Medicare Advantage Plans in Texas
Texas has one of the largest, most competitive Medicare Advantage markets in the country. Here's how to make sense of it.
Reviewed by Cameron Erwin, Licensed Texas Insurance Agent (TDI License #3498689)
Original Medicare vs. Medicare Advantage
Original Medicare (Parts A and B) is run directly by the federal government and is accepted by nearly every provider nationwide. Medicare Advantage (Part C) is an alternative offered by private insurers that's approved by Medicare — it typically bundles hospital, medical, and often drug coverage into one plan, usually with a defined network (HMO or PPO) and extra benefits like dental, vision, or hearing that Original Medicare doesn't include.
The Texas market at a glance
*Many Medicare Advantage plans in Texas are available with a $0 monthly premium; the statewide average reflects the full mix of plan types. Out-of-pocket costs still depend on the plan's deductibles, copays, and network.
Carriers to know
Market strength varies a lot by region, but the carriers most Texans will run into include UnitedHealthcare, Humana, Aetna, Blue Cross and Blue Shield of Texas, Wellcare, and regional/hospital-affiliated plans such as Baylor Scott & White Health Plan and KelseyCare Advantage. Humana has particularly deep roots in the San Antonio area, while UnitedHealthcare and Humana together hold the majority of the Austin-area market. See our county guides for local detail.
When to enroll
- Initial Enrollment Period: a 7-month window around your 65th birthday (3 months before, your birthday month, 3 months after).
- Annual Enrollment Period (AEP): October 15 – December 7 each year, when anyone can switch plans for the following year.
- Medicare Advantage Open Enrollment Period: January 1 – March 31, for people already enrolled in a Medicare Advantage plan who want to make one change.
Medicare Advantage vs. Medigap
Instead of Medicare Advantage, some Texans choose Original Medicare paired with a Medigap (Medicare Supplement) policy, which helps cover Original Medicare's out-of-pocket costs in exchange for a separate monthly premium. Medigap generally allows you to see any provider nationwide who accepts Medicare, without network restrictions or referrals, which can matter for people who travel often or split time between Texas and another state. Medicare Advantage, by contrast, usually costs less month to month and often bundles in drug coverage and extra benefits, but ties you to a defined network. Neither option is universally better; the right choice depends on how much you value network flexibility versus lower monthly cost.
Extra benefits worth comparing
Beyond hospital and medical coverage, many Texas Medicare Advantage plans include dental, vision, and hearing benefits that Original Medicare doesn't cover at all. Some plans also offer a fitness program membership, an over-the-counter allowance for health items, or transportation assistance to medical appointments. These extras vary significantly by plan and carrier, so it's worth comparing them directly rather than assuming all Medicare Advantage plans include the same add-ons.
A common mistake to avoid
Enrolling in a Medicare Advantage plan based on premium alone, without confirming your specific doctors and prescriptions are covered, is one of the most common regrets Texans report after switching plans. Networks and drug formularies can change from year to year even with the same carrier, so it's worth re-checking both every Annual Enrollment Period rather than assuming last year's plan still fits.
Special Needs Plans
Some Texans qualify for a Medicare Advantage Special Needs Plan (SNP), a category designed for people with specific chronic conditions, those who qualify for both Medicare and Medicaid, or those living in an institutional setting like a nursing home. SNPs often include care coordination and benefits tailored to the qualifying condition, and can be worth exploring if you or a family member fits one of these categories, since they're priced and structured differently from standard Medicare Advantage plans.
Medicare guides
In-depth guides to the decisions that actually shape what you pay and which doctors you keep in Texas.
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