Medicare Advantage in Texas

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Texas state

Information about Medicare Advantage Plans in Texas

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37 percent of Medicare beneficiaries in Texas were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.1

There are 129 different Texas Medicare Advantage plans in 2019.1 Not every plan may be available where you live in Texas, as plan availability, benefits and costs can vary.

Read below to learn more about Medicare in your state.

You can also learn more about other types of Texas Medicare plans:

Average costs of Medicare Advantage in Texas

The average 2019 Medicare Advantage plan premium in Texas was $5 per month.

There were 89 different Texas Medicare advantage plans that offered $0 monthly premiums in 2019, which affects the overall average premium.

  • Average monthly premium cost in 2019 (weighted): $5
  • Average in-network out-of-pocket spending limit: $4,290
  • Average deductible in 2019 (weighted): $164.081

It's important to note that Medicare Advantage plan premiums, deductibles and out-of-pocket costs may vary greatly depending on where you live and the plan you have.

Further below in this guide, you can also explore the average 2019 Medicare Advantage plan costs in Texas by county.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Compare Texas Medicare Advantage plan costs

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

TX Medicare Eligibility & Enrollment

In order to sign up for a Medicare Advantage plan in Texas, you must enroll in Original Medicare (Part A and Part B).

To be eligible for Original Medicare at age 65, you must meet the following requirements:

  • You must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.

  • You or your spouse must be eligible to receive Social Security or Railroad Retirement benefits.

  • You or your spouse must be government employees or retirees who have not paid into Social Security, but you've paid Medicare payroll taxes.

You could potentially be eligible for Medicare under 65 if:

  • You receive Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.

  • You have ALS (amyotrophic lateral sclerosis, also called Lou Gehrig's disease).

  • You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for the required period of time.

It’s important to note that if you have ESRD, you may not qualify for most Medicare Advantage plans. However, you may be able to sign up for a Texas Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs.

How to sign up for a Medicare Advantage Plan in Texas

The first time most Medicare beneficiaries can enroll in a Texas Medicare Part C plan is during their Medicare Initial Enrollment Period (IEP).

Medicare Initial Enrollment Period graphic

Your Initial Enrollment Period beings three months before your 65th birthday, includes the month of your 65th birthday and continues for another three months after your birth month.

You may also be able to enroll in Medicare Advantagae (or switch your Medicare plan) during other Medicare enrollment periods, which include:

Medicare Advantage Open Enrollment Period graphic

Medicare Advantage Open Enrollment Period: January 1 – March 31

If you're already enrolled in a Part C plan, you may switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare from January 1 to March 31 each year.

If you switch to Original Medicare during this period, you'll also have a chance to sign up for a Medicare standalone prescription drug plan (Medicare Part D).

Medicare AEP graphic

Medicare Annual Enrollment Period (AEP): October 15 – December 7

You may enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another during Medicare AEP, which lasts from Oct. 15 to Dec. 7 every year.

You may also drop your existing Medicare Advantage plan and return to Original Medicare.

You may also join, switch or drop a Medicare Part D plan during AEP. This period is also sometimes called the Annual Election Period.

Medicare Special Enrollment Periods (SEP)

Depending on your circumstances, you may be granted a Medicare Special Enrollment Period (SEP) at any time throughout the year.

Find out if you qualify for a Medicare Special Enrollment Period by calling to speak to a licensed insurance agent.

Find a Texas Medicare Advantage plan

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in Texas 2019

The Centers for Medicare & Medicaid Services (CMS) issues star ratings for all Medicare Advantage plans every year, using a system of one to five stars.2

If a Medicare Advantage plan is awarded four or more stars out of five stars, it is considered a top-rated plan.

There are 66 top-rated 2019 Medicare Advantage plans in Texas that are rated four stars or higher.

Medicare Star Ratings
Star Ratings

★★★★★

Excellent

★★★★

Above Average

★★★

Average

★★

Below Average

Poor

Medicare Advantage plans are rated in the following five categories:

  • Preventive care and health maintenance (screenings, tests, vaccines, etc.)
  • Management of chronic conditions
  • Member experiences and ratings of the plan
  • Member complaints, problems receiving services and member retention
  • Customer service

The CMS bases its Star Ratings on several pieces of information, including Medicare’s regular monitoring activities as well as member surveys.

