Medicare Advantage Plans in Edinburg and McAllen, TX

More than half (53%) of all Medicare beneficiaries in Hidalgo County, TX, were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019, which totaled nearly 58,000 individuals in all.¹

Learn more about Medicare Advantage in Texas.

2020 Medicare Advantage plans in Hidalgo County

The high rate of participation in Medicare Advantage plans in Hidalgo County in 2019 may come as little surprise. While there were only 2 different plans in the county from which to choose, both available plans featured $0 premiums. The weighted average deductible for plans was just a little more than $3 per year.

While there weren't any 2019 plans that were rated four stars or higher based on Medicare Star Ratings, you can check with a licensed insurance agent to find out if any 2020 Medicare Advantage plans in Hidalgo County are rated four stars or higher.² Plans rated four stars or higher are considered top-rated Medicare plans.

Premiums, deductibles and other costs may vary. The numbers reported in the table above are taken from the Centers for Medicare and Medicaid Services (CMS). A licensed insurance agent will be able to help you review and compare costs for specific plans available in Hidalgo County or wherever you may live.

List of Medicare Advantage plans in Edinburg, McAllen and Hidalgo County

Medicare Advantage plans can come in several different forms.

Nearly all Medicare Advantage enrollees in Texas belonged to an HMO plan in 2019.

• HMO (Health Maintenance Organization) plans utilize a network of participating doctors and other health care providers. Care is typically not covered by the plan when received outside of the network.
  
  
• PPO (Preferred Provider Organization) plans are also available in Texas. These plans offer some more flexibility when choosing a doctor and allow for some coverage outside of the plan’s intended network. 

Private Fee-For-Service (PFFS) plans and Medical Savings Accounts were also available in Texas in 2019.

In the state of Texas, the breakdown of plan types in 2019 was as follows:

How to Sign up for a Medicare Advantage Plan in Hidalgo County

There are different Medicare enrollment periods in the year during which you may able to sign up for a Medicare Advantage plan in Edinburg, McAllen and Hidalgo County, depending on your eligibility. 

Initial Enrollment Period (IEP)

When you first become eligible for Medicare, you will typically be granted an Initial Enrollment Period (IEP). This period begins three months before you turn 65 years old, includes the month of your birthday and continues for an additional three months. 

Annual Enrollment Period (AEP)

The Annual Enrollment Period (AEP, also called the Medicare Open Enrollment Period for Medicare Advantage plans) takes place from October 15 to December 7 each year. This period is open to all eligible Medicare beneficiaries who wish to add, drop or change Medicare plans.  

Special Enrollment Period

If you experience a qualifying circumstance, you may be granted a Special Enrollment Period (SEP) at any time throughout the year to allow you to enroll in a Medicare Advantage plan.

Such circumstances may include situations like moving outside of your plan’s service area or losing your Medicare Advantage plan coverage through no fault of your own. A licensed insurance agent can help you determine if you are eligible for a Special Enrollment Period and what actions you may be able to take during that time. 

Find a Medicare Advantage plan where you live

Medicare Advantage plans can come in a variety of types and can include different benefits, networks, costs and more.

Connect with a licensed insurance agent today for help determining your eligibility and finding the best Medicare Advantage plan for you in Hidalgo County. 

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

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.

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