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.
How Medicare Advantage Plans Work in Texas
Private insurance companies provide Medicare Advantage plans in Texas. By enrolling in a Medicare Advantage plan, you essentially leave the federal Medicare program to join a private insurance plan.
Currently, there are 39 MA plans available. However, each plan will have different benefits and costs depending on the carrier. For example, some Medicare Advantage plans provide Medicare Part D coverage.
Medicare Advantage Plans Offered in Texas
The primary difference between MA plans and Medicare Supplement plans is that the federal government regulates supplements but 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 plans have $0 deductibles, others have $0 premiums and Part B premium reductions.
Medicare Advantage Plans with a Zero-dollar Premium in Texas
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. It is essential to consider these various costs 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 in Texas
The following plans in Texas have a $0 drug deductible as well as 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 |
Medicare Advantage Plans with a 5-Star Rating 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 in Texas
Most Texas Medicare beneficiaries are responsible for paying a Medicare Part B premium every month. Some Medicare Advantage plans offer a Part B reduction, meaning that they help reduce your Medicare Part B monthly premiums. It is essential to remember that these plans are only available in specific ZIP codes.
UnitedHealthcare’s MA plan reimburses beneficiaries $30 for their Part B premiums every month while maintaining a four-star rating.
Ascension Complete offers the most significant Part B reduction, reducing your Original Medicare premiums by $100 every month. Wellcare also offers 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 the additional benefits. Since MA plans come from private companies, they can provide various benefits that Medigap plans and Original Medicare do not include. For example, Medicare Advantage plans may include dental, vision, prescription drug coverage, and other benefits.
FAQs
How Do I Sign Up for Medicare in Texas?
If you receive benefits from the Railroad Retirement Board or Social Security, you qualify for automatic Medicare enrollment. Otherwise, you can apply for Medicare in Texas through your local Social Security office.
Who Is Eligible for Medicare in Texas?
Texas residents who are 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 are comfortable with 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.
How to Get Help Enrolling in a Texas Medicare Advantage Plan
Texas Medicare Advantage plans vary by carrier and location. We can help you find the best plan 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.
