Medicare Advantage in Texas

If you live in Texas and are looking for Medicare Advantage coverage, you may have many options depending on which plans are available in your area.

How Medicare Advantage works in Texas

Generally, Medicare Advantage works the same way in Texas as it does in other states: as another way to receive your Original Medicare, Part A and Part B, benefits. What differs will be the specific insurance companies and plans available, which will depend on your location and zip code.

Medicare Advantage plans provide Part A and Part B benefits through private insurance companies have a contract with the federal program. If you have Medicare Advantage, you are still in Medicare, and you will still get all of the same benefits that you would in Original Medicare (except hospice care, which is still covered by Medicare Part A). Some plans offer other benefits not included in Original Medicare, such as health and wellness programs, routine vision and dental benefits, or prescription drug benefits. You will need to continue to pay your Part B premium if you have Medicare Advantage.

Many Medicare Advantage plans offer prescription drug coverage; these are known as Medicare Advantage Prescription Drug (MA-PD) plans. You can't have both a Medicare Advantage plan and a stand-alone Medicare prescription drug plan.

You can enroll in a Medicare Advantage plan if you have both Medicare Part A and Part B, live in the service area of the plan you wish to join, and do not have end-stage renal disease (ESRD). You can enroll, switch plans, and disenroll during the following periods:

Types of Medicare Advantage plans in Texas

There are multiple types of Medicare Advantage plans. As a Medicare beneficiary living in Texas, availability will depend on your county and, in some cases, whether you meet certain eligibility criteria:

Comparing Medicare Advantage plans available in Texas

When you're choosing a Medicare Advantage plan in Texas, it's important to consider all of your options and research what's available. Although all Medicare Advantage plans are required to provide at least the same amount of coverage as Original Medicare, there can be huge differences in cost and any additional benefits they offer. Some plans may even offer premiums as low as $0, although you must continue to pay your Part B premium for any Medicare Advantage plan you join.

Ultimately, the county and zip code you reside in determine which plans are available to you. It's especially important to shop around if you're looking for a Medicare Advantage plan that includes drug coverage. Out-of-pocket costs can vary widely for Medicare Advantage plans and will depend on the drugs you take, whether the plan covers them, and which cost tier the drugs fall under. Remember to consider costs like copayments, deductibles, and out-of-pocket maximums, in addition to the plan premium.

To begin comparing Medicare Advantage plans in Texas, you can:

Medicare has neither reviewed nor endorsed this information.

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