If you’re approaching retirement in the Lone Star State, you’ve probably already thought about your health insurance options. A common option for seniors is Medicare, a federal health insurance program offered through both the government and individual insurance providers authorized to offer plans. Medicare has multiple plan options that can get confusing if you don’t begin your research ahead of time. The best Medicare in Texas for you might vary depending on your income and health needs. Our guide will help you learn more about Medicare and know your options.
Best Medicare Plans in Texas
- Best Overall in Texas: Humana
- Cheapest Medicare Plan in Texas: Aetna
- Best for Medicare Part D Coverage: WellCare
- Best for Plan Comparisons: HealthInsurance.net
- Best for Pre-Medicare Coverage: Pivot Health
- Best Coverage for Medicare in Texas: Cigna
Here are a few fast facts regarding Medicare beneficiaries in Texas, according to CMS:
- Nearly 2.4 million beneficiaries are enrolled in Medicare Part A and/or Part B.
- Approximately 1.5 beneficiaries are enrolled in a Medicare Advantage plan.
- There are 177 Medicare Advantage plans available.
- 32% of people with Medicare Part D receive Extra Help, which is a low-income subsidy that helps pay for drug coverage.
Private insurance companies compete for your business and they do so by offering competitive rates and valuable health and wellness programs.
Here are our top picks for Medicare Advantage plans in Texas, based on data we’ve gathered from CMS, Medicare.gov, J.D. Power and U.S World & News Report.
1. Best Overall in Texas: Humana
Humana’s GoldPlus HMO plan is a 4-star plan, affordably priced and recommended by Medicare.gov. It received high marks from J.D. Power’s annual Medicare Advantage plan survey in customer service, billing and payment, pricing, provider choice and overall satisfaction.
Many Humana plans also feature:
- Free fitness programs
- Dental and vision coverage
- Prescription drug plans
- Meal delivery after an overnight hospital stay
- Telemedicine visits
A large Medicare Part C coverage provider in Texas, Humana offers a variety of affordable HMO plan choices. Many of Humana’s plans have $0 premiums, and you can see healthcare providers offered through Humana’s wide service network. Many of Humana’s plans also include additional benefits not covered by the Original Medicare (like dental and hearing benefits).
Pros
- $0 premiums are available
- Meal delivery could change the life of an elderly loved one
- Fitness, wellness, dental and vision programs help bolster this plan
Cons
- You may find that prices are higher, even if the services you need are all included and seem too good to be true
2. Cheapest Medicare Plan in Texas: Aetna
Aetna’s MedicarePlus, a 4-star PPO plan, is a bargain at $2,080. It’s ranked 8th in J.D. Power’s survey and recommended by Medicare.gov.
You can save money on prescription drugs if you choose the plan’s provider network and can choose your own primary care doctor, specialists and other health care providers.
Aetna’s plans also feature fitness, health coaching and wellness programs. If you already have a team of medical professionals that you want to continue seeing, you may want to choose PPO coverage from Aetna. This plan option allows you to see any medical professional that you want while also using your coverage benefits. Aetna’s PPO plans in Texas also come with $0 monthly premiums in most parts of the Lone Star state.
Pros
- You can choose your own doctor to maintain the care you’re accustomed to
- There are prescription drug savings built into the plan
Cons
- While the prices are thought to be lower than most, they might be out of your price range
3. Best for Medicare Part D Coverage: WellCare
You can add Medicare Part D coverage to both a Medicare Advantage Plan (if the plan doesn’t already cover prescription drugs) or Original Medicare coverage.
WellCare offers a variety of affordable prescription drug plan choices throughout Texas. With WellCare, you may pay a copay of as little as $1 for preferred generic drugs, and monthly plans are available from about $15 a month in most parts of Texas.
Pros
- Prescription drug coverage could help those that need to save money
- The tiering for drug prices is far lower than most would expect
Cons
- Not everyone needs to add Part D, and the price may be too high for those that do
4. Best for Plan Comparisons: HealthInsurance.net
Comparing all of your Medicare options can quickly become a hassle — especially if there are a multitude of providers offering coverage in your area.
HealthInsurance.net makes it easy to quickly compare plan costs and options in your area. Enter your zip code to start viewing plan choices available in your area without requesting a quote from each individual provider.
Pros
- A quick online search gives you an idea of what’s available
- You can review choices and prices all in one place
- Look through all the carriers that are out there so that you can make a wise decision
Cons
- Remember that every state is different, and you may need to research further because Medicare plans and locations can vary widely
5. Best for Pre-Medicare Coverage: Pivot Health
As you age, you’ll likely find that your health insurance premiums tend to begin to take up a larger percentage of your income if you continue with Affordable Care Act (ACA) insurance plans.
