Compare 2026 Medicare Advantage Plans and Benefits in Texas

A Texas Medicare Advantage plan features a $4.66 average state premium for 2026, alongside a $2,100 Part D out-of-pocket maximum for plans that include prescription drug coverage. Serving as a private insurance alternative to Original Medicare, Medicare Advantage plans combine Parts A and B under one policy. They cover everything Original Medicare does, alongside potential additional routine benefits like dental, vision, and hearing care.

Can I enroll in a Texas Medicare Advantage plan right now?

Mid-year enrollment opportunities depend on your personal timeline or specific life events.

Initial Enrollment Period (IEP)

If you are celebrating your 65th birthday soon, you may not have to wait for the Annual Enrollment Period to enroll in a Medicare plan. Turning 65 triggers your Initial Enrollment Period, a seven-month window that includes the three months before your birthday month, your birth month, and the three months directly after it. During this time, Texans can enroll in Medicare coverage, including a Medicare Advantage plan.

Special Enrollment Periods (SEP)

Certain life changes grant you a Special Enrollment Period to change your coverage or enroll in a different plan outside of standard enrollment windows. Common qualifying triggers for an SEP include moving to a new address outside your current plan's service area (such as relocating to a new Texas county) or losing employer-sponsored health coverage.

The 2026 Provider Directory SEP

For 2026, the Centers for Medicare & Medicaid Services (CMS) introduced a new temporary Special Enrollment Period specifically protecting consumers from inaccurate network data. If you enrolled in your current Medicare Advantage plan using the official Medicare Plan Finder tool and later realize your preferred doctor is actually out-of-network, you qualify for this protection. You have a three-month window from your plan's effective date to call 1-800-MEDICARE and switch to a plan that includes your doctor.

Annual Standard Enrollment Windows

If you do not qualify for any mid-year enrollment periods, you can make changes during Medicare's standard annual windows later in the year:

• Annual Enrollment Period (AEP): Running from October 15 to December 7, this is the main window where anyone can join, drop, or switch plans for the upcoming year.

• Medicare Advantage Open Enrollment Period (OEP): Running from January 1 to March 31, this window is exclusively for individuals already enrolled in a Medicare Advantage plan who want to switch to a different plan or unenroll and return to Original Medicare.

What are the Medicare Advantage plan choices in Texas?

Medicare Advantage (also known as Medicare Part C) is an all-in-one alternative to Original Medicare. Offered by private insurance companies approved by Medicare, these plans bundle hospital care (Part A) and medical insurance (Part B) into a single plan and frequently include prescription drug coverage, along with extra benefits like dental and vision.

When choosing a plan in the Lone Star State, your options largely depend on where you live, with Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) being the two most common Medicare Advantage plan types.

HMO vs. PPO Availability in Texas

• HMO Plans (Health Maintenance Organizations): These plans typically require you to see doctors and providers within a specific network to be covered, and you usually need a referral to see a specialist. HMO networks are highly dense and widely available across major Texas urban centers like Dallas, Houston, San Antonio, and Austin, offering robust, coordinated care at lower out-of-pocket costs.

• PPO Plans (Preferred Provider Organizations): These plans offer more flexibility by allowing you to see out-of-network doctors and specialists without a referral, though you will generally pay a higher cost-share for out-of-network care. PPO plans are often vital for rural Texans who may need to travel outside their local county or immediate area to access specific specialists who do not participate in a standard HMO network.

Will prescription drugs be covered under a Texas MAPD plan?

Yes, prescription drugs can be covered under a Medicare Advantage Prescription Drug (MAPD) plan, but it depends on the specific policy you choose. When you are exploring your options in Texas, it helps to understand the difference between bundled coverage and standalone coverage.

• Medicare Advantage Prescription Drug (MAPD) Plans: These are all-in-one health plans that combine your medical insurance (Parts A and B) with prescription drug coverage (Part D) under a single policy. 

• Standalone Part D Plans: These are separate policies. They are typically paired with Original Medicare or specific Medicare Advantage plans that do not include drug coverage.

