BSW SeniorCare Advantage Premium (HMO-POS) 2026 Plan Details for Somervell County, Texas Residents
BSW SeniorCare Advantage Premium (HMO-POS) 2026 Plan Details for Somervell County, Texas Residents
Navigating your Medicare Advantage options in Somervell County for 2026 can be overwhelming, but we're here to help. With BSW SeniorCare Advantage Premium (HMO-POS) included in your plan options, you can evaluate it alongside other plans to make an informed decision. Enroll online quickly, or consult with a licensed agent if you need assistance.
The latest CMS enrollment data shows an estimated 106 Medicare beneficiaries are enrolled in this plan, with 0 members in Somervell County, TX.
BSW SeniorCare Advantage Premium Overview
| Plan ID H8142-006-0 Overview | |
|---|---|
| Health Plan ID: | H8142-006-0 |
| Medicare Advantage Plan Type: | HMO-POS |
| Plan Year: | 2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $4500.00 (In-Network) |
| Part B Give Back: | −$50.00 reduction |
| Part D Drug Plan Benefit: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Somervell County, TX |
| Insured By: | Baylor Scott & White Health Plan |
Why Consider BSW SeniorCare Advantage Premium?
BSW SeniorCare Advantage Premium is a flexible Medicare Advantage HMO-POS plan that blends comprehensive coverage with provider choice. It includes all benefits from Medicare Part A and Part B and has a monthly premium of $0.00. As a Point of Service plan, it lets you receive care in-network for lower costs or go out-of-network when needed — giving you more control over how and where you get care.
Primary care visits have a $0 copay, specialist visits come with a $0 copay, urgent care services carry a $40 copay, and ambulance transportation is $40 copay. These costs apply toward the plan’s maximum out-of-pocket (MOOP) limit of $4500.00. Once you’ve hit that threshold, the plan pays 100% of your in-network costs for the rest of the year — a smart choice for those who want flexibility without sacrificing financial predictability.
CMS recognizes this plan as H8142-006-0. You’ll find cost-sharing details below, including what you can expect to pay for common services. Still have questions? Check the FAQ section for more insights.
| We're Here to Help You Enroll |
|---|
Out-of-Pocket Expenses
BSW SeniorCare Advantage Premium includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H8142-006-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | In-network: $0 copay |
| Specialist: | In-network: $0 copay |
Medicare Advantage plans often include preventive and wellness benefits designed to help members stay healthy, identify risks early, and maintain an active lifestyle.
| Service | Enrollee Cost (in-network) |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | Not covered |
| Fitness benefits: | In-network: $0 copay |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over the counter drug benefits: | In-network: $0 copay |
| Health transportation (non-emergency): | In-network: $0 copay |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $90 copay |
| Wordwide emergency care: | $0 copay |
| Urgent care: | $40 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $100 per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $50 per day for days 21-100 |
| Ground ambulance: | In-network: $40 copay |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | In-network: $0 copay |
| Outpatient group therapy: | In-network: $0 copay |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $100 per stay |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $10 copay |
| Occupational therapy: | In-network: $10 copay |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | In-network: $0 copay |
| Durable medical equipment: | In-network: $0 copay |
| Prosthetics: | In-network: $0 copay |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | In-network: $0 copay |
| Lab services: | In-network: $0 copay |
| Outpatient x-rays: | In-network: $0 copay |
| Diagnostic tests and procedures: | In-network: $0 copay |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance |
This section details the dental services covered under your plan including Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Oral exam: | In-network: $0 copay | Out-of-network: 0%-50% coinsurance |
| Dental x-rays: | In-network: $0 copay | Out-of-network: 0%-50% coinsurance |
| Cleaning: | In-network: $0 copay | Out-of-network: 0%-50% coinsurance |
| Periodontics: | In-network: 50% coinsurance | Out-of-network: 0%-50% coinsurance |
| Endodontics: | In-network: 50% coinsurance | Out-of-network: 0%-50% coinsurance |
| Restorative services: | In-network: 50% coinsurance | Out-of-network: 0%-50% coinsurance |
| Implant services: | In-network: 50% coinsurance | Out-of-network: 0%-50% coinsurance |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: 50% coinsurance | Out-of-network: 0%-50% coinsurance |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Fitting/evaluation: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Prescription hearing aids: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| OTC hearing aids: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Contact lenses: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Eyeglass frames only: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Eyeglass lenses only: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Eyeglasses (frames & lenses): | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Upgrades: | Not covered |
Medicare Advantage plans may include extra benefits and special needs services designed to support members with chronic conditions, mobility limitations, or other complex health needs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Adult day health services: | Not covered |
| Home based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | Not covered |
| 'Wigs for chemotherapy hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | Not covered |
Certain preventive services are covered 100% by BSW SeniorCare Advantage Premium as a Part B benefit.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
Understanding CMS Star Ratings
The Centers for Medicare & Medicaid Services (CMS) reviews and rates Medicare Advantage (Part C) and drug plans (Part D) annually, using a 5-star system to measure aspects such as member satisfaction, preventive services, and management of chronic conditions.
Higher star ratings generally indicate better plan performance, which can be a useful factor to consider when deciding on a plan that aligns with your healthcare goals and preferences.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Eligibility Requirements for BSW SeniorCare Advantage Premium
To enroll in BSW SeniorCare Advantage Premium, you must meet the following criteria:
- Be eligible for Medicare Part A and Part B.
- Reside in the plan’s service area.
If you meet these requirements, you are eligible to enroll in BSW SeniorCare Advantage Premium and benefit from its comprehensive coverage options.
When Can I Enroll in BSW SeniorCare Advantage Premium?
To ensure you don’t miss your chance to enroll in BSW SeniorCare Advantage Premium, be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to get assistance from a licensed insurance agent.
How to Sign Up for BSW SeniorCare Advantage Premium
Joining BSW SeniorCare Advantage Premium is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join BSW SeniorCare Advantage Premium.
- Direct Enrollment: You can also choose to enroll directly with BSW SeniorCare Advantage Premium. The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
Here are some of the most frequently asked questions people have about plan ID H8142-006-0:
How much does H8142-006-0 cost per month?
For 2026, the monthly premium is $0.00, and you still pay your Part B premium to Medicare.
What’s the MOOP for BSW SeniorCare Advantage Premium in 2026?
Your costs top out at $4500.00 (for in-network services) in 2026; after that the plan pays 100% of covered services.
How is this plan rated by Medicare?
For 2026, plan H8142-006-0 has a ★4.0 rating. The best rating is 5 stars.
How many people are enrolled in this plan?
Enrollment stands at roughly 106 members.
Contact Baylor Scott & White Health Plan
| Contact Type | Details |
|---|---|
| Website: | Baylor Scott & White Health Plan Plan Page |
| New Members: | 1-866-334-3141 |
| Existing Members: | 1-866-334-3141 |
| Plan Address: | 1206 West Campus Drive | Temple, TX 76502 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 14, 2025
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed October 13, 2025
Learn more about how we use CMS data.
- Baylor Scott & White Health Plan, http://BSWHealthPlan.com/Medicare — Last accessed October 13, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content managed by David Bynon, Medicare Analyst.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, HealthSpring℠, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint