Medicare Advantage Plans in Texas

What is Medicare Advantage?

Medicare Advantage plans bundle your Part A (hospital insurance) and Part B (medical insurance) coverage together. Most plans also include Part D (prescription drug coverage). When you join a Medicare Advantage plan, you still have Medicare, but you get your coverage from the plan rather than Original Medicare.

What do these plans typically cover?

• Hospital Care (Part A): Inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.
• Medical Care (Part B): Services from doctors and other health care providers, outpatient care, medical equipment, and preventive services.
• Prescription Drugs (Part D): Most plans include drug coverage, which is highly convenient.
• Extra Benefits: Many plans offer benefits not covered by Original Medicare, such as routine dental, vision, hearing, and fitness memberships (like SilverSneakers).

What to Consider Before Choosing

While Medicare Advantage offers excellent all-in-one convenience, it's important to understand how these plans operate:

• Networks: You generally must use doctors and hospitals within the plan's network (HMO or PPO). Going out-of-network can cost more or may not be covered at all.
• Out-of-Pocket Costs: You will pay copayments or coinsurance for services, but plans have a yearly limit (an out-of-pocket maximum). Once you reach this limit, the plan pays 100% of covered services for the rest of the year.
• Annual Changes: Benefits, premiums, and network providers can change every year. You must review your plan during the Annual Enrollment Period to ensure it still meets your needs.

Enrollment Periods

You can only join, switch, or drop a Medicare Advantage plan during specific times of the year, such as your Initial Enrollment Period when you first turn 65, or the Annual Enrollment Period (Oct 15 - Dec 7). For a full explanation of these periods, read our Enrollment Periods Guide.