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Texas Medicare Advantage Plans - TX Medicare Part C

Texas Medicare Advantage is an alternative to Original Medicare (Parts A and B). Through this plan you will receive both your Medicare Part A and Part B benefits, which include medical and hospital coverage. Medicare Advantage plans offer at least the same amount of coverage as Original Medicare, and must cover emergency and urgent care. Some plans offer additional coverage such as dental, vision, and hearing. Generally, you will have fewer out-of-pocket costs through a Medicare Advantage plan than through Original Medicare, but you will still be required to visit doctors within your plan?s network.

Medicare Advantage plan coverage is provided by private insurance companies approved through Medicare. The three main types offered are:

  • Managed healthcare plans: Health maintenance organizations, or HMOs, require referrals from primary care physicians to see a specialist, and typically have lower out-of-pocket costs than other managed healthcare plans, such as preferred provider organizations, or PPOs.
  • Private Fee-for-Service plans (PFFS): Your provider must agree to the terms and conditions of PFFS plans before performing services. These plans vary and some may not include a service area, but every plan requires copayments or coinsurance payments.
  • Special Needs Plans (SNPs): Enrollment in SNPs is limited to people with specific diseases or characteristics. The three categories include Chronic Condition SNPs (for those with one or more severe or disabling chronic conditions), Institutional SNPs (for those in an institution or who require home nursing care), and Dual Eligible SNPs (for those eligible for both Medicare and Medicaid).

To be eligible for Medicare Advantage in Texas, you must live in the plan's service area, be enrolled in both Medicare Part A and Part B, and not have end-stage renal disease. Not all types of plans are available in every county. Availability of MA plans in Texas varies by county, so it would be in your best interest to compare plans with the links below in your area to find the right one for your needs.

Counties in Texas with Medicare Advantage Plans