Medicare Advantage plans for Texas residents

Medicare Advantage is offered by private insurance companies approved by Medicare, and in Texas the specific plans available to you depend on the county you live in rather than the state as a whole. Networks, service areas, and plan designs vary widely across the state's urban metros, suburban growth corridors, and rural counties. RGI Group is a licensed independent Texas insurance agency that helps residents compare Medicare Advantage options by phone or virtual appointment, in English or Spanish. This page explains the general concepts to understand before comparing plans in your own county.

Service areas are set county by county

A Medicare Advantage plan can only be sold where it has been approved to operate, and that approval is defined by county. Because Texas has well over 200 counties with very different populations and provider availability, a plan sold in one county may not be offered at all in a neighboring one, even a short drive away.

HMO-type and PPO-type structures, generally

Many Medicare Advantage plans are built around an HMO-style network, which generally expects you to use in-network providers and often a primary care referral, while other plans use a PPO-style structure that generally allows more flexibility to see out-of-network providers at a different cost. The exact rules vary by plan, so the HMO/PPO label is a starting point for questions, not a full answer on its own.

Networks are not the same as a hospital being well known

Texas has large, well-known hospital systems in its major metros, but being well known does not mean a provider is contracted with every plan. Confirming whether your specific doctors, specialists, and preferred hospital system participate in a given plan's network for the coming year is a necessary step before enrolling.

Rural and border-area considerations

In rural Texas counties and along the border, the number of in-network specialists nearby can be more limited, which makes referral rules and travel distance especially relevant. In the Rio Grande Valley, seasonal winter-Texan residents should also ask how a plan treats care received while they are away from Texas for part of the year.

Extra benefits still depend on the plan and county

Some Medicare Advantage plans include extra benefits beyond Original Medicare, such as limited routine dental or vision coverage, but which benefits are included, and any network or dollar limits that apply, differ by plan and by county. None of these extras are guaranteed to be part of every plan everywhere in Texas.

Comparing plans in your own county

Because so much depends on local service areas, the most useful comparison starts with your county, your current doctors, your pharmacy, and your prescription list, then narrows to the plans actually offered where you live. A plan that a friend in another Texas city likes may not even be sold in your county.

Questions to ask before choosing a plan

  • Which Medicare Advantage plans are approved to operate in my county?
  • Does this plan use an HMO-style or PPO-style network, and what does that mean for referrals?
  • Are my current doctors and hospital system in this plan's network for next year?
  • What extra benefits, if any, does this plan include, and what limits apply?
  • How does this plan handle care I receive while temporarily outside Texas?

Frequently asked questions

  • Can I enroll in any Medicare Advantage plan I find online, no matter where I live in Texas? No. Medicare Advantage plans are approved county by county, so you can only enroll in plans that serve the county of your legal residence.
  • Is an HMO-style plan always cheaper than a PPO-style plan? There is no fixed rule; cost and coverage depend on the specific plan, not just whether it is labeled HMO or PPO. Comparing actual plan details for your county is the only reliable way to know.
  • Does RGI Group only help people near its Austin office? No. RGI Group's one office is in Austin, but Texans statewide are served by phone or virtual appointment, so your county does not need to be near Austin to get help comparing plans.
  • If a plan is available in my county, is it guaranteed to include my doctor? No. County availability only tells you the plan can be sold where you live; it does not guarantee any specific doctor, hospital, or pharmacy participates in that plan's network.
  • Do Medicare Advantage plan options change every year in Texas? Yes, plans can adjust their service areas, networks, and benefits annually, which is why reviewing your options each year during the Annual Enrollment Period is generally recommended.

Important notice

  • Plan availability, benefits, and any Part B premium reduction vary by county, plan, and individual circumstances. The Annual Enrollment Period (Oct 15 – Dec 7, 2026) is different from your Initial Enrollment Period around your 65th birthday.
  • We do not offer every plan available in your area. We are not affiliated with or endorsed by the U.S. government or the federal Medicare program. Any information we provide is limited to the plans we offer in your area. To find all of your options, contact Medicare.gov, 1-800-MEDICARE, or the Texas Health Information, Counseling and Advocacy Program (HICAP).

Talk with a licensed Texas agent

Call 346-888-0811. Office: 5900 Balcones Drive, Ste 100, Austin, TX 78731. Monday–Sunday, 8:00 AM–11:00 PM. Licensed in Texas. Guidance available in English and Spanish.