Plans as low as $0 monthly premiums
Find the right Medicare plan for you
- 2024 Medicare Advantage Plan Facts for De Kalb
- Why Choose a Medicare Advantage Plan?
- Medicare Advantage Companies in De Kalb
- Top 5 Medicare Advantage Insurance Companies in De Kalb
- 2024 De Kalb Medicare Advantage Plans
- Top 9 Medicare Advantage Plans with the Highest Star Ratings in De Kalb
- Types of Medicare Advantage Plans Available in De Kalb
- When to Enroll in a Medicare Advantage Plan in De Kalb
- Medicare Doctors Near Me in De Kalb, Texas
- Frequently Asked Questions
While there are 182 Medicare Advantage plans in Texas, there are 23 plans available to you in De Kalb, Texas. De Kalb is located in Bowie County. Connie Health gathered the plan cost and coverage information that matters most to you. Continue reading to discover the Medicare Advantage plan right for your health & budget and when to enroll.
2024 Medicare Advantage Plan Facts for De Kalb
- 40.97% of Medicare beneficiaries are enrolled in a Medicare Advantage plan in De Kalb.
- All Medicare beneficiaries in De Kalb have access to a $0 premium plan.
- There are 18 $0 premium Medicare Advantage plans available in De Kalb.
- For those that pay a premium, the average is $85.40 per month.
- The average out-of-pocket maximum is $5,904.55 per year.
- The average prescription drug plan deductible (for plans that include Part D) is $382.00 per month.
- There are 6 plans available in De Kalb that Medicare rated four stars or higher.
- There are 3 Medicare Advantage plan types you can choose from, including: Local HMO, Local PPO, Regional PPO.
Speak with a local licensed insurance agent
(Monday-Saturday 8am - 8pm, Sunday 9am - 5pm)
No obligation to enroll
1-888-813-8911(TTY: 711)
Why Choose a Medicare Advantage Plan?
There are three primary reasons you may choose to enroll in a Medicare Advantage plan:
- Low or no-cost monthly premiums,
- Lower out-of-pocket costs, and
- Additional benefits such as comprehensive dental, vision, hearing, and more.
1. Low or no-cost monthly premiums
You have access to a Medicare Advantage plan as low as $0 monthly. If you don't qualify for a $0 premium plan, the average is $85.40 per month. This premium is low, especially compared to a Medicare Supplement plan or your Part B premiums.
2. Lower out-of-pocket costs
Original Medicare doesn't cap their out-of-pocket costs, so you could end up with unexpectedly high medical bills. With Original Medicare Part B, you must pay the premium, deductible, and 20% coinsurance for Medicare-approved services and procedures. The 20% can add up.
3. Additional benefits not available with Original Medicare
Want routine dental coverage? Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) don't offer comprehensive dental, vision, or hearing coverage. These services would be entirely out-of-pocket for you.
The good news? Medicare Advantage plans have low or no-cost premiums, an out-of-pocket maximum, offer additional benefits, and are regulated by the Centers for Medicare & Medicaid Services (CMS). With a Medicare Advantage plan, you could receive prescription drug coverage, routine dental, vision, hearing, transportation, reduced cost-sharing, a gym membership, and more.
Medicare Advantage Companies in De Kalb
5 insurance companies offer Medicare Advantage plans in De Kalb.
| Medicare Advantage Insurance Companies in De Kalb |
|---|
| Aetna Medicare |
| Blue Cross and Blue Shield |
| CHRISTUS Health Advantage |
| Humana |
| UnitedHealthcare |
Top 5 Medicare Advantage Insurance Companies in De Kalb
These 5 Medicare Advantage insurance companies enroll the largest amount of Medicare beneficiaries in De Kalb. They offer the most popular plans.
| # | Medicare Advantage Insurance Companies in De Kalb |
|---|---|
| 1 | Cha Hmo, Inc. |
| 2 | Humana Insurance Company |
| 3 | Sierra Health And Life Insurance Company, Inc. |
| 4 | Care Improvement Plus South Central Insurance Co. |
| 5 | Unitedhealthcare Community Plan Of Texas, L.L.C. |
2024 De Kalb Medicare Advantage Plans
There are 23 Medicare Advantage plans to choose from in De Kalb. Below are the many available options. Click on any of the links to review additional plan details.
| Medicare Advantage Plan Name | Plan Type | Monthly Plan Premium | Maximum Out-of-Pocket | Rx Deductible | Medicare Star Rating |
|---|---|---|---|---|---|
| HumanaChoice H5216-043 (PPO) | Local PPO | $0.00 | $6,700.00 | $0.00 | 4.5 |
| Humana USAA Honor (PPO) | Local PPO | $0.00 | $5,400.00 | - | 4.5 |
| Humana USAA Honor (PPO) | Local PPO | $0.00 | $6,900.00 | - | 4.5 |
| HumanaChoice H5216-358 (PPO) | Local PPO | $0.00 | $7,500.00 | $395.00 | 4.5 |
| Humana Gold Plus H0028-043 (HMO) | Local HMO | $0.00 | $4,700.00 | $0.00 | 4 |
| AARP Medicare Advantage from UHC TX-0010 (HMO-POS) | Local HMO | $0.00 | $5,900.00 | $0.00 | 4 |
| Aetna Medicare Choice Plan (PPO) | Local PPO | $0.00 | $6,350.00 | $250.00 | 3.5 |
| HumanaChoice R4182-001 (Regional PPO) | Regional PPO | $0.00 | $5,100.00 | - | 3.5 |
| HumanaChoice R4182-003 (Regional PPO) | Regional PPO | $72.00 | $6,900.00 | $175.00 | 3.5 |
| HumanaChoice R4182-004 (Regional PPO) | Regional PPO | $49.00 | $6,900.00 | $275.00 | 3.5 |
| UHC Medicare Advantage TX-0030 (Regional PPO) | Regional PPO | $48.00 | $7,550.00 | $395.00 | 3.5 |
| CHRISTUS Health Medicare Complete (HMO) | Local HMO | $0.00 | $4,400.00 | $0.00 | 3 |
| CHRISTUS Health Medicare Plus (HMO) | Local HMO | $20.00 | $4,400.00 | $0.00 | 3 |
| CHRISTUS Health Medicare Guardian (HMO) | Local HMO | $0.00 | $4,400.00 | - | 3 |
| Blue Cross Medicare Advantage Complete (PPO) | Local PPO | $0.00 | $5