List of Medicare Advantage Plans Available in Texas in 2019

To view a list of plans offered in your area of Texas, use our plan comparison tool.

Find a Texas Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in Texas

Several insurance companies may offer Medicare Advantage plans in Texas, but local availability depends on where you live.

Private insurance companies offer Medicare Advantage plans that could potentially be unique to the plan area they serve.

A licensed insurance agent can help you compare the Medicare Advantage plans that are sold by insurance companies in your area of Texas.

When you’re shopping for Medicare Advantage plans in Texas, you can compare plans from several different carriers.

You can use some of the following information sources to help you compare companies and plans:

  • Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.

  • The Medicare Star Ratings can give you an idea of a plan’s overall quality.

  • You can read through Medicare Advantage plan reviews and testimonials from customers
  • Websites such as the Better Business Bureau and Consumer Reports can teach you about a company’s reputation among its customers.

Texas Medicare Advantage plans by county

The chart below provides some more information about 2019 Texas Medicare Advantage plans by county.1

  • Harris County featured 8 top-rated MA plans in 2019, which was the most out of any county in the state.

  • El Paso County and Bexar County each offered the most $0 premium plans, with 10 such plans available in each county in 2019.
2019 TX Medicare Advantage by County
County Total of County MA Enrollees % of Medicare Beneficiaries Enrolled in MA Average Monthly Premium Number of Plans Available Number of $0 Premium Plans Available % Enrolled in a $0 Premium Plan
Anderson 3568 32% $29 9 4 50%
Andrews 629 28% $19 0 0 2%
Angelina 6072 33% $22 2 2 63%
Aransas 3181 37% $0 3 3 100%
Archer 355 18% $29 0 0 50%
Armstrong 99 20% $35 0 0 38%
Atascosa 4352 47% $1 7 4 93%
Austin 1953 29% $18 7 7 67%
Bailey 200 17% $10 0 0 82%
Bandera 1956 28% $1 2 0 99%
Bastrop 5048 31% $11 3 2 80%
Baylor 201 19% $35 0 0 40%
Bee 2090 42% $1 1 1 99%
Bell 17310 32% $15 7 3 80%
Bexar 138079 45% $1 12 10 95%
Blanco 790 21% $71 2 0 38%
Borden 24 17% $35 0 0 40%
Bosque 1868 35% $13 0 0 90%
Bowie 4973 24% $27 0 0 0%
Brazoria 20420 39% $21 3 1 69%
Brazos 5798 24% $9 0 0 90%
Brewster 652 27% $40 0 0 29%
Briscoe 99 22% $29 0 0 50%
Brooks 687 40% $22 0 0 63%
Brown 2295 24% $40 0 0 29%
Burleson 1365 30% $11 0 0 85%
Burnet 3927 29% $19 0 0 71%
Caldwell 2498 32% $43 0 0 8%
Calhoun 896 20% $35 0 0 38%
Callahan 968 28% $35 0 0 38%
Cameron 31952 49% $1 4 4 99%
Camp 960 31% $40 2 1 33%
Carson 312 25% $35 0 0 38%
Cass 2576 31% $27 0 0 0%
Castro 265 21% $29 0 0 50%
Chambers 2197 33% $17 3 1 73%
Cherokee 3786 34% $15 0 0 30%
Childress 371 26% $35 0 0 40%
Clay 587 21% $29 0 0 50%
Cochran 173 29% $10 0 0 83%
Coke 232 24% $49 0 0 29%
Coleman 505 19% $44 0 0 33%
