What Medicare Advantage plans are available in my area?
Your county and ZIP code decide which Medicare Advantage plans you can join. Here is how to look up your own list and narrow it down.
- Which Medicare Advantage plans you can join is set by your county and ZIP code, so your list differs from one in another town.
- Look your list up on the Plan Finder at Medicare.gov, and enter every medicine you take with the dose.
- Annual Enrollment runs October 15 through December 7 for coverage that starts January 1, and plan details come out in early October.
Your county and your ZIP code decide which Medicare Advantage plans you can join. A plan sold in McAllen may not be sold in Rio Grande City, and the same plan name can carry different benefits in each place. Your address sets your list.
How many plans Hidalgo County has
Hidalgo County is one of the more competitive Medicare markets in the country. There are many plans to choose from, and many of them charge no premium of their own. A premium is the monthly bill for the coverage.
The large local health systems are well represented in the networks. A network is the list of doctors and hospitals a plan has a contract with.
Starr, Cameron and Willacy counties have their own sets of plans. They overlap with ours but are not the same.
How to look plans up yourself
Work through the Plan Finder in this order.
- Go to the Plan Finder at Medicare.gov.
- Enter your ZIP code, not just your city.
- Enter every medicine you take, with the dose. People skip this step, and it changes the results more than anything else.
- Add the pharmacy you use.
- Sort by total estimated yearly cost, not by premium.
That last step moves the list around a lot. Premium alone tells you very little about what a year will cost. See why a zero premium is not the number to compare.
How to narrow a long list down
You do not have to study every plan. Three questions rule most of them out quickly.
- The network, the list of doctors and hospitals under contract. Are your doctors and your hospital in that plan for next year? See how to check.
- The formulary, the plan's list of covered drugs. What do your prescriptions cost on it, at your own pharmacy?
- The out of pocket maximum, the most the plan can make you pay in a year for covered care. What would a bad year cost?
Whatever is still standing after those three is worth a close look. Extra benefits are a tiebreaker, not the place to begin. See how to compare the plans that are left.
If you are dual eligible
Dual eligible means you have Medicare and Medicaid at the same time. If you have Medicaid, or qualify for a Medicare Savings Program that helps pay your Medicare costs, there is a type of plan built for that situation. It leaves you paying much less. See dual eligible special needs plans.
Check this even if you assume your income is too high. The limits on those savings programs are higher than most people expect.
Why we do not list the plans on this page
What is offered, what it costs and what it covers change every year and by ZIP code. Medicare also has rules about how an agency shows plan details in public marketing. Anything we printed here would be wrong by January.
It also would not answer the question that matters to you, which is how a plan treats your doctors and your medicines. As an independent agency we can pull what is offered at your address and lay it beside your prescriptions and your doctors. That costs you nothing and takes about an hour.
Your ZIP code decides your list, so start there. Enter your ZIP code and a licensed agent calls you back with the plans sold at your address.
When to check: every fall
Annual Enrollment runs October 15 through December 7, for coverage that starts January 1. Plan details for the coming year come out in early October, so the window for comparing is short.
Start in October, not the last week of November. See what to do during Annual Enrollment.
Pull your list by ZIP code, then check your doctors and your medicines against the few plans that are left. If you would rather have someone do that with you, call our McAllen office at (956) 687 3334, or enter your ZIP code in the plan pricing box on this page.
Common follow-up questions
Why do my options differ from my neighbor's?
Usually a different ZIP code, or different eligibility. Having Medicaid along with Medicare opens plan types others cannot join.
Can I join a plan from another county?
No. Each plan has a service area, the counties where it is sold, and you have to live in it. Moving out opens a special enrollment window, a period when you may change plans outside the fall dates.
Does the plan list change every year?
Yes. Plans come and go each year, and benefits reset on January 1. Checking every fall is the only way to stay current.
Want this looked at properly?
We are an independent agency in McAllen serving Hidalgo, Cameron and Starr counties. There is no obligation to talk it through.
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Gerino Alejos
Licensed insurance agent · License 3128710 · NPN 18243381
Owner of McAllen Insurance Group, an independent agency on North 10th Street in McAllen. Works with clients across Hidalgo, Cameron and Starr counties on Medicare, Marketplace health, life and auto coverage. Se habla español.