A Medicare Advantage (MA) plan is health insurance offered by private insurance companies bound by Medicare rules. It provides Medicare Part A and B coverage and, frequently, Part D drug coverage. They often offer additional benefits like routine hearing, vision, dental exams, and fitness club memberships.
Plan availability varies by zip code and county. Discover the best Medicare Advantage plans in Texas that provide comprehensive coverage and exceptional benefits for your healthcare needs.
Best Medicare Advantage Plans in Texas in 2023: shortlist
- Humana — overall best Medicare Advantage Plan provider in Texas
- AARP — $0 options for plan costs, nationwide provider network, robust additional benefits
- Cigna — high-quality ratings, cost-effective with outstanding benefit options
Best Medicare Advantage Plans in Texas in 2023: our top picks
Our top three picks for Texas's best Medicare Advantage Plans are available in 2023. Our search included only plans rated above average on the Centers for Medicare and Medicaid Services (CMS) star ratings with broad service areas and the best overall value for the member.
However, you might value lower costs, greater access to care, or additional perks and benefits. You are unique, and so are Medicare Advantage Plans. Read more on these top picks and learn about other search tools to find the best fit for your unique health needs.
1. Humana — best Medicare Advantage plan in Texas
Humana is noteworthy for its high quality and customer service ratings, large service area, and outstanding unique benefits. Some unique benefits include Part B premium giveback, SilverSneakers fitness memberships, and a spending allowance.
Humana has an extensive network of healthcare providers covering all 254 Texas counties and 1,746 contract options. Humana provides a wide range of prescription drug coverage.
2. AARP insured by UnitedHealthcare — great provider in Texas with $0 options
AARP, insured by UnitedHealthcare, is a cost-effective, high-quality plan that offers a large service in Texas and a robust option of additional benefits. AARP offers some plans with $0 options for monthly premiums and annual drug deductibles, making it affordable for most people.
Some other benefits offered by AARP are fitness, dental, and hearing. They also have an eyewear allowance and 24/7 telephone access to a nurse. AARP achieved a 4.5 CMS star rating, the highest average CMS star rating in Texas.
3. Cigna — top cost-effective MA plan in Texas
Cigna is a strong, cost-effective provider with outstanding benefit options. They offer incentives for wellness visits, 24/7 telehealth, and transportation to health facilities. Cigna offers a $0 annual drug deductible beneficial for members taking prescription medications.
Cigna's additional benefits include Healthy Rewards, medication management therapy, meal delivery, OTC and hearing aid allowances, and a fitness membership.
Medicare Advantage plans Texas: comparison
This chart provides an at-a-glance view of the evaluation criteria utilized in our article. We reviewed MA Plan costs, availability, quality, and customer satisfaction ratings.
|Avg. monthly premium||$59.31 ($0 option)||$71 ($0 option)||$17 ($0 option)|
|Avg. in-network maximum out-of-pocket||$6,380.49||$5,234.40||$5,050.91|
|Avg. annual drug deductible||$201.83 ($0 option)||$269.13 ($0 option)||$0 (across all plans)|
|Extra benefits||Part B Premium giveback, SilverSneakers, spending allowance||Fitness, dental, hearing, eyewear allowance, see any doctor in the national network, 24/7 access to nurse||Healthy Rewards, Case Mgmt, Medication Therapy Mgmt, Pharmacy Network, 24/7 support|
|Number of contracts available||1,749||360||220|
|Number of counties serviced||254||135||50|
|Types of plans||PFFS, HMO, PPO and Regional PPO||PPO and HMO-POS||PPO and HMO|
|Avg. CMS ratings||4.2||4.5||4.3|
|NCQA-based on quality and member experience||Accredited 4/5||Not listed||Not Accredited 3/5|
|JD Powers (overall customer satisfaction index ranking 2022)||2nd||Not ranked, but parent company, UnitedHealthcare, ranked 4th||8th|
You can compare plans specific to your zip code on Medicare’s plan finding tool.
How we ranked the best Texas Medicare Advantage plans?
To rank the top Medicare Advantage Plans in Texas, we evaluated cost, availability, quality ratings, and customer satisfaction ratings.
- Cost. We utilized the Centers for Medicare and Medicaid Services (CMS) 2023 data to evaluate plan costs such as monthly premiums, annual prescription drug coverage, and in-network max-out-of-pocket limits.
- Availability. Service areas for MA plans are based on Texas county and zip code. We used CMS 2023 data to tally the number of providers and contracts provided per county.
- Quality ratings. We used CMS Star Ratings from CMS.gov and data from the National Committee for Quality Assurance (NCQA) Report Cards. The NCQA is a non-profit organization that is the leader in healthcare accreditation.
