Medicare Advantage Plans Bexar County 2025

Searching for Medicare Advantage plans in Bexar County? This guide cuts through the confusion to detail what Medicare Advantage plans Bexar County has to offer, their costs, and how to enroll.

From zero-premium options to special needs plans, you’ll find straightforward facts to help you choose the right coverage for you.

 

Key Takeaways

  • Bexar County offers 64 diverse Medicare Advantage Plans provided by 18 insurers, including popular PPO and HMO options, with premiums ranging from $0 to $213 and high engagement from the county’s Medicare-eligible population.

 

  • Medicare Advantage plans in Bexar County are rated for quality, with top providers like Humana and UnitedHealthcare offering highly-rated plans; they include added benefits such as fitness programs, dental, vision, and over-the-counter drug coverage.

 

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Overview of Medicare Advantage Plans in Bexar County

 

Medicare Advantage Plans Bexar County 2025 Overview of Medicare Advantage Plans in Bexar County

 

In Bexar County, there’s a rich array of 64 Medicare Advantage Plans offered by 18 different health insurance providers, including Medicare Advantage PPO plans.

These plans provide an enticing alternative to Original Medicare, balancing the same benefits with potential additional ones for Medicare beneficiaries. They come in various forms, from HMO and PPO plans to Medicare supplement plans, each designed with unique features to cater to different needs.

Diverse as they are, these plans share a common goal – to offer health plans that ensure comprehensive coverage for both Medicare and non-Medicare services. So, whether you’re considering an HMO, PPO, or any other type of Medicare Advantage plan, rest assured, there’s a plan for every resident in Bexar County.

 

Key Facts about Bexar County Medicare Advantage

Delving into the specifics, the most enrolled Medicare Advantage Plans in Bexar County are:

  1. HumanaChoice H5216-043 (PPO) with a monthly premium of $10.00 and 100,888 enrollments
  2. UnitedHealthcare Medicare Advantage Choice (Regional PPO) with 36,742 enrollments
  3. AARP Medicare Advantage SecureHorizons (HMO-POS) has 37,595 enrollments and boasts a $0 monthly premium.

Interestingly, nearly half of the Medicare-eligible individuals in San Antonio, part of Bexar County, have chosen to participate in Medicare Advantage plans.

The monthly premiums for these plans can be as low as $0, or around $50.90 for those who don’t qualify for a $0 premium plan, with the range of plan premiums spanning from $0 to a maximum of $213.

In fact, every Medicare-eligible resident in Texas, including Bexar County, has access to at least one Medicare Advantage plan with a $0 monthly premium.

 

Types of Medicare Advantage Plans in Bexar County

 

Medicare Advantage Plans Bexar County 2025 Types of Medicare Advantage Plans in Bexar County

 

Medicare Advantage plans in Bexar County generally fall into four categories: HMO, PPO, PFFS, and HMO-POS. Each type provides varying levels of flexibility and network restrictions.

The Medicare Advantage HMO health plan is a popular choice among Medicare Advantage HMO plans, requiring members to seek care from a specific network of designated providers, except during emergencies.

Contrarily, Preferred Provider Organization (PPO) plans provide greater flexibility by enabling members to use both in-network and out-of-network providers, though out-of-network care often comes with higher costs.

The Private Fee-For-Service (PFFS) plans offer members the liberty to see any healthcare provider who agrees to the plan’s payment terms, although network restrictions may still apply.

Lastly, the HMO Point-of-Service (HMO-POS) plans strike a balance, offering some flexibility by allowing members to receive certain services outside the HMO network, albeit often at a higher out-of-pocket cost.

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Extra Benefits Offered by Medicare Advantage Plans

 

Medicare Advantage Plans Bexar County 2025 Extra Benefits Offered by Medicare Advantage Plans

 

The additional benefits offered by Medicare Advantage plans in Bexar County contribute to their popularity. For instance, they provide fitness program benefits like gym memberships or discounts, promoting health and wellness beyond the typical coverage of Original Medicare.

Some plans go a step further, offering additional services like dental deep cleanings and preventive dental care, routine eye exams, hearing care benefits, and coverage for over-the-counter drugs that are not included in Part D prescription drug coverage. Additionally, some plans provide a quarterly over-the-counter (OTC) allowance for essential everyday items and $0 transportation coverage for medical appointments.

For instance, Aetna’s Medicare Advantage plans in Texas offer services focusing on total health, such as:

  • Dental

 

  • Vision

 

  • Hearing

 

  • Other wellbeing services

 

These additional benefits contribute significantly to the overall health and wellness of the beneficiaries.

 

Special Needs Plans (SNPs) in Bexar County

For residents with specific health needs, Bexar County offers 38 Medicare Special Needs Plans (SNPs). Medicare beneficiaries can qualify for SNPs if they are institutionalized, are dual-eligible, or have a severe or disabling chronic condition.

These SNPs can be further categorized into Dual Eligible Special Needs Plans for those with both Medicare and Medicaid, Institutional Special Needs Plans for residents in long-term care facilities, and Chronic Special Needs Plans for individuals with severe or disabling chronic conditions.

There are 15 SNP-specific chronic conditions that qualify an individual for C-SNPs, including chronic health issues like cardiovascular disorders, chronic heart failure, dementia, diabetes mellitus, end-stage liver disease, and more. Plans can tailor their benefit packages to offer customized benefits designed to treat specific conditions.

