Baylor Scott & White Health Plan Medicare Advantage 2024 Review – NerdWallet

Baylor Scott & White Health Plan Medicare Advantage plans are available in 47 Texas counties. The company excels on measures of member experience, and its overall quality ratings are about average.

Here’s what you should know about Baylor Scott & White Health Plan Medicare Advantage.

Baylor Scott & White’s Medicare Advantage plans have advantages and disadvantages.

• Member experience: Baylor Scott & White Health Plan gets great member experience ratings on metrics including customer service and care coordination.

• Pharmacy benefits: Baylor Scott & White Health Plan advertises $0 generic prescriptions and a card that covers $30-$75 per quarter for over-the-counter items.

• Limited availability: Baylor Scott & White plans are available only in 47 of the 254 counties in Texas.

Average star rating, weighted by enrollment: 3.96

The Centers for Medicare & Medicaid Services’ (CMS) annual star ratings rank Medicare plans from best (5 stars) to worst (1 star). The agency’s ratings are based on data measuring plans’ quality of care and customer satisfaction.

Based on the most recent year of data and weighted by enrollment, Baylor Scott & White Health Plan’s 2024 Medicare Advantage plans get an average overall rating of 3.96 stars^[0]

For comparison, the average star rating for plans from all providers for 2024 is 4.04^[0]

Costs for Medicare Advantage plans will depend on your plan, geographic location and health needs.

One of the costs to consider is the plan’s premium. In 2024, about 39% of Baylor Scott & White’s Medicare Advantage plans have $0 premiums^[0]

Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $164.90 per month in 2023 ($174.70 in 2024), although some plans cover part or all of this cost^[0]

Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:

• Whether the plan covers any part of your monthly Medicare Part B premium.

• The plan’s yearly deductibles and any other deductibles, such as a drug deductible.

• Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.

• The plan’s in-network and out-of-network out-of-pocket maximums.

• Whether your medical providers are in-network or out-of-network, or how often you may go out-of-network for care.

• Whether you require extra benefits, and whether the plan charges for them.

To get a sense of costs, use Medicare’s plan finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Baylor Scott & White plans or compare across carriers. You can also shop directly from Baylor Scott & White Health Plan’s website by entering your ZIP code.

There are several kinds of Baylor Scott & White Medicare Advantage plans, and they vary in structure, costs and benefits. About 65% of Baylor Scott & White Medicare Advantage plans include prescription drug coverage.

Plan offerings include the following types:

Baylor Scott & White Health Plan offers Medicare Advantage plans in 47 counties in Texas. The company covers about 29,000 Medicare Advantage beneficiaries^[0]