List of Medicare Advantage Plans in Texas 2019/2020

The state of Texas had 129 different Medicare Advantage plans available for sale in 2019.1

Plan selection may vary from one county or zip code to the next.

Call to speak with a licensed insurance agent who can help you determine your eligibility to enroll and compare the Medicare Advantage plans that are available in your area of Texas. 

Find Medicare Advantage plans in your area

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

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Types of Texas Medicare Advantage plans

There are several different types of Medicare Advantage plans that may be available, though not each type of plan may be available where you live.

The 2019 breakdown of Medicare Advantage plan enrollment in Texas is illustrated in the chart below.1

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

Texas Health Maintenance Organization (HMO) plans

Health Maintenance Organization (HMO) plans feature a network of participating doctors, pharmacies and other health care providers.

You typically are required to choose a primary care physician (PCP) when you have an HMO plan. Your PCP coordinates your health care and provides a referral when you need to see a specialist. 

A Medicare HMO plan will typically only care that is received within the network of participating providers.

In 2019, 82.5% of Medicare Advantage beneficiaries in Texas are enrolled in HMO plans.

Texas Preferred Provider Organization (PPO) plans

A Preferred Provider Organization (PPO) plan also typically includes a network of participating providers, but you may be able to go outside of the network for care and still receive at least partial coverage.

You will typically pay higher out-of-pocket costs, however, if you receive medical services outside of your Medicare PPO plan network than you would if you visited an in-network provider.

You typically aren't required to get a referral from a physician in order to visit a specialist when you have a PPO plan, but individual restrictions may vary.

In 2019, 16.9% of Texas Medicare Advantage plan beneficiaries are enrolled in Local PPO plans.

Texas Private Fee-For-Service (PFFS) plans

Private Fee-For-Service (PFFS) plans allow members to receive care from any provider that accepts the plan’s coverage, agrees to the terms and conditions of the plan and accepts Medicare.

With most Medicare PFFS plans, you aren’t required to designate a primary care doctor.

Less than 1% of Texas Medicare Advantage plan beneficiaries in 2019 are enrolled in a PFFS plan.

Special Needs Plans (SNPs)

Medicare Advantage Special Needs Plans (SNPs) feature benefits that are designed for people with certain medical conditions or who are dual eligible for Medicare and Medicaid.

Medicare SNPs aren’t available in all areas. Depending on where you live and what type of special needs you may have, a licensed insurance agent can help you find a Medicare SNP that may fit your needs, if one is available.

You can also learn more about additional Medicare plans in Texas, such as:

Medicare Advantage plans in Texas

More than 1.6 million people in Texas were enrolled in a Medicare Advantage plan in 2019. That accounted for 37 percent of all Medicare beneficiaries in the state.1

  • There were a total of 129 different plans available across the state, available in 34 different counties. 10 or more different Medicare Advantage plans were available in Colin (14 plans), Bexar (12), El Paso (11) and Harris (10) counties.

  • The average weighted premium for a Medicare Advantage plan in Texas was $5 per month in 2019.

  • 89 Medicare Advantage plans in Texas featured $0 premiums in 2019.

    $0 premium plans may not be available in all areas, so be sure to check with a licensed insurance agent who can help you find any $0 premium plans in your area.

  • The weighted average deductible for a Medicare Advantage plan in Texas was $164 per year in 2019.

Individual plan costs and premiums may vary.

66 plans across Texas were rated four stars or higher by the Centers for Medicare and Medicaid Services (CMS) in 2019.2 A plan that has four or more stars is considered a highly rated Medicare Advantage plan.

Texas Medicare Advantage plans at a glance

  • Number of unique plans: 129
  • Number of $0 premium plans: 89
  • Number of plans rated four stars or higher: 66
  • Average weighted monthly premium: $5
  • Average weighted annual deductible: $164.08
  • Percentage of Medicare beneficiaries enrolled in a Medicare Advantage plan: 37
  • Number of people enrolled in a Medicare Advantage plan: 1,645,147

How to enroll in a Medicare Advantage plan in Texas

Call today to speak with a licensed insurance agent who can help you determine your eligibility to enroll and compare Medicare Advantage plans where you live. A licensed agent may also be able to:

Connect with a licensed insurance agent today to explore your Texas Medicare Advantage plan options. 

 

Find Medicare Advantage plans in your area

Compare Plans

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