Medicare Advantage Plans in Grayson County, TX:
Your Complete 2025 Guide
Discover 38 Medicare Advantage plans in Grayson County for 2025. These plans combine your Medicare Part A and Part B benefits into one convenient plan, and may offer additional benefits such as dental, hearing and/or vision and/or fitness. There may not be a plan in your area that has all of these benefits in one plan.
Types of Medicare Advantage Plans in Grayson County, TX
With 38 Medicare Advantage plans available in Grayson County, it’s easier than ever to find one that meets your healthcare needs. However, there are no 5-star plans available this year. Your 2025 options include:
Summary of Medicare Advantage Plan Types Available in Grayson County, Texas
- Preferred Provider Organization (PPO) Plans: These plans (20 available) offer flexibility with out-of-network care at a higher cost. The average monthly premium for these plans is $19.70.
- Health Maintenance Organization (HMO) Plans: These plans (9 available) require in-network care and generally have lower costs. The average monthly premium for these plans is $4.07.
- HMO Point-of-Service (HMO-POS) Plans: These plans (9 available) blend HMO and PPO features, allowing some out-of-network care. The average monthly premium for these plans is $10.44.
- Special Needs Plans (SNP): These highly specialized Medicare Advantage plans cater to individuals with specific healthcare needs. Learn more here: Medicare Special Needs Plans in Grayson County, TX .
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans give you the flexibility to seek care from both in-network and out-of-network providers. While out-of-network care may come with higher costs, PPO plans are ideal for those who prefer more choices in managing their healthcare.
- Out-of-Network Costs: PPO plans allow you to see out-of-network providers, but this flexibility often comes with higher costs. Evaluate additional costs if you prefer providers outside the plan's network.
- Provider Network: Verify your preferred doctors and specialists are in-network to lower costs. If flexibility is important, confirm the network meets your needs.
- Premiums and Out-of-Pocket Maximums: Compare premiums and out-of-pocket maximums across plans. Higher premiums may provide more coverage, but assess if benefits justify additional cost.
- Additional Benefits: Many PPO plans include extras like dental, vision, or fitness programs. Assess which benefits align best with your healthcare priorities, keeping in mind availability varies.
Medicare Advantage HMO Plans
Health Maintenance Organization (HMO) plans offer lower costs in exchange for using in-network providers. These plans are a great choice for those who are comfortable with a more restricted network and want to keep their healthcare expenses predictable and affordable.
| Plan Name | Rating* | Premium/Mo | MOOP | Rx Ded. |
|---|---|---|---|---|
| Prominence Extra Help | $18 | $3,000 | $590 | |
| Prominence Giveback $100 | $0 | $6,200 | $375 | |
| Prominence Plus | $0 | $3,250 | $0 | |
| Humana Gold Plus H0028-043 | $0 | $3,450 | $200 | |
| Wellcare Assist | $18 | $3,450 | $570 | |
| Wellcare Patriot Simple | $0 | $3,450 | N/A | |
| Blue Cross Medicare Advantage Dental Value | $0 | $4,850 | $590 | |
| Blue Cross Medicare Advantage Saver | $0 | $7,500 | $0 | |
| Blue Cross Medicare Advantage Value | $0 | $4,100 | $0 | |
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- In-Network Care: HMO plans generally require you to use in-network providers for all non-emergency care. Verify your preferred doctors, specialists, and hospitals are in-network before enrolling.
- Primary Care Referrals: Many HMO plans require referrals from your primary care doctor to see specialists. Be comfortable with this care coordination requirement.
- Lower Costs: HMO plans typically have lower premiums and out-of-pocket costs compared to other plan types, beneficial if cost savings are your priority.
- Additional Benefits: Some HMO plans offer extras like dental, vision, or fitness programs. Evaluate which benefits are most important, noting availability may vary.
Medicare Advantage HMO-POS Plans
HMO Point-of-Service (HMO-POS) plans offer a blend of HMO and PPO features. While these plans require in-network care for lower costs, they also allow you to seek care outside of the network at a higher expense. This balance makes HMO-POS plans a flexible option for those who want the best of both worlds.
| Plan Name | Rating* | Premium/Mo | MOOP | Rx Ded. |
|---|---|---|---|---|
| AARP Medicare Advantage CareFlex from UHC TX-44 | $0 | $6,700 | $495 | |
| AARP Medicare Advantage Essentials from UHC TX-22 | $0 | $3,900 | $340 | |
| AARP Medicare Advantage Extras from UHC TX-27 | $0 | $4,100 | $420 | |
| AARP Medicare Advantage from UHC TX-0042 | $29 | $3,900 | $340 | |
| AARP Medicare Advantage Giveback from UHC TX-39 | $0 | $6,700 | $495 | |
| AARP Medicare Advantage Patriot No Rx TX-MA02 | $0 | $6,400 | N/A | |
| AARP SecureHorizons Medicare Advantage TX-0025 | $65 | $3,500 | $340 | |
| Prominence Beyond | $0 | $4,700 | $0 | |
| Wellpoint Medicare Advantage 2 | $0 | $9,350 | $0 | |
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- Out-of-Network Costs: HMO-POS plans allow out-of-network providers, but at higher costs. Evaluate potential extra costs for out-of-network care.