 

Enrolling in a Medicare Advantage Plan in Bexar County

The process of enrolling in a Medicare Advantage plan in Bexar County is uncomplicated. Residents have the option to enroll during the Initial Enrollment Period, a 7-month window around their 65th birthday, or the Annual Enrollment Period from October 15 to December 7.

Enrolling within these specified periods helps avoid late penalties and ensures timely coverage.

Most people with Medicare in Texas, including Bexar County, are eligible to join a Medicare Advantage plan. However, specific plan availability can be a key determining factor for enrollment.

Special Needs Plans have their own set of rules. Residents of Bexar County who qualify for Special Needs Plans can enroll or switch plans during a Medicare Election Period, with enrollment in SNPs available through direct calling of the plan, through a trusted partner, or via the official Medicare website.

 

Tips for Choosing the Right Medicare Advantage Plan

With a plethora of options available, picking the right Medicare Advantage Plan can seem daunting. Nevertheless, a few tips can simplify this task. Begin by evaluating the plan’s costs, such as:

  • premiums

 

  • deductibles

 

  • copayments

 

  • coinsurance

 

Take into account the maximum out-of-pocket limit and out of pocket costs to manage potential financial risks during a health event.

Second, when choosing a health insurance plan, make sure to:

  • Confirm that your preferred doctors, hospitals, and pharmacies are in the plan’s network

 

  • Understand the rules and costs related to non-network providers

 

  • See if your prescription drugs are covered by the plan

 

  • Consider a standalone prescription drug plan if necessary

 

  • Look for plans that offer additional benefits, such as fitness programs or non-traditional services like transportation, that cater to your lifestyle and health needs.

 

Lastly, when reviewing a Medicare plan, consider the following:

  • Coverage in various settings

 

  • Availability of support services such as customer service and member assistance

 

  • Adequate coverage outside your usual service area, especially if you travel frequently

 

It is also recommended to seek guidance from a licensed Medicare specialist for personalized advice to find a plan that matches your individual healthcare preferences.

 

Local Resources for Medicare Assistance

Bexar County offers various local resources to help with Medicare. For example, the Texas Health Information, Counseling, and Advocacy Program provides eligible residents with free assistance and counseling on Medicare and benefits.

Through a collaborative effort with the Texas Legal Services Center and the Area Agencies on Aging, Texas Health and Human Services provides information on Medicare Advantage and Prescription Drug plans and supports enrollment.

Medicare Savings Programs such as QMB, SLMB, QI-1, and QDWI can assist beneficiaries with monthly payments, co-pays, and deductibles. For residents with limited income and assets, the Low-Income Subsidy under Medicare Part D offers additional help with prescription medicine costs.

The Long-Term Care Ombudsman Program within the Texas Area Agencies on Aging advocates for residents in long-term care facilities and helps with Medicare and Medicaid appeals and hearings, including Medicaid services and Medicare supplement options.

Our Medicare helpline at 1-833-641-4938 can guide residents through Medicare’s complexities.

Summary

Medicare Advantage plans in Bexar County offer a wide variety of options to cater to diverse health needs. These plans, provided by various reputable health insurance providers, offer alternatives to Original Medicare, often with additional benefits that contribute to overall health and wellness.

As we’ve seen, choosing the right plan depends on a multitude of factors, from costs and network coverage to prescription drug coverage and additional benefits.

In conclusion, finding the right Medicare Advantage plan in Bexar County is an important step toward securing a healthier future. Remember, the best plan is one that fits your unique health needs and financial circumstances.

So, take your time, consider your options, and make an informed decision that paves the way to a healthier, happier life.

 

Frequently Asked Questions

 

→ What is the most highly rated Medicare Advantage Plan?

The most highly rated Medicare Advantage Plan is Humana, which has been recognized as the best overall Medicare Advantage Plan company for member experience and low premium plans in 2024. United Healthcare is also rated as the best company for drug plan ratings in the same year.

 

→ Who is the largest provider of Medicare Advantage plans?

The largest provider of Medicare Advantage plans is UnitedHealth Group, with 7.6 million people in its plans and $257 billion in premium revenues in 2022.

 

→ What is the alternative to a Medicare Advantage Plan?

The alternative to a Medicare Advantage Plan is a Medigap plan, which helps cover out-of-pocket costs not paid by Original Medicare and offers financial protection and peace of mind. Unlike Medicare Advantage plans, Medigap plans generally do not offer additional coverage benefits such as dental, vision, and hearing.

 

→ What are the main types of Medicare Advantage Plans in Bexar County?

In Bexar County, the main types of Medicare Advantage Plans include HMO, PPO, PFFS, and HMO-POS. Each plan has its own features and benefits to consider when making a choice.

 

→ How can I enroll in a Medicare Advantage Plan in Bexar County?

You can enroll in a Medicare Advantage Plan in Bexar County during the Initial Enrollment Period, which is a 7-month period surrounding your 65th birthday, or during the Annual Enrollment Period from October 15 to December 7.

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 ZRN Health & Financial Services, LLC, a Texas limited liability company

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Speak with a licensed insurance agent

 1-833-641-4938
TTY 711

Mon-Fri : 8am-9pm EST

Russell Noga
( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.