Collin 36692 29% $8 14 8 89%
Collingsworth 93 14% $35 0 0 40%
Colorado 1244 22% $35 0 0 38%
Comal 10664 30% $3 0 0 83%
Comanche 913 24% $41 0 0 33%
Concho 222 28% $35 0 0 40%
Cooke 2343 27% $34 1 1 47%
Coryell 3058 27% $12 0 0 85%
Cottle 117 25% $35 0 0 40%
Crane 217 30% $40 0 0 29%
Crockett 153 21% $35 0 0 40%
Crosby 469 34% $3 0 0 96%
Culberson 103 19% $40 0 0 29%
Dallam 193 18% $35 0 0 40%
Dallas 127309 37% $3 4 3 94%
Dawson 653 27% $37 0 0 43%
Deaf Smith 739 25% $31 0 0 44%
Delta 354 25% $28 0 0 16%
Denton 32040 31% $4 0 0 93%
DeWitt 1085 23% $40 0 0 29%
Dickens 144 25% $29 0 0 50%
Dimmit 757 38% $31 0 0 44%
Donley 217 23% $35 0 0 40%
Duval 936 38% $35 0 0 38%
Eastland 1324 27% $41 0 0 33%
Ector 5700 28% $18 2 1 1%
Edwards 140 23% $35 0 0 38%
El Paso 78732 59% $0 11 10 100%
Ellis 9635 33% $3 0 0 92%
Erath 1801 25% $35 0 0 38%
Falls 1382 37% $8 0 0 93%
Fannin 2076 25% $27 0 0 7%
Fayette 1565 22% $53 0 0 6%
Fisher 249 24% $35 0 0 40%
Floyd 406 31% $3 0 0 95%
Foard 62 17% $35 0 0 40%
Fort Bend 39355 40% $6 3 3 90%
Franklin 764 27% $28 0 0 15%
Freestone 1281 28% $82 0 0 29%
Frio 1051 37% $44 0 0 30%
Gaines 509 24% $35 0 0 40%
Galveston 20904 35% $3 0 0 96%
Garza 282 31% $5 0 0 91%
Gillespie 1773 20% $29 0 0 50%
Glasscock 29 13% $35 0 0 40%
Goliad 490 27% $40 0 0 29%
Gonzales 1066 25% $13 0 0 77%
Gray 862 20% $33 0 0 50%
Grayson 8368 28% $27 0 0 54%
Gregg 8159 31% $33 0 0 6%
Grimes 1915 31% $37 0 0 64%
Guadalupe 8544 30% $2 1 1 89%
Hale 1748 30% $1 0 0 99%
Hall 203 24% $35 0 0 40%
Hamilton 853 33% $12 0 0 89%
Hansford 134 14% $35 0 0 40%
Hardeman 220 21% $35 0 0 40%
Hardin 4784 40% $30 0 0 55%
Harris 261839 46% $5 10 9 92%
Harrison 4621 33% $34 0 0 6%
Hartley 152 21% $35 0 0 40%
Haskell 358 25% $35 0 0 40%
Hays 10135 32% $7 0 0 78%
Hemphill 93 15% $35 0 0 40%
Henderson 7635 34% $26 1 1 55%
Hidalgo 57737 53% $0 2 2 99%
Hill 3095 33% $60 0 0 40%
Hockley 1436 34% $1 0 0 98%
Hood 5537 31% $2 0 0 97%
Hopkins 1848 22% $17 0 0 23%
Houston 1634 29% $29 0 0 50%
Howard 1320 23% $35 0 0 38%
Hudspeth 327 38% $2 0 0 96%
Hunt 4664 24% $28 0 0 56%
Hutchinson 840 20% $35 0 0 40%
Irion 70 18% $35 0 0 40%
Jack 411 23% $35 0 0 38%
Jackson 762 24% $40 0 0 29%
Jasper 2794 32% $25 0 0 57%
Jeff Davis 172 22% $35 0 0 40%
Jefferson 19316 42% $4 0 0 89%
Jim Hogg 361 36% $29 0 0 50%
Jim Wells 3927 47% $0 0 0 100%
Johnson 14465 45% $1 0 0 99%
Jones 988 27% $35 0 0 38%
Karnes 818 28% $35 0 0 38%
Kaufman 6887 31% $32 0 0 45%
Kendall 3045 26% $4 0 0 80%
Kenedy 13 25% $25 0 0 57%
Kent 67 32% $35 0 0 40%
Kerr 3473 20% $29 0 0 40%
Kimble 282 20% $35 0 0 40%
King 0 0% $35 0 0 40%
Kinney 286 29% $37 0 0 43%
Kleberg 2566 49% $1 0 0 99%
Knox 208 23% $35 0 0 40%
La Salle 463 38% $31 0 0 44%
Lamar 2067 17% $35 0 0 40%
Lamb 843 30% $3 0 0 95%
Lampasas 1669 29% $8 0 0 89%
Lavaca 1073 19% $35 0 0 40%
Lee 1105 29% $55 1 0 42%
Leon 1610 29% $7 0 0 90%
Liberty 6256 42% $15 0 0 48%
Limestone 1728 31% $69 0 0 33%
Lipscomb 106 17% $35 0 0 40%
Live Oak 756 34% $35 0 0 38%