Pivot Health offers a unique and affordable option to traditional ACA-compliant plans for those preparing to transition to Medicare coverage. Pivot’s “Bridge to Medicare” plan option includes benefits like unlimited access to telehealth services to help you avoid draining your retirement savings on healthcare expenses before you qualify for Medicare.
Pros
- ACA-compliant plans make it easier for seniors to find coverage
- You can save money using this platform, especially when you are on a fixed income
- Bridge to Medicare can help you get the services you need without overpaying
Cons
- Pivot is best known for short-term plans, and it may not have the coverage you need
6. Best Coverage for Medicare in Texas: Cigna
Cigna’s PPO and HMO plans offer reasonable rates and receive above-average star ratings across the board.
Both feature fitness programs, prescription drug plans and low monthly premiums.
Hearing and eye exams are covered and some dental benefits are offered. Cigna’s HealthSpring plan was ranked 3rd in J.D. Power’s 2018 Medicare Advantage study. Cigna plans also feature a 24-hour nurse advice line and televisits.
Pros
- There are good rates and high levels of coverage
- The company is both financially stable and has a broad reach
- There are wellness programs that could help those who are in need of health support
Cons
- Cigna can be a difficult place to get customer service as there are many departments and wait times can be lengthy
What is Medicare?
Medicare is a federal health insurance program for men and women over the age of 65 and younger men and women with select disabilities. Medicare was designed to help make medical care costs more affordable when compared to private health insurance options. There are multiple parts of Medicare, and each part represents a different type of coverage. You can get original Medicare through the federal government or a Medicare Advantage plan through private insurance providers.
Great Plan Choices in Texas
There are plenty of good resources available to help you research Medicare Advantage plan options in the Lone Star state. Many offer competitive rates, low copays, zero monthly premiums and other extras like fitness programs and hearing and vision coverage.
Make a list of your health concerns and needs. Do you take a lot of medications? If so, you’ll need a prescription drug plan that’s affordable. If hearing, dental and eye care coverage are important, it makes sense to choose a Medicare Advantage plan over Original Medicare because you can get these benefits rolled into one plan.
Carefully consider every aspect when choosing a plan to make sure it’s right for you. Once you turn 65 and make your choice, you’re committed to it until open enrollment, which runs annually from October 15 through December 7.
Frequently Asked Questions
What are the different parts of Medicare?
Medicare has 4 parts named Parts A, B, C, and D. Part A provides hospitalization coverage while Part B provides outpatient coverage, like doctor visits. Parts A and B make up Medicare’s core coverages. Part C is provides private-market Medicare plans, called Medicare Advantage Plans. Part C coverage often includes additional benefits. Medicare Part D provides coverage for prescription drugs. Get a Medicare Insurance Quote through the top providers here.
Is Medicare free?
Because there are 4 parts to Medicare, there can be different cost structures. Most people won’t have to pay for Medicare Part A (hospitalization). Eligibility for premium-free Part A is based on your work history during which you paid Medicare taxes. Many people do pay a monthly premium for Medicare Part B, however, which covers outpatient medical services, like doctor visits. Deductibles also apply to services covered under Medicare Parts A and B, so you’ll pay a part of the annual cost.
Medicare Parts C and D are optional coverages and have premium costs of their own. Medicare Part C refers to Medicare Advantage Plans that offer additional coverage in exchange for a monthly premium. Part D, the prescription plan, reduces the cost of medications but also requires a monthly premium. Subsidies may be available for low income households to help reduce overall Medicare costs.
Do I need to sign up for Medicare?
If you signed up for Social Security before age 65, you were enrolled in Medicare automatically but benefits will begin at age 65. In most cases, there are penalties for not enrolling at age 65, so it pays to sign up on time. Click here to get a medicare quote in minutes from the best providers.
If you have employer coverage, you may be able to delay Medicare coverage while your work plan is still in force. However, the size of the employer determines whether you’ll pay a penalty for not enrolling at age 65. Employees (and their spouses) of companies that offer group health insurance to 20 or more people are usually exempt from late sign-up penalties if they are covered by the employer’s plan.
What is the average cost of Medicare in Texas?
In 2021, the average Texan who had Medicare Part C insurance paid $21.52 each month for their Medicare Advantage coverage.
What company has the best Medicare in Texas?
The answer to this question depends on your healthcare needs, how much you can afford to pay in premiums each month and the county that you live in. While we recommend beginning your search with our partner providers, there is no single company that offers the best Medicare in Texas.
Explore More: BEST LIFE INSURANCE IN TEXAS
About Laura Hipshire
Expert-level knowledge of Medicare Advantage plans and regulatory guidelines