- In-Network vs. Out-of-Network Care: Compare coverage options between in-network and out-of-network care. Decide if flexibility justifies additional expenses.
- Referral Requirements: Many HMO-POS plans require a referral from your primary care doctor for specialist visits. Confirm you're comfortable with this requirement.
- Additional Benefits: Many HMO-POS plans include extras like dental, vision, or fitness programs. Determine which benefits best match your healthcare needs, acknowledging that not all benefits may be available in every plan.
Enrolling in a Medicare Advantage Plan in Grayson County means understanding your enrollment options. Whether you’re turning 65 or considering a plan change, knowing when and how to enroll ensures that you get the coverage that best fits your healthcare needs.
When to Enroll
- Initial Enrollment Period (IEP): Your first opportunity to enroll in Medicare begins three months before your 65th birthday and ends three months after. This is when you can choose your Medicare Advantage plan. Learn more
- Medicare Advantage Open Enrollment Period (MA OEP): Between January 1 and March 31, people who are currently enrolled in a Medicare Advantage plan can switch to a new one or return to Original Medicare if necessary. Learn more
- Annual Enrollment Period (AEP): From October 15 to December 7, you can review and adjust your Medicare coverage for the next year. Learn more
- Special Enrollment Periods (SEPs): You may qualify for a SEP due to life changes like relocation or losing other coverage, allowing you to make plan changes outside the typical enrollment periods. Learn more
How to Enroll
- Speak with a Licensed Agent: Speak with a licensed health insurance agent from HealthCompare 1-833-748-3201 (TTY 711) (Mon-Fri 5am-6pm, Sat 6am-5pm PST) for personalized guidance.
- Reach Out to the Plan Provider: Visit the plan provider’s website or call their customer service line to enroll directly.
- Go to Medicare.gov: Explore plan options and enroll online at Medicare.gov.
What types of Medicare Advantage plans are available?
Medicare Advantage plans come in different types, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS), and Special Needs Plans (SNPs). Each plan type offers different levels of flexibility in choosing healthcare providers and services.
Do Medicare Advantage plans cover prescription drugs?
Many Medicare Advantage plans, known as Medicare Advantage Prescription Drug (MAPD) plans, include prescription drug coverage. These plans bundle Medicare Parts A, B, and D into one plan. However, not all Medicare Advantage plans include drug coverage, so it's important to check before enrolling.
Are there any additional costs with Medicare Advantage plans?
While Medicare Advantage plans often have lower premiums than Original Medicare, you may still have out-of-pocket costs such as copayments, coinsurance, and deductibles. The costs can vary depending on the specific plan and services you use.
When can I enroll in a Medicare Advantage plan?
You can enroll in a Medicare Advantage plan during the Initial Enrollment Period (IEP), which starts three months before your 65th birthday and lasts three months after. You can also enroll during the Annual Enrollment Period (AEP) from October 15 to December 7, or during a Special Enrollment Period (SEP) if you qualify due to certain life events.
Can I change my Medicare Advantage plan after enrolling?
Yes, you can change your Medicare Advantage plan during the Annual Enrollment Period (AEP) or the Medicare Advantage Open Enrollment Period (MA OEP) if you are currently enrolled in a Medicare Advantage plan. Special Enrollment Periods (SEPs) may also allow plan changes if you qualify based on specific life events.
What happens if I miss the Annual Enrollment Period?
If you miss joining a plan during the Annual Enrollment Period (AEP), you may have to wait until the next AEP to join a Medicare Advantage plan. In some cases, Special Enrollment Periods (SEPs) may allow you to enroll or make changes outside the standard enrollment windows.
The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in Denison, Gunter, Pottsboro, Sherman, Bells, Howe, Whitewright, Van Alstyne, Collinsville, Gordonville, Sadler, Tioga, Whitesboro, and all other areas of Grayson County, Texas.
Plans Offered for Enrollment through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
CMS Plan IDs Presented
The Medicare Advantage plan pages listed in the tables above include localization to assist beneficiaries with plans available in their service area. However, most Part C plans are available in more than one service area, which can lead to confusion. The following list of CMS IDs links to our master plan pages without localization.
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage", Last Accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You", Last Accessed 25 May, 2025
- CMS.gov, Landscape Source Files, Last Accessed March 15, 2025