- Customer satisfaction. We considered J.D. Powers' overall customer satisfaction index ranking from 2022 for each MA plan. This J.D. Power analysis considered six factors: coverage and benefits; provider choice; cost; customer service; information and communication; and billing and payment.
Medicare Advantage in Texas: things to know
In most cases, Medicare Advantage Plans provide everything covered by your Medicare Part A and B services, Part D, and additional benefits. You may select an MA plan regardless of your preexisting health conditions. You might need to choose a new health provider if your health provider joins or leaves your MA plan, which can happen at any time during the year. By using your in-network health services, you can save costs.
- MA Plan service area is based on your Texas county and zip code
- Average consolidated monthly premium of Texas MA Plans (excluding $0 premiums): $74.45
- Average annual drug deductible of Texas MA Plans (excluding $0 deductibles): $301.78
- Average in-network maximum out-of-pocket amount: $5,089.65
- Medicare mandates that the max OOP amount for MA Plans is $8,300 although most plans have lower amounts
- Average overall star rating: 3.96
What providers offer Medicare Advantage plans in Texas
Various health insurance models may be offered by Medicare Advantage plans in Texas, such as HMO, PPO, PFFS, MSA, and SNP. To learn more about each model of MA plan, read the best Medicare Advantage Plans article. HMO and PPO plans are the most commonly offered.
These are the 27 providers that offer MA plans in Texas in 2023. They are listed alphabetically, along with the number of contracts each provider offers:
- Aetna Medicare – 291
- Alignment Health Plan – 4
- Amerigroup – 188
- Amerigroup Insurance Company – 28
- Ascension Complete – 52
- Baylor Scott & White Health Plan – 284
- Blue Cross and Blue Shield of NM, TX – 114
- Blue Cross and Blue Shield of OK, TX – 593
- Blue Cross and Blue Shield of Texas – 156
- Care N’ Care Insurance Company – 70
- CHRISTUS Health Plan Generations – 80
- Cigna – 220
- Clover – 7
- Community First Health Plans – 1
- Devoted Health – 69
- GlobalHealth – 14
- Humana – 1,749
- Imperial Insurance Companies, Inc – 45
- KelseyCare Advantage – 41
- Lasso Healthcare – 508
- Memorial Hermann Health Plan – 17
- Molina Healthcare of Texas, Inc. – 168
- Prominence Health Plan – 16
- SCAN Health Plan – 4
- UnitedHealthcare – 622
- Wellcare – 261
- Wellcare by Allwell - 342
5-star Medicare Advantage plans in Texas
The Centers for Medicare and Medicaid Services (CMS) rates Medicare Advantage plans with prescription drug coverage on a star rating system based on five main categories comprising 38 quality measures. These ratings are reviewed annually and updated on CMS.gov. Each category is rated on a scale of 1–5 stars, with 1 being the worst and 5 being the best.
Nationwide, about 78% of MA Plan beneficiaries were enrolled in a plan rated 4 or more stars in 2023. MA Plans rated 4 or 5 are considered “excellent.”
The CMS rating categories include:
- Staying healthy: Screenings, tests and vaccines
- Managing Chronic (Long Term) Conditions
- Member Experience with Health Plan
- Member complaints and changes in the health plan’s performance
- Health Plan Customer Service
The 2023 CMS 5-star Medicare Advantage providers and specific contracts in Texas are:
Baylor Scott & White Health Plan
- BSW SeniorCare Advantage Preferred (HMO)
- BSW SeniorCare Advantage Preferred Rx (HMO)
- BSW SeniorCare Advantage Premium (HMO)
- BSW SeniorCare Advantage Premium Rx (HMO)
- BSW SeniorCare Advantage Select (HMO)
- BSW SeniorCare Advantage Select Rx (HMO)
- Cigna Alliance Medicare (HMO)
- Cigna Courage Medicare (HMO)
- Cigna Preferred Medicare (HMO)
- Cigna Preferred Savings Medicare (HMO)
- KelseyCare Advantage Gold (HMO)
- KelseyCare Advantage Gold Community (HMO-POS)
- KelseyCare Advantage Gold Freedom (HMO-POS)
- KelseyCare Advantage Platinum (HMO)
- KelseyCare Advantage Silver (HMO)
- KelseyCare Advantage Silver Community (HMO-POS)
- KelseyCare Advantage Silver Freedom (HMO-POS)
- AARP Medicare Advantage (HMO-POS)
- AARP Medicare Advantage Patriot (HMO-POS)
- AARP Medicare Advantage SecureHorizons (HMO-POS)
- AARP Medicare Advantage SecureHorizons Plan 1 (HMO-POS)
- AARP Medicare Advantage SecureHorizons Plan 2 (HMO-POS)
- Erickson Advantage Freedom (HMO-POS)
- Erickson Advantage Liberty with Drugs (HMO-POS)
- Erickson Advantage Livery without Drugs (HMO-POS)
- Erickson Advantage Signature with Drugs (HMO-POS)
Medicare Advantage plans in Texas: Comparing different counties
Texas comprises 254 counties with more than 30 million residents, of which 13% are aged 65+. Texas ranks 3rd in the U.S. for the largest population of older adults, following California and Florida. The chart below shows cost averages and the number of plans available for four counties with a large (more than 75,000) population of people aged 65+.
