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Best Medicare Advantage Plans in Texas for 2020

There are many people who are enrolled in some of the best Medicare Advantage plans in Texas for 2020. If you have recently enrolled in Medicare Part A and Part B or if you will be eligible in the near future, you might want to join them and look into Medicare Advantage plans in Texas yourself. It’s possible to just stick with Original Medicare (Medicare Part A and Medicare Part B), but opting for a Medicare Advantage plan can help you significantly reduce your out-of-pocket expenses and can provide you with some extra perks.

Overview of Medicare Advantage Plans in Texas for 2020

Medicare Advantage plans are a little different from Medicare Supplement plans, although both can help you enhance your Original Medicare coverage. With Medicare Supplement insurance (Medigap), you just use your new policy to fill in the gaps of Medicare. With Medicare Advantage plans, on the other hand, you effectively replace Original Medicare (Medicare Part A and Part B).

During the Medicare Advantage enrollment period, you can enroll in an HMO, HMO-POS, PPO or another type of MA policy. This will allow you to avoid many of the coinsurance, copayments (copays) and deductibles of Original Medicare (Medicare Part A and Part B). Some extra perks like prescription drug coverage might be included as well.

If you’re overwhelmed about switching from Original Medicare (Medicare Part A and Part B) to a Medicare Advantage plan, you should know that you aren’t alone. We have licensed insurance agents here who can help you compare plans, get a complete description of benefits for the different health plans that are available for you and more. We’ll even help you compare rates so that you can find rates that are affordable for you.

Best Medicare Advantage Plans in Texas: When Can You Enroll?

Of course, you will need to be eligible for Medicare first. Once you are signed up for Medicare Part A and Part B, you can sign up for a Medicare Advantage plan during a Medicare Enrollment Period:

  • Medicare Initial Coverage Election Period ICEP: The first opportunity that you will have to sign up for a Medicare Advantage policy is when you first become enrolled in Medicare Part A and Part B.
  • Medicare Annual Election Period AEP: All Medicare beneficiaries can disenroll or switch to a different Medicare Advantage plan during the annual period from October 15 to December 7.
  • Medicare Advantage Disenrollment Period MADP: Before it was discontinued, the MADP was designed for people who wanted to disenroll from Medicare Advantage plans and change back to Original Medicare {Medicare Part A and Medicare Part B).
  • Medicare Advantage Open Enrollment Period MA OEP: The MA OEP ran for the first time from January 1 to March 31, 2019, but it will continue to run during this period each year. During this time, you can change your MA policy.
  • Medicare Special Election Periods SEP: Losing your coverage because of a move, loss of your dual-eligible Medicaid status or because of other issues (like your insurer not signing a contract renewal with Medicare) can be scary, but an SEP will be triggered so that you can sign up for a Medicare Advantage plan if you want to.

Best Types of Medicare Advantage Plans in Texas

These are the Medicare Part C options in Texas that are most popular and that are considered by many to be the best. You’ll probably want to compare them so that you will know which one will be best for you as a beneficiary:

PPO Preferred Provider Organization Plans (PPO) in Texas

  • Has network service areas
  • Does allow you to seek care from healthcare providers outside of your insurance company’s network, such as doctors, hospitals, skilled nursing facility options, and nursing homes
  • You do pay less by sticking with in-network providers
  • No referrals are necessary for specialists

HMO Health Maintenance Organization Plans (HMO) in Texas

  • $0 premium options are available
  • Even if you do have to pay a monthly premium, you’ll probably find the best rates with this type of Medicare Part C policy in Texas
  • Outside of emergency situations, you’ll have to see in-network providers if you want your insurance company to pay
  • You must see your primary care doctor (PCP) for specialists

Private Fee-for-Service PFFS in Texas

  • The coverage that you will have is determined by the policy
  • Network restrictions do not apply

Special Needs Plans SNPs in Texas

  • People who suffer from chronic health conditions or institutional conditions typically sign up for Special Needs Plans. An example of a qualifying condition is end-stage renal disease ESRD.
  • Medicare Part D prescription drug plans are always included, despite the fact that Medicare Part D plans are not always included in most MA policies

Enrollment Figures for Texas Medicare Advantage Plans for 2020

As a beneficiary of Medicare, you might be curious about what others use when going to the doctor or hospital. These are a few interesting stats:

  • The five largest counties in Texas are Harris, Dallas, Tarrant, Bexar, and Travis.
  • There were 4,090,568 Medicare beneficiaries in Texas in 2018.
  • 1,458,533 of Medicare beneficiaries in Texas were enrolled in Medicare Advantage in 2018.

Do Medicare Advantage Plans in Texas Cover Prescription Drugs?

When you look for a Medicare Advantage plan in Texas, you may want to look at policies that include Medicare Advantage prescription drug plans in their premiums. A quick look at the prescription drug tiers and the formulary for each policy will give you an idea of what will and will not be covered.

Of course, you can sign up for a stand-alone policy for prescription drug coverage, but you may want to choose an MA policy that includes a Medicare Part D prescription drug plan so that you can save money.

Network Restrictions for Medicare Advantage Plan in Texas

  • In-Network vs. Out-of-Network Within Coverage Area: HMO Medicare Advantage plans and PPO Medicare Advantage plans will both cover out-of-network care if you’re in an emergency situation. In other situations, an HMO will not cover out-of-network care. A PPO will, but you will have to pay more.
  • Traveling With Plan: Whether you have one of the health maintenance organization HMO plans or preferred provider organization PPO plans, you can seek emergency care when you are traveling in the United States. If you have a PPO, you can get medical care throughout the United States, but your own costs will be higher. An HMO will not cover anything outside of emergency care when you’re traveling outside of your network.
  • Moving Across State Lines: If you move to another state, you’ll need to buy a new Medicare Part C policy in your new location.

Added Benefits of Medicare Advantage Plan in Texas for 2020

Not all policies include these perks, but these are some perks that you can look for when shopping for your policy:

  • Hearing care, routine vision, and dental care
  • Wellness programs
  • Silver Sneakers or other similar gym membership
  • Recommendations for diet and nutrition
  • Allowance for over-the-counter medication costs
  • Healthy living seminars and classes
  • Transportation to and from medical appointments
  • Payment of some or all of the Medicare Part B premium

Here are a few changes for 2020:

  • Starting in 2020, insurance companies that provide Medicare Advantage plans in Texas will be able to add some supplemental non-health related benefits to certain beneficiaries, such as providing help with making structural changes to the home when needed. This is designed to help those who might need help with widening doorways or installing ramps for their homes.
  • The Centers for Medicare and Medicaid Services approved a 2.53% payment increase to Medicare insurers that offer Medicare Advantage plans in Texas.

Your Local Options for Medicare Part C Plans in Texas

Do you live in one of these cities?

  • Houston
  • San Antonio
  • Fort Worth
  • Austin
  • El Paso
  • Dallas

If you do, or if you live in any other city or town across Texas, we can help you find the best Medicare Advantage plan in Texas for your needs and budget.

For example, these are some of the big-name, well-known Medicare Advantage plan companies that we can make a 2020 comparison of for you:

  • Care Improvement Plus
  • WellCare
  • Aetna
  • Advantra
  • Cigna
  • Blue Cross Blue Shield
  • Humana

Texas Medicare Resources

Understanding the Medicare benefits of Medicare Parts A and B can be tough. Learn more about Medicare, Medicare plans, options for saving on out-of-pocket costs for healthcare services and health insurance and more with these resources. You can also give us a call so that we can help you find the best rates on MA policies in Texas with top star ratings!