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Medicare Advantage Plans in Texas- Pros and Cons

Author: Benedict Kemper
by Benedict Kemper
Posted: Mar 15, 2019

Well, we cannot simply say Medicare Advantage plans are better than Original Medicare or vice versa because each person has personal preferences, needs, and different lifestyle. But most people see more value in Medicare Advantage plans than Original Medicare because Original Medicare pays for many, but not all, healthcare services. If you want complete coverage through Original Medicare, you have to buy Medigap policy.

So today we will look at the pros and cons of Medicare Advantage plans that help you understand Medicare Advantage plans.

Pros of Medicare Advantage Plans

Part D coverage

Most of the Medicare Advantage plans in Texas include Medicare prescription drug coverage (PartD) often for no additional premium. So if you need Medicare prescription drug coverage, Medicare Advantage plan is the better choice than Original Medicare because Original Medicare does not include part D coverage. You have to buy the stand alone part D plan to get the Medicare prescription drug coverage and have to pay a premium for it.

Out-of-pocket maximum

Original Medicare does not have an out-of-pocket maximum. You have to pay the portion of the cost of the services as you use them. On the other hand, Medicare Advantage plan limits your maximum out-of-pocket expense. Once you hit that limit, you don't have to pay for the covered medical services for the remainder of the year; your plan will pay for the expenses. It can save you thousands of dollars especially if you have poor health year.

Offers extra health benefits

Medicare Advantage plan offers a vast range of extra health benefits apart from Original Medicare benefits such as routine vision care, hearing aids, prescription drug coverage, routine dental care, wellness program and fitness center membership. Original Medicare does not offer these benefits; you have to buy Medigap policies to get additional coverage. However, not all Medicare Advantage plans offer these additional benefits, but every Medicare Advantage plan must provide Original Medicare benefits.

Save money

Some Medicare Advantage plans may cost you less than the Original Medicare plus Medigap plans for the same level of coverage. Some Medicare Advantage plans have a premium as low as $0.

Cons of Medicare Advantage plans

Medicare Advantage plan is a one-stop solution for all your health needs, but it has a few cons as well.

  • Medicare Advantage plans it restricted to a specific network of doctors and medical providers. If you go outside of this network, your plan will not cover the cost of medical services. So, it limits your freedom in the choice of doctors and healthcare providers.
  • Some medical services covered in the Medicare Advantage plans require a referral from a primary doctor to see a specialist. You need authorization from the primary doctor to see a specialist. So, it limits your flexibility when seeking medical specialists.

These are the pros and cons of Medicare Advantage plans in Texas.

The Harrin Group, LLC is an independent insurance agency providing health insurance, life insurance, Medicare Advantage plans, Medicare Supplement plans, retirement solutions, and annuities for San Antonio and all of Texas, California, and Florida. To know more, visit

About the Author

I'm a freelance copywriter and I write on a variety of topics.

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Author: Benedict Kemper

Benedict Kemper

Member since: Sep 26, 2016
Published articles: 46

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