2026 Inflation Reduction Act (IRA) Updates

Significant federal updates under the Inflation Reduction Act have gone into effect, offering additional savings and predictability for Texas seniors:

• Strict $2,100 Annual Cap: Out-of-pocket spending for covered Part D prescription drugs is capped at $2,100 annually. Once you reach this limit, you will pay $0 for your covered medications for the rest of the calendar year.

• The "Donut Hole" is Permanently Gone: The complex and costly coverage gap—previously known as the prescription drug donut hole—has been officially eliminated. You will now move directly from your initial coverage stage to the $0 catastrophic coverage stage without hitting a sudden spike in drug costs.

• Standard Deductible Limits: While some Texas MAPD plans offer a $0 drug deductible, the maximum allowable Part D deductible any plan can charge is $615.

Popular Medicare Advantage Carriers Available in Texas

Source: CMS Part C and D Performance Data  

CMS Star Ratings are evaluated annually by the Centers for Medicare & Medicaid Services (CMS). Ratings and plan availability can vary significantly by Texas county.

Plan Availability by Top Texas Counties

Medicare Advantage plan options are hyper-local, meaning your specific coverage choices, costs, and network of doctors depend entirely on the county you live in. A plan available to someone in Houston might not be accessible to someone living just a few miles away in a neighboring county.

Because options vary greatly across the Lone Star State, here’s a look at what the Medicare landscape looks like across major Texas hubs:

• Harris County (Houston): As Texas's most populous county, Harris County residents benefit from a competitive insurance market. This area features $0 premium HMO options, allowing seniors to find low-cost coverage within local provider networks.

• Dallas County: Serving the heart of the metroplex, Dallas County offers a dense network of both HMO and PPO choices. This variety gives residents the flexibility to choose between coordinated HMO care or broader PPO networks that cover preferred specialists throughout the region.

• Tarrant County (Fort Worth): Tarrant County represents a growing age-in market. Insurance companies have responded to this influx of newly eligible retirees by expanding their local plan benefits, creating highly competitive options for those turning 65.

• Bexar County (San Antonio): Bexar County has a strong presence of veteran-focused plans that complement VA benefits. Additionally, the county offers numerous Dual-Eligible Special Needs Plans (D-SNPs) tailored for individuals who qualify for both Medicare and Medicaid.

Disclaimer: Medicare Advantage plan availability, premiums, and provider networks in Texas vary by county and ZIP code. County-level descriptions are based on general Medicare market trends, population distribution, and typical rural vs. urban plan availability patterns. Actual plan options and benefits are determined by each insurance carrier and may change annually. 

Compare Medicare Supplement Plans in Texas

While Medicare Advantage plans bundle your coverage, they are not the only way to manage your healthcare costs. Texans may prefer to pair Original Medicare (Parts A and B) with a standalone , also known as Medigap. These policies are designed to cover out-of-pocket costs that Original Medicare does not cover, such as deductibles, copayments, and coinsurance. Because Medigap plans do not use network restrictions, you can see any doctor or specialist in the country who accepts Medicare.

Note: You cannot be enrolled in a Medicare Advantage plan and a Medigap plan at the same time.

Why choose SelectQuote for Texas Medicare plans?

Navigating dozens of different insurance choices across the Lone Star State can feel overwhelming, but you don’t have to do it alone. With over 40 years of experience helping families find the right coverage, SelectQuote is here to simplify the process. Our licensed insurance agents act as your personal advocate, allowing you to compare plans from a dozen of the nation's most recognized insurance carriers in just a matter of minutes. We save you time and money by matching your specific doctors, prescriptions, and budget to the ideal policy.

Don’t just take our word for it—thousands of beneficiaries trust us to guide their healthcare decisions, backed by proven social proof:

• Excellent Trustpilot Rating: We consistently hold a high-rated, multi-star rating on Trustpilot, reflecting our commitment to transparent customer service and clear communication.

• A+ BBB Rating: As an accredited business with the Better Business Bureau, we maintain the highest standards of integrity, consumer trust, and professional reliability.

• Localized Reviews: Texans across the state—from Houston to El Paso—frequently praise our agents for helping them uncover hidden savings, understand complex state guidelines, and secure peace of mind.