Medicare Supplement plans is that the federal government regulates supplements, not Advantage plans. The availability of Medicare Advantage plans will vary from state to state and with different carriers.
Below, we will review the available Texas Medicare Advantage plans. While some programs have $0 deductibles, others have $0 monthly premiums or Part B premium reductions.
Medicare Advantage plans with a zero-dollar premium
Some beneficiaries can enroll in a Medicare Advantage plan without paying an additional monthly premium. Although some Texas Medicare Advantage plans have $0 monthly premiums, they will likely come with higher out-of-pocket costs. Considering these various costs is essential when exploring Medicare Advantage plan options.
For example, Aetna’s HMO Medicare Advantage plan has a $0 monthly premium but a maximum out-of-pocket (MOOP) cost of $5,900.
Imperial offers the lowest MOOP at $2,999. However, UnitedHealthcare’s MA plan is an HMO with a four out of five-star rating, indicating higher overall plan effectiveness.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATING |
| Imperial | $0 | $2,999 | HMO | N/A |
| UnitedHealthcare | $0 | $5,500 | HMO-POS | 4 |
| Ascension Complete | $0 | $2,900 | HMO | N/A |
| Wellcare | $0 | $4,000 | HMO | 3 |
| Aetna | $0 | $5,900 | HMO | 3 |
Medicare Advantage plans with a zero-dollar drug deductible
The following plans in Texas have a $0 drug deductible and a $0 monthly premium.
Ascension Complete has a low MOOP of $2,900 through an HMO plan. Imperial also has an HMO with a low MOOP of $2,999.
While Humana has a higher MOOP of $4,900, its four-star rating is a plus.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATING |
| Imperial | $0 | $2,999 | HMO | N/A |
| Ascension Complete | $0 | $2,900 | HMO | N/A |
| Wellcare | $0 | $4,000 | HMO | 3 |
| Amerigroup | $0 | $7,550 | HMO | 3 |
| Humana | $0 | $4,900 | HMO | 4 |
5-Star Medicare Advantage plans in Texas
If you have a five-star MA plan available in your ZIP code, you may be eligible to enroll during the Special Enrollment Period. A five-star rating indicates that a plan has maximum overall effectiveness. However, five-star plans are rare or unavailable in most areas.
The only five-star Medicare Advantage plan in Texas is UnitedHealthcare’s HMO-POS. This plan has a $0 monthly premium and a maximum out-of-pocket of $3,900.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATING |
| UnitedHealthcare | $0 | $3,900 | HMO-POS | 5 |
Medicare Advantage plans with a Part B reduction
Most Texas Medicare beneficiaries are responsible for paying monthly Medicare Part B premiums. Some Medicare Advantage plans offer a Part B reduction, meaning that they help reduce your Medicare Part B monthly premiums. It’s essential to remember that these plans are only available in specific ZIP codes.
UnitedHealthcare’s MA plan reimburses beneficiaries $30 for their monthly Part B premiums while maintaining a four-star rating.
Ascension Complete offers the most significant Part B reduction, reducing your Original Medicare premiums by $100 monthly. Wellcare also provides a high Part B premium reduction of $95, a $6,700 MOOP, and a $0 monthly premium.
| PLAN | PREMIUM | MOOP | PART B REDUCTION | STAR RATING |
| UnitedHealthcare | $0 | $5,550 | $30.00 | 4 |
| Ascension Complete | $0 | $2,900 | $100.00 | N/A |
| Wellcare | $0 | $6,700 | $95.00 | 3 |
| Humana | $0 | $5,400 | $50.00 | 4 |
| Aetna | $0 | $7,550 | $45.00 | 3 |
Ancillary/DVH
Many beneficiaries enroll in a Medicare Advantage plan for additional benefits. Since MA plans come from private companies, they can provide various benefits that Medigap and Original Medicare don’t include. For example, Medicare Advantage plans may include dental, vision, prescription drug coverage, and other benefits.
Estimated premiums for Medicare Advantage plans in Texas Cities
The attached charts provide estimated premium information for the various types of Medicare Advantage coverage in the following cities:
FAQs
Are there any Medicare Advantage PPO plans in Texas?
Yes. Medicare Advantage plans in Texas come in all options. Plan options include PPO, HMO, HMO-POS, PFFS, and SNP plan options.
How do I sign up for Medicare in Texas?
You qualify for automatic Medicare enrollment if you receive benefits from the Railroad Retirement Board or Social Security. Otherwise, you can apply for Medicare in Texas online or through your local Social Security office.
Who is eligible for Medicare in Texas?
Texas residents at least 65 years old are typically eligible for Medicare. You can apply for Medicare up to three months before you turn 65. You may be eligible before 65 if you have Lou Gehrig’s disease (ALS), end-stage renal disease (ESRD), or a disability.
What is the best Medicare Advantage plan in Texas?
Each Medicare Advantage plan has a different list of benefits and costs. In addition, insurance carriers offer varying coverage and benefit options depending on the ZIP code. To determine which plan is best for you, consider what premium you’re comfortable paying and your insurance needs.
What is the Medicare Savings Program in Texas?
A Medicare Savings Program is a Medicaid-administered program in Texas that helps beneficiaries reduce their Medicare costs. Those who qualify can receive help paying for their Original Medicare premiums, copayments, and coinsurance costs.
What is a Medicare intermediary in Texas?
A Medicare intermediary is someone who processes Medicare claims and manages provider relations. In Texas, Medicare intermediaries are also called Medicare Administrative Contractors, or MACs.
Get help finding the best Medicare Advantage plan in Texas
Texas Medicare Advantage plans vary by carrier and location. We can help you find the best program by comparing plans from the top carriers in Texas. Get started today by calling us at the number above or filling out our online form.
