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BCBS of Texas Medicare Advantage Reviews

BlueCross BlueShield of Texas offers a variety of Medicare Advantage plans with comprehensive coverage, additional benefits, and a strong network of healthcare providers, making it a solid choice for Texans on Medicare.
By . Last update: June 18, 2024

Many of the plans featured here are available through our partners who may compensate us for enrollments. This influences which Medicare plans we write about, but it does not influence our evaluations. Our opinions are our own. Member opinions and comments are their own and do not express the views of MedicareWire. How we make money.

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  • Our approach: We analyze government data, study consumer intelligence websites, and scour the web for consumer sentiment.
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BCBS of Texas Medicare Advantage Reviews
The BCBS of Texas logo is a registered trademark of Health Care Service Corporation.

BlueCross BlueShield of Texas (BCBSTX or BCBS of Texas) is a leading provider of Medicare Advantage plans in Texas, offering a range of options to meet the diverse needs of its members. As a Health Care Service Corporation brand, BCBSTX emphasizes comprehensive coverage, including medical, hospital, and prescription drug benefits, often coupled with additional perks such as wellness programs and preventive services. Their network includes numerous doctors and hospitals, providing widespread access to quality healthcare services across the state.

In this editorial review, we will explore the top Medicare Advantage plans offered by BlueCross BlueShield of Texas, detailing their coverage options, costs, and feedback from customers.

Table of Contents

Member Reviews for BCBS of Texas

The following BCBS of Texas reviews have been left by our members.

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PROS

  • Comprehensive Coverage: Plans often include benefits beyond Original Medicare, such as dental, vision, hearing, and prescription drugs.
  • Large Provider Network: BCBS of Texas has a broad network of doctors, specialists, and hospitals, providing extensive access to healthcare services.
  • Additional Benefits: Many plans offer extra perks like fitness memberships, wellness programs, and telehealth services at no additional cost.
  • Care Coordination: Some plans include care management programs to help coordinate care between healthcare providers, improving health outcomes and reducing costs.
  • Customer Service: BCBS of Texas is known for strong customer support, helping members navigate their healthcare options and manage their benefits effectively.

CONS

  • Network Restrictions: Some plans may require beneficiaries to use in-network providers, limiting choice and flexibility.
  • Prior Authorization Requirements: Certain services and treatments may require prior authorization, potentially delaying care.
  • Plan Limitations: Additional benefits, such as dental and vision coverage, may have annual limits or restrictions, leading to out-of-pocket expenses.
  • Geographic Limitations: BCBS of Texas Medicare Advantage plans may not be available in all areas, limiting options for beneficiaries in certain regions.
  • Annual Changes: Like all Medicare Advantage plans, BCBS of Texas plans may change annually, including premiums, benefits, and provider networks.
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How Do BCBS of Texas Medicare Advantage Plans Work?

BCBS of Texas Medicare Advantage plan members receive all of their Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) benefits through their plan. This includes preventive care, screenings, vaccinations, doctor and specialist visits, and inpatient care.

All BCBS of Texas Medicare Advantage plans include coverage for:

  • Inpatient hospital admissions.
  • Doctor and specialist care.
  • Preventive care, screenings, and vaccinations.
  • Diagnostic services, lab work, X-rays and other imaging.
  • Outpatient services.
  • Ambulance transportation for emergencies.
  • Durable medical supplies and equipment.

Medicare rules say that all BCBS of Texas plans must provide at least the same coverage and benefits as Original Medicare. But, each plan sets its own out-of-pocket costs.

Some BCBS of Texas plans offer additional benefits like routine dental, vision, hearing, and wellness programs, which are not usually covered by Original Medicare.

By enrolling in a BCBS of Texas Medicare Advantage plan, many beneficiaries enjoy the convenience of having all their healthcare needs managed under one plan, often with lower out-of-pocket costs and additional perks tailored to their health and lifestyle.

However, it's important to understand that lower costs are not guaranteed. Costs are largely based on the specific plan and usage of healthcare services. Also, depending on the BCBS of Texas plan chosen, there may be access restrictions, including referrals and prior authorization, which do not exist in Original Medicare.

Extra Benefits from BCBS of Texas

Most BlueCross BlueShield of Texas Medicare Advantage plans offer additional benefits beyond tradition Medicare coverage (Part A and Part B). These benefits often include:

  • Dental, Vision, and Hearing Coverage: Many plans provide allowances for dental, vision, and hearing services.
  • Over-the-Counter (OTC) Allowances: Members receive a quarterly or monthly allowance for purchasing OTC health products.
  • SilverSneakers Fitness Programs: Access to fitness centers and wellness programs at no extra cost.
  • Telehealth Services: Expanded telehealth options for convenient access to healthcare providers.
  • Healthy Foods Card: An allowance for purchasing approved healthy foods at participating stores.
  • Meal Delivery Services: Coverage for meal delivery services following a hospital stay to aid in recovery.
  • Transportation Services: Benefits may include transportation to and from medical appointments.
  • Insulin Savings Programs: Lower costs for insulin as part of plans that include Part D coverage.