Llano 2228 28% $8 0 0 87%
Loving 0 37% $40 0 0 29%
Lubbock 17867 29% $0 0 0 100%
Lynn 341 31% $8 0 0 88%
Madison 799 32% $79 0 0 31%
Marion 1024 18% $39 0 0 36%
Martin 152 23% $35 0 0 38%
Mason 307 31% $29 0 0 50%
Matagorda 2358 39% $22 0 0 63%
Maverick 4079 20% $28 0 0 50%
McCulloch 446 36% $35 0 0 40%
McLennan 16734 29% $7 1 1 91%
McMullen 57 38% $40 0 0 29%
Medina 3816 22% $0 0 0 99%
Menard 147 23% $35 0 0 40%
Midland 4827 37% $19 0 0 1%
Milam 2296 32% $13 0 0 87%
Mills 476 29% $61 0 0 21%
Mitchell 436 20% $35 0 0 40%
Montague 1094 40% $29 0 0 50%
Montgomery 36999 17% $8 0 0 86%
Moore 461 35% $29 0 0 50%
Morris 1341 24% $31 0 0 40%
Motley 92 28% $29 0 0 50%
Nacogdoches 3374 28% $19 0 0 67%
Navarro 3067 30% $28 0 0 50%
Newton 870 25% $25 0 0 57%
Nolan 865 52% $35 0 0 40%
Nueces 32383 15% $0 2 2 100%
Ochiltree 206 24% $35 0 0 40%
Oldham 104 39% $35 0 0 40%
Orange 6987 22% $23 0 0 63%
Palo Pinto 1500 31% $35 0 0 38%
Panola 1688 28% $28 0 0 45%
Parker 7475 15% $3 0 0 95%
Parmer 228 25% $35 0 0 40%
Pecos 610 0% $40 0 0 29%
Polk 5937 26% $19 0 0 72%
Potter 5094 25% $40 0 0 38%
Presidio 468 24% $40 0 0 29%
Rains 893 27% $25 0 0 57%
Randall 5749 24% $40 0 0 38%
Reagan 108 23% $35 0 0 40%
Real 290 22% $31 0 0 44%
Red River 873 23% $27 0 0 1%
Reeves 458 21% $40 0 0 29%
Refugio 523 28% $45 0 0 30%
Roberts 42 21% $35 0 0 40%
Robertson 1091 27% $7 0 0 93%
Rockwall 4505 28% $3 1 1 93%
Runnels 431 16% $35 0 0 40%
Rusk 3616 34% $36 0 0 3%
Sabine 826 22% $35 0 0 40%
San Augustine 753 29% $29 0 0 50%
San Jacinto 2845 41% $20 0 0 71%
San Patricio 7146 51% $0 0 0 100%
San Saba 436 27% $73 0 0 36%
Schleicher 141 22% $35 0 0 40%
Scurry 806 26% $35 0 0 40%
Shackelford 189 25% $35 0 0 38%
Shelby 1687 31% $32 0 0 44%
Sherman 69 17% $35 0 0 40%
Smith 14616 31% $23 1 0 20%
Somervell 620 30% $73 0 0 36%
Starr 4186 43% $18 0 0 70%
Stephens 507 23% $35 0 0 40%
Sterling 44 18% $35 0 0 40%
Stonewall 82 21% $35 0 0 40%
Sutton 110 14% $35 0 0 40%
Swisher 330 21% $16 0 0 76%
Tarrant 123283 43% $3 2 1 95%
Taylor 7000 27% $43 0 0 33%
Terrell 75 27% $40 0 0 29%
Terry 784 36% $2 0 0 96%
Throckmorton 73 17% $29 0 0 50%
Titus 1749 30% $27 0 0 1%
Tom Green 6653 29% $7 1 0 60%
Travis 44505 30% $7 3 2 81%
Trinity 1581 33% $34 0 0 44%
Tyler 1608 30% $34 0 0 46%
Upshur 3024 32% $33 0 0 6%
Upton 172 28% $35 0 0 40%
Uvalde 1866 33% $38 0 0 38%
Val Verde 2901 32% $35 0 0 40%
Van Zandt 4406 32% $35 0 0 47%
Victoria 6078 33% $23 0 0 58%
Walker 4225 39% $15 0 0 77%
Waller 2677 36% $14 0 0 77%
Ward 517 26% $40 0 0 29%
Washington 2338 26% $60 0 0 21%
Webb 10429 31% $25 0 0 67%
Wharton 2452 29% $9 0 0 86%
Wheeler 191 16% $35 0 0 40%
Wichita 4825 19% $35 0 0 40%
Wilbarger 765 26% $35 0 0 40%
Willacy 1754 47% $24 0 0 64%
Williamson 26107 33% $10 1 0 75%
Wilson 3467 37% $1 0 0 94%
Winkler 261 22% $40 0 0 29%
Wise 3911 31% $0 0 0 99%
Wood 4578 30% $15 0 0 29%
Yoakum 320 25% $35 0 0 40%
Young 674 15% $35 0 0 40%
Zapata 573 27% $35 0 0 40%
Zavala 912 44% $34 0 0 46%

