Medicare Plans in
Smith County, TX
35 Medicare Advantage Plans Found in Smith County. See Plans
Smith County, TX
Medicare Information
For Smith County’s Medicare beneficiaries, private plans like Medicare Advantage plans offer an alternative to Original Medicare, and Part D plans (PDP) can work alongside your Original Medicare benefits.
Currently, 35 private Medicare plans are available in Smith County, and coverage is provided through Medicare-approved private companies, following rules set by Medicare.
MA plans, which are also referred to as Medicare Part C, may offer additional benefits that aren't available through Original Medicare.
Part D plans, also referred to as PDPs, cover retail prescription drugs.
Some Medicare Part C plans include coverage for prescription medications. Known as Medicare Advantage Prescription Drug plans, or MAPDs, these plans offer comprehensive coverage for seniors who want to minimize their out-of-pocket costs.
Learn more about some of the Medicare plans in Smith County, Texas, including average costs, out-of-pocket expenses and what’s involved in obtaining prescription drug coverage.
The following is HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files as well as carrier-provided plan data supplied by SunFire Inc.
Average Cost of Medicare
Plans in Smith County
Average Cost of Medicare Advantage Plans in Smith County, Texas | |
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Average Monthly Premium | $48.80 |
Average in-network out-of-pocket spending limit | $7,180.00 |
Average drug deductible in 2025 (weighted) | $426.56 |
Percentage of plans rated 4 stars or higher | 22.9% |
Average Cost of Medicare Advantage Plans in Smith County, Texas |
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Average Monthly Premium $48.80 |
Average in-network out-of-pocket spending limit $7,180.00 |
Average drug deductible in 2021 (weighted) $426.56 |
Percentage of plans rated 4 stars or higher 22.9% |
Learn More About Medicare
Prescription Drug Plans
Plan Type | Description |
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HMO | HMO enrollees typically receive services through in-network providers and must obtain referrals for visits to specialists. However, most plans permit out-of-network care in emergencies or out-of-area dialysis. HMO plans often include prescription drug coverage. |
PPO | Members of PPO plans can typically go in or out of network for care, including hospitalization, although visits to non-network providers may cost considerably more. Referrals are usually not needed for visits to specialists, and many PPO plans include prescription drug coverage. |
PFFS | Private fee-for-service plans determine how much a doctor or facility will be paid for services, and members may seek care from any in or out-of-network provider that agrees to the plan's terms. Some PFFS plans include prescription drug coverage. Otherwise, members may seek coverage for medications through standalone Medicare drug plans, which are also known as Part D plans. |
SNP | Special Needs Plans are designed for individuals with specific conditions or medical characteristics. Benefits such as providers and drug formularies are tailored to members' unique needs, and most care is provided by in-network physicians and facilities. SNPs are required to provide prescription drug coverage. |
Plan Type and Description |
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HMO enrollees typically receive services through in-network providers and must obtain referrals for visits to specialists. However, most plans permit out-of-network care in emergencies or out-of-area dialysis. HMO plans often include prescription drug coverage.
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Members of PPO plans can typically go in or out of network for care, including hospitalization, although visits to non-network providers may cost considerably more. Referrals are usually not needed for visits to specialists, and many PPO plans include prescription drug coverage.
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Private fee-for-service plans determine how much a doctor or facility will be paid for services, and members may seek care from any in or out-of-network provider that agrees to the plan's terms. Some PFFS plans include prescription drug coverage. Otherwise, members may seek coverage for medications through standalone Medicare drug plans, which are also known as Part D plans.
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Special Needs Plans are designed for individuals with specific conditions or medical characteristics. Benefits such as providers and drug formularies are tailored to members' unique needs, and most care is provided by in-network physicians and facilities. SNPs are required to provide prescription drug coverage.
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Some beneficiaries may be eligible for standalone prescription drug plans. Otherwise known as a PDP or Part D plan, a standalone prescription drug plan adds coverage for prescription medications to Original Medicare and some PFFS plans. It’s important to note that some MA plans, such as HMOs, may disenroll members who sign up for a separate drug plan.