What Types of Plans Does BCBS of Texas Offer?

Not all BCBS of Texas plans are the same. And, BCBS of Texas may not offer all plan types where you live, so it pays to explore using our Medicare Advantage Plan Finder tool. Here are the plan types BCBS of Texas offers:[6]

Medicare preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. With a PPO plan, you generally do not need to choose a primary care doctor, and you don’t need referrals to see specialists. And you can seek out-of-network care, although it may cost more than seeing an in-network doctor.

Health maintenance organization (HMO) plans require that you use a specific network of doctors and hospitals. Also, with a BCBS of Texas HMO plan you may need a referral from your primary care doctor in order to see a specialist. Out-of-network benefits are usually very limited. However, in an emergency you are not limited to care from your local hospital of emergency room.

NOTE: BCBS of Texas may also offer Medicare Advantage Special Needs Plans (SNPs). Due to the highly specialized nature of D-SNP (dual eligible), C-SNP (chronic condition), and I-SNP (institutional) insurance plans, we review them separately.

How Much Do BCBS of Texas Plans Cost?

The cost of a BCBS of Texas plan will vary depending on the specific plan chosen, your location, usage of healthcare services, and the plan's out-of-pocket costs. We detail out-of-pocket costs on all BCBS of Texas Medicare Advantage Plans in our plan finder.

Generally, BCBS of Texas will charge you a monthly premium, which can vary based on the level of coverage and additional benefits included. You must also continue to pay your Part B premium. If you're a high-income earner, Medicare may add a Income Related Monthly Adjustment Amount (IRMAA) to your premium.[5]

BCBS of Texas’s monthly premiums are highly dependent on where you live. For instance, the average cost of a Medicare Advantage plan from BCBS of Texas in Texas is $21.74 per month, but in New Mexico the average cost is $25.18 per month. These averages do not include Special Needs Plans.

BCBS of Texas's Premiums vs. Competitors

The following list shows BCBS of Texas's nationwide average monthly premium (excluding Special Needs Plans) vs. several competitors.

BCBS of Texas
$10.11
AARP/UHC
$13.97
Aetna
$7.75
Wellcare
$26.20
UnitedHealthcare
$22.97

There also may be copayments or coinsurance for healthcare services, such as doctor visits or hospital stays. The costs in each BCBS of Texas plan we evaluated varied based on the level of coverage and the type of services received.

Some plans offer $0 premiums or minimal copayments for certain services, while others might have higher premiums with lower out-of-pocket expenses. Carefully reviewing the cost and coverage details of each plan is the only way to find the one that aligns best with your needs.[7]

We analyzed the following popular BCBS of Texas plans to give you an idea of what members pay to use healthcare services. This is just a sample, use our Medicare Advantage Plan Finder to see plans and costs where you live.

Important costs for plan ID H3909-009-0 reviewed in Chester County, PA.
  • Monthly premium: $158
  • Out-of-pocket max: $5,000
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $9.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None
Important costs for plan ID H3909-015-0 reviewed in Chester County, PA.
  • Monthly premium: $0
  • Out-of-pocket max: $7,550
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $9.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None
Important costs for plan ID H3909-016-0 reviewed in Chester County, PA.
  • Monthly premium: $0
  • Out-of-pocket max: $8,300
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $9.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None

Is BCBS of Texas a Good Medicare Advantage Plan?

BlueCross BlueShield of Texas (BCBSTX) offers a variety of Medicare Advantage plans tailored to meet different healthcare needs. Evaluating the quality of these plans involves looking at several key factors, including customer satisfaction, plan performance, and financial stability.

J.D. Power Ranking In its 2023 U.S. Medicare Advantage Study, J.D. Power assesses member satisfaction with Medicare Advantage plans across various factors such as coverage and benefits, provider choice, and customer service. BCBSTX ranked 4th out of 6 in Texas, reflecting a solid performance but with room for improvement in certain areas (https://www.jdpower.com/business/healthcare/us-medicare-advantage-study).

NCQA Health Plan Score The National Committee for Quality Assurance (NCQA) rates health plans annually based on quality of care, patient satisfaction, and efforts to improve. In the 2023 ratings, BCBS of Texas received scores ranging from 3.0 to 4.0 stars out of 5, indicating generally favorable outcomes but with variability across different plans (https://www.ncqa.org).

AM Best Financial Strength Rating AM Best, a credit rating agency focusing on the insurance industry, assigns financial strength ratings to insurers. BCBS of Texas has an "A" (Excellent) rating from AM Best, signifying strong financial stability and a robust ability to meet ongoing insurance obligations (https://www.ambest.com).

Better Business Bureau (BBB) The Better Business Bureau (BBB) evaluates companies based on customer complaints and business practices. BCBS of Texas holds an A+ rating from the BBB, the highest possible rating, indicating a commitment to resolving consumer issues and maintaining high service standards (https://www.bbb.org).

These ratings provide a comprehensive view of BCBSTX's Medicare Advantage plans, highlighting strengths in financial stability and customer service, with some variability in member satisfaction and plan performance.