TX Medicare Advantage enrollees by plan type

The chart below illustrates the percentage of 2019 Texas Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.1

Plan type Percentage of Texas enrollees (2019)
HMO 82.5%
Local PPO 16.9%
Regional PPO <1%
PPFS <1%
Other Plans <1%

The major types of Medicare Advantage plans include:

  • HMO
    If you have a Texas Health Maintenance Organization (HMO) plan, you'll typically be required to visit doctors, hospitals and pharmacies that are part of your plan’s network (except in the case of emergencies).

    An HMO plan will also typically require you to get a referral from your primary care physician (PCP) in order to see a specialist.

  • PPO
    If you have a Medicare Preferred Provider Organization (PPO) plan, you may be able to see providers outside of your plan’s network, but you'll typically pay higher out-of-pocket costs for going outside of the plan network.

    You'll typically pay less out of pocket if you seek medical services from providers within your plan’s network.

    PPO plans typically do not require you to get a referral before you can see a specialist.

  • PFFS
    A Private Fee-For-Service (PFFS) plan will typically determine how much you are required to pay for health care services at the point when care is received.

    With a PFFS plan, you can typically receive care from any doctor, hospital or health care provider that accepts Medicare as well as your plan’s terms. Not all providers will accept these terms, however.

  • SNP
    A Special Needs Plan (SNP) is a type of Medicare Advantage plan that is limited to people with certain chronic health conditions and other specific characteristics.

    SNP plans are required to provide prescription drug coverage.

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 Texas Medicare Advantage plans that are available where you live.

Local health insurance resources in Texas

  • The Health Information Counseling & Advocacy Program of Texas provides benefits counseling to the state’s seniors to help them gain a deeper understanding of their Medicare benefits and rights.

    The assistance is provided by trained volunteers, and all information given is free and unbiased. The program may be reached at 800-252-9240.  

  • You can also explore more information about the insurance industry in Texas by visiting the state’s Department of Insurance website.

  • Texas Prescription Drug Assistance Programs
    The state of Texas has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

1 MedicareAdvantage.com's internal analysis of CMS Medicare Advantage landscape source files, accessed May 2019. Data retrieved from www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.

Includes 2019 approved contracts/plans. PACE, Special Needs Plans, Part B Only Plans, and Employer sponsored plans (800 series) are excluded. Plans under sanction are not shown.

2 Every year, Medicare evaluates plans based on a 5-star rating system.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC is a licensed and certified representative of A Medicare Advantage [HMO, PPO and PFFS] organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any plan depends on contract renewal.

TZ Insurance Solutions LLC and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program. This website does not contain a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877) 486-2048), 24 hours a day / 7 days a week or consult www.medicare.gov.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year.

Medicare has neither reviewed nor endorsed this information.

Last Updated: 6/24/2019