|Collin County||Tarrant County||Harris County||Travis County|
|Percent of population aged 65+||11.7%||12.3%||11.7%||11%|
|Avg. monthly premium (excluding $0 premiums)||$71.89||$64.31||$68.99||$67.73|
|Number of MA Plan providers||16||16||17||11|
|Number of contracts available||73||69||77||46|
|Avg. in-network maximum out-of-pocket cost||$5,405.93||$5,450.83||$5,199.35||$5,746.58|
|Avg. annual drug deductible||$341.07||$334.64||$283.71||$330.40|
What are the eligibility requirements for a Medicare Advantage plan in Texas?
To be eligible to enroll in a Medicare Advantage Plan in Texas, you must be a Medicare beneficiary with Part A and B coverage, not enrolled in Medigap, and live within the service area of your chosen MA plan. You are not required to answer any health questions before enrollment unless you have end-stage renal disease, and you cannot be denied coverage based on a pre-existing health condition.
To be a Medicare beneficiary, you must:
- Qualify to receive Social Security (or Rail Road Retirement) benefits by having worked for at least 10 years while paying Medicare and Social Security taxes
- Be at least 65 years old or have a qualifying disease or disability for earlier enrollment
You may sign up for, switch, or drop an MA plan during set enrollment periods. These include:
- Initial Enrollment Period when you turn 65
- Medicare Advantage Open Enrollment Period
- Special Enrollment Period
Choosing the best Medicare Advantage plan in Texas
When choosing the best MA plan, consider these questions to help obtain the right coverage for you. If your needs change, you can change MA plans or switch to Original Medicare at set times throughout the year.
- Plan Network. Are your doctors and specialists in-network?
- Cost. What will the plan cost? Consider the monthly premium, drug cost, deductibles, co-pays/coinsurance, and max out-of-pocket costs.
- Benefits. What are the additional perks and benefits?
- Medications. Are my prescription medications covered?
- Utilization. How often do you plan to use your benefits?
- Coverage area. Will you be traveling often?
Medicare.gov offers a plan comparison tool that many people find useful: Medicare’s plan finding tool.
These free Texas State programs also provide assistance in choosing the right health coverage:
Texas State Health Insurance Assistance Program (SHIP) offers free local health insurance counseling to people with Medicare coverage. These programs are paid for with federal government money and are independent of any insurance company. Visit the Texas Medicare Help Line or call 1-800-252-9240.
Texas Health and Human Services Department works with the Area Agencies on Aging to provide free counseling services regarding insurance benefits. They also offer various programs focused on maintaining health and independence for people aged 60+. Contact your Texas county agency for more information, or visit this directory.
Medicare Advantage plans in other states
What is the average cost of Medicare Advantage plans in Texas?
Some costs to consider for your Texas MA plan are monthly premiums, drug deductibles, and max out-of-pocket costs. The average consolidated monthly premium of Texas MA plans (excluding $0 premiums) is $74.45. The average Annual Drug Deductible of Texas MA plans (excluding $0 deductibles) is $301.78. The average In-Network max out-of-pocket amount is $5,089.65.
What are the different types of Medicare Advantage plans in Texas?
The types of MA plans available in Texas are Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), Medical Savings Account (MSA), and Private Fee-for-Service (PFFS). The most common plans are PPO and HMO. PPO plans offer flexibility in choosing healthcare providers without a referral. HMO plans offer coordinated care via a primary care physician as the main point of contact for healthcare.
Does Blue Cross Blue Shield offer PPO Medicare Advantage plans in Texas?
Yes, Blue Cross Blue Shield (BCBS) offers PPO Medicare Advantage plans in Texas. BCBS offers a variety of PPO Medicare Advantage plans, such as Classic, Choice, Choice Plus, Dental Premier, Flex, Flex Access, Health Choice, Protect, and Saver Plus. These plans cover a variety of needs at various price points. Visit bcbstx.com/medicare for more information on these plans.