BCBS of Texas's Medicare Star Ratings

BCBS of Texas's average 5-star rating: 3.00*
*Our calculation is weighted by enrollments in public plans, excluding Special Needs Plans, with CMS star ratings across 1 contracts covering 15,104 members.

If you want the government’s take on the quality of BCBS of Texas’s Medicare Advantage plans, check out the Centers for Medicare and Medicaid Services' star ratings, which rank each plan from 1 (worst) to 5 (best) stars. The health agency assigns ratings based on quality of care and customer satisfaction measurements, and updates ratings every year.[9]

Every Medicare Advantage plan is reviewed based on CMS health plan standards. Those that provide prescription drug coverage are also rated on drug plan criteria. Using the most recent data and accounting for enrollment figures, BCBS of Texas’s 2024 Medicare Advantage plans achieve an average of 3.00 stars.[9] [11]

As of January 1, 2024, 0% of members with BCBS of Texas are in contracts that have earned a Medicare star rating of 4 stars or more.

Discover the ratings for plans available in your area using our Medicare Advantage Plan Finder tool.

Plan Availability

BCBS of Texas's Medicare Advantage plans are accessible in 2 states, covering:

NM, and TX.

BCBS of Texas extends its coverage to 0 of the 3,140 counties across the U.S.[8]

BCBS of Texas's Top Plans

Here's a list of BCBS of Texas's most popular plans (by enrollments):[9][10]

Medicare Advantage Search and compare Medicare Advantage plans available in your area.

Find Plans in your area with your ZIP Code

Frequently Asked Questions

The following are the most frequently asked questions we found about BCBS of Texas's Medicare Advantage plans:

MA Plan Pros

  1. The maximum out-of-pocket cost is $7,550 a year
  2. Many plans cost $0 extra a month
  3. Most plans include drug coverage
  4. Many include basic hearing, dental, and vision benefits
  5. May include gym discounts (Silver Sneakers)

MA Plan Cons
  1. Can only switch during Open Enrollment
  2. Not easy to compare because plans are not standardized
  3. No nationwide coverage (plans don't travel with you)
  4. Most are HMO plans that require referrals to see a specialist
  5. Plans can change health and drug coverage each year

Learn more in this article.

Some Medicare Advantage plans offer a zero-dollar monthly premium because what Medicare pays the plan, plus your Medicare Part B premium, cover the full cost. For healthy people who want to keep their monthly costs low, these plans are an attractive option. But, just be aware that the premium is not the only cost. Plans also have copays or coinsurance you must pay when you use services. To learn more about free Medicare Advantage plans, read Why are Some Medicare Advantage Plans Free?

There is no debate when it comes to which plan offers better coverage. Original Medicare and a supplement plan offer the best coverage, but it costs more up-front. For a complete breakdown of the differences between Medicare Advantage plans and Medigap plans, read: Medicare Advantage vs Medigap: Which is Best for You?

Researching your health plan options is important. Here are some key questions to consider before choosing a Medicare Advantage plan as well as additional companies to read about:

Key Questions

All plans potentially have monthly premiums, deductibles, copayments, and/or coinsurance, including plans from BCBS of Texas. Are these costs within your budget?

  • Does the plan cover your prescriptions? Knowing how a plan covers them is important if you have regular prescriptions because costs and coverage vary widely from plan to plan.
  • Are your doctors in the plan’s network? If you have preferred providers, ensure they participate in the plan’s network.
  • Is routine dental, vision, and hearing covered? Traditional Medicare doesn’t cover these services. If you need it, be sure to explore plans that cover it.
  • What extras does the plan include? Plans may include many beneficial extras, like gym memberships (SilverSneakers), medical transportation, meal delivery, telehealth, and more.

Top Companies

If you have additional questions, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

About BCBS of Texas

Headquartered in Richardson, Texas, BlueCross BlueShield of Texas is part of the Health Care Service Corporation, the largest customer-owned health insurer in the United States. BCBSTX offers a wide range of health insurance options, including Medicare Advantage Plans (Medicare Part C), Medicare Part D Plans (prescription drug plans), Medicaid coverage, and dental and vision plans.

Recently, BCBSTX announced enhancements to their Medicare Advantage plans, including expanded telehealth services and additional wellness programs aimed at improving member health outcomes.

You can enroll in a BCBSTX Medicare Advantage plan during your Initial Enrollment Period (IEP) at age 65, during the annual Open Enrollment Period (Oct 15 - Dec 7), or during a Special Enrollment Period (SEP), which Medicare grants based on special circumstances such as moving or losing employer coverage.

 

Company
Health Care Service Corporation
Phone Number
877-774-8592
Website
https://www.bcbstx.com/
Facebook Page
https://www.facebook.com/bluecrossblueshieldoftexas/
X (Twitter) Page
https://twitter.com/bcbstx

Citations

MedicareWire uses trustworthy sources to inform its work, including government websites, government data, actuarial service data, consumer intelligence websites, and peer-reviewed studies. All content is fact-checked for accuracy, timeliness, and relevance. We used the following information sources in this review: