Medicare Advantage Plans in Texas

How Medicare Advantage generally works

Medicare Advantage plans are offered by private companies approved by Medicare and must cover at least the same services as Original Medicare Parts A and B. Many plans also include Part D prescription drug coverage bundled in, along with additional benefits that vary by plan. These plans typically operate through a provider network, meaning your choice of doctors and hospitals may be more limited than under Original Medicare, and cost-sharing structures like copays, deductibles and out-of-pocket maximums vary from plan to plan. Because plan details differ, it's worth comparing specific plan documents rather than assuming all Advantage plans work the same way.

Network types and what they mean in Texas

Medicare Advantage plans commonly use HMO or PPO-style network structures, which affect whether you need referrals or can see out-of-network providers. In Texas metro areas such as Houston, Dallas-Fort Worth, San Antonio and Austin, provider networks tend to include a larger number of nearby specialists. In more rural regions, including parts of West Texas, the Panhandle and the Rio Grande Valley, a plan's network may include fewer nearby specialists, which can mean more travel time for certain types of care. Reviewing a plan's provider directory for your specific area before enrolling is a reasonable step.

Extra benefits and their limits

Some Medicare Advantage plans advertise additional benefits beyond what Original Medicare covers, such as routine dental, vision or hearing services. These extra benefits vary widely by plan and are not guaranteed to be included, so it's important to review what a specific plan actually offers rather than assuming a benefit is standard. We do not represent that any particular extra benefit will be available in a given plan without confirming the specific plan's documents.

Enrollment timing

You can generally enroll in a Medicare Advantage plan during your Initial Enrollment Period when you first become eligible for Medicare. Each year's Annual Enrollment Period (October 15 to December 7) allows you to switch into, out of, or between Medicare Advantage plans for the following year. There is also a Medicare Advantage Open Enrollment Period (January 1 to March 31) for people already enrolled in an Advantage plan who want to make one additional change. Certain qualifying life events may open a Special Enrollment Period outside these standard windows.

Who this may help

• People newly eligible for Medicare who want an alternative to Original Medicare
• Current Medicare Advantage members reviewing their plan during Annual Enrollment
• Texans wanting to understand network structures before enrolling
• People interested in plans that may bundle Part D coverage

Potential benefits

• A single plan that combines Part A, Part B and often Part D benefits
• Potential for additional benefits beyond Original Medicare, depending on the specific plan
• Defined out-of-pocket maximums, which vary by plan

What to consider

• Provider networks may limit which doctors and hospitals you can see
• Rural areas of Texas may have fewer in-network specialists nearby
• Extra benefits and costs vary significantly between plans and are not guaranteed
• RGI Group does not offer every Medicare Advantage plan available in Texas

How enrollment works

• Confirm you're in an enrollment period that allows you to make a change
• Review your current or prospective providers against a plan's network
• Compare plan documents for benefits, costs and drug coverage
• Discuss your questions with us by phone or virtual appointment
• Verify final details on Medicare.gov before enrolling

Frequently asked questions

• Does RGI Group offer every Medicare Advantage plan in my Texas county? No. We do not offer every plan or carrier available in every part of Texas. Medicare.gov's plan finder and 1-800-MEDICARE can show the full range of plans available where you live.
• Can I use any doctor with a Medicare Advantage plan? It depends on the plan's network structure. HMO-style plans typically require you to use in-network providers, while PPO-style plans may allow out-of-network care, often at a higher cost. Reviewing a specific plan's provider directory is the best way to confirm.
• Do all Medicare Advantage plans include dental or vision benefits? No. Extra benefits vary by plan and are not standard across all Medicare Advantage plans, so it's important to confirm what a specific plan includes before assuming a benefit will be there.
• When can I switch Medicare Advantage plans? You can generally make changes during the Annual Enrollment Period (October 15–December 7) or, if you're already in an Advantage plan, during the Medicare Advantage Open Enrollment Period (January 1–March 31). Certain qualifying events may allow changes at other times.
• Is Medicare Advantage the same as Medicare Supplement? No. Medicare Advantage replaces how you receive your Medicare benefits through a private plan with its own network and cost structure, while Medicare Supplement works alongside Original Medicare. The two cannot be combined.
• Does RGI Group have an office in my city? No. RGI Group has one office, in Austin, and serves Texas residents statewide by phone and virtual appointment. Paperwork can usually be completed electronically, so you do not need to travel to meet with us.
• Is there a cost to review my options with RGI Group? You do not pay RGI Group a separate fee to review coverage options. You are also free to enroll on your own through the official government resources linked on this page.
• Can we talk in Spanish? Yes. Appointments and follow-up can be handled in English or Spanish, whichever you prefer.
• Which plans and carriers are available to me? Availability depends on your county, eligibility, and the product you are looking at, and it can change from year to year. We can tell you what we are able to offer for your situation rather than promise a specific plan or price.
• What should I have ready for a first conversation? Your ZIP code, who needs coverage, the doctors or prescriptions that matter to you, and a general sense of your budget. Please do not send Social Security numbers, Medicare ID numbers, date of birth, income, diagnoses, or prescription details through this website.

Official resources

• Medicare.gov — https://www.medicare.gov (Compare Medicare Advantage plans available in your area using the official plan finder.)
• Texas Department of Insurance — https://www.tdi.texas.gov (Consumer information on Medicare Advantage plans regulated in Texas.)
• 1-800-MEDICARE — https://www.medicare.gov/talk-to-someone (Speak with a federal Medicare representative about plan options.)

Talk with a licensed Texas agent

Call or text (346) 888-8811. Office: 5900 Balcones Drive, Ste 100, Austin, TX 78731. Open 24 hours, 7 days a week. Licensed in Texas. Guidance available in English and Spanish.