Medicare Advantage Plans
Aetna Inc. Medicare Plans in Smith County, TX
The following table includes cost information and other plan details for Aetna Inc. private Medicare plans available in Texas in 2025.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Aetna Medicare Dual Complete (HMO D-SNP) | H8597: 001 | $0 | $0 | $9,350 | Yes | 3.5 out of 5 |
Aetna Medicare Choice (PPO) | H3288: 008 | $0 | $590 | $6,750 | Yes | 3.5 out of 5 |
Aetna Medicare Freedom Preferred (PPO) | H2293: 014 | $0 | $590 | $6,350 | Yes | 4 out of 5 |
Centene Corporation
Centene Corporation Medicare Plans in Smith County, TX
The following table includes cost information and other plan details for Centene Corporation private Medicare plans available in Texas in 2025.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Wellcare Dual Liberty (HMO D-SNP) | H5294: 010 | $0 | $0 | $9,350 | Yes | 3.5 out of 5 |
Wellcare Dual Access (HMO D-SNP) | H5294: 015 | $0 | $0 | $9,350 | Yes | 3.5 out of 5 |
Cigna Medicare Plans in Smith County, TX
The following table includes cost information and other plan details for Cigna private Medicare plans available in Texas in 2025.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Cigna Preferred Medicare (HMO) | H4513: 026 | $0 | $0 | $4,200 | Yes | 4.5 out of 5 |
Cigna TotalCare (HMO D-SNP) | H4513: 027 | $0 | $0 | $3,400 | Yes | 4.5 out of 5 |
Cigna Preferred Savings Medicare (HMO) | H4513: 083 | $0 | $0 | $7,200 | Yes | 4.5 out of 5 |
Cigna Courage Medicare (HMO) | H4513: 009 | $0 | N/A | $4,300 | No | 4.5 out of 5 |
Humana Inc. Medicare Plans in Smith County, TX
The following table includes cost information and other plan details for Humana Inc. private Medicare plans available in Texas in 2025.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
HumanaChoice R4182-001 (Regional PPO) | R4182: 001 | $0 | N/A | $6,750 | No | 3.5 out of 5 |
HumanaChoice Giveback H5216-358 (PPO) | H5216: 358 | $0 | $590 | $8,300 | Yes | 3.5 out of 5 |
HumanaChoice H5216-352 (PPO) | H5216: 352 | $0 | $250 | $6,400 | Yes | 3.5 out of 5 |
Humana Gold Plus H0028-041 (HMO) | H0028: 041 | $0 | $200 | $4,200 | Yes | 3.5 out of 5 |
Humana Gold Plus SNP-DE H0028-032 (HMO D-SNP) | H0028: 032 | $0 | $0 | $9,350 | Yes | 3.5 out of 5 |
Humana USAA Honor Giveback (PPO) | H5216: 128 | $0 | N/A | $6,750 | No | 3.5 out of 5 |
Humana USAA Honor Giveback (PPO) | H5216: 348 | $0 | N/A | $7,900 | No | 3.5 out of 5 |
HumanaChoice H5216-043 (PPO) | H5216: 043 | $26 | $250 | $7,700 | Yes | 3.5 out of 5 |
HumanaChoice H5216-042 (PPO) | H5216: 042 | $60 | $250 | $6,750 | Yes | 3.5 out of 5 |
HumanaChoice R4182-004 (Regional PPO) | R4182: 004 | $83 | $350 | $7,400 | Yes | 3.5 out of 5 |
HumanaChoice R4182-003 (Regional PPO) | R4182: 003 | $138 | $275 | $7,400 | Yes | 3.5 out of 5 |
Molina Healthcare, Inc.,
Molina Healthcare, Inc., Medicare Plans in Smith County, TX
The following table includes cost information and other plan details for Molina Healthcare, Inc., private Medicare plans available in Texas in 2025.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Molina Medicare Complete Care (HMO D-SNP) | H7678: 001 | $0 | $0 | $9,350 | Yes | 3 out of 5 |
UnitedHealthcare Medicare Plans in Smith County, TX
The following table includes cost information and other plan details for UnitedHealthcare private Medicare plans available in Texas in 2025.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
UHC Dual Complete TX-S001 (Regional PPO D-SNP) | R6801: 011 | $0 | $0 | $9,350 | Yes | 3 out of 5 |
UHC Dual Complete TX-S003 (HMO-POS D-SNP) | H4514: 021 | $0 | $0 | $9,350 | Yes | 3.5 out of 5 |
AARP Medicare Advantage Giveback from UHC TX-41 (HMO-POS) | H0609: 068 | $0 | $495 | $7,900 | Yes | 4.5 out of 5 |
UHC Dual Complete TX-D002 (HMO-POS D-SNP) | H4514: 023 | $0 | $0 | $9,350 | Yes | 3.5 out of 5 |
UHC Dual Complete TX-V001 (HMO-POS D-SNP) | H4514: 019 | $0 | $0 | $4,900 | Yes | 3.5 out of 5 |
AARP Medicare Advantage from UHC TX-0026 (HMO-POS) | H0609: 060 | $0 | $340 | $4,900 | Yes | 4.5 out of 5 |
AARP Medicare Advantage from UHC TX-0007 (PPO) | H1278: 015 | $0 | $420 | $6,700 | Yes | 4 out of 5 |
UHC Complete Care Support TX-1A (Regional PPO C-SNP) | R6801: 008 | $10 | $590 | $9,350 | Yes | 3 out of 5 |
UHC Complete Care TX-29 (Regional PPO C-SNP) | R6801: 009 | $22 | $495 | $7,500 | Yes | 3 out of 5 |
UHC Medicare Advantage TX-0030 (Regional PPO) | R6801: 012 | $64 | $570 | $7,900 | Yes | 3 out of 5 |
Wellcare Health Plans, Inc. Medicare Plans in Smith County, TX
The following table includes cost information and other plan details for Wellcare Health Plans, Inc. private Medicare plans available in Texas in 2025.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Wellcare Patriot Simple (HMO) | H5294: 014 | $0 | N/A | $3,450 | No | 3.5 out of 5 |
Wellcare Assist (HMO) | H5294: 016 | $18 | $570 | $3,450 | Yes | 3.5 out of 5 |
Wellpoint
Wellpoint Medicare Plans in Smith County, TX
The following table includes cost information and other plan details for Wellpoint private Medicare plans available in Texas in 2025.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Wellpoint Full Dual Advantage (HMO D-SNP) | H8849: 010 | $0 | $0 | $9,350 | Yes | 3.5 out of 5 |
Wellpoint Dual Advantage (HMO D-SNP) | H8849: 011 | $18 | $0 | $9,350 | Yes | 3.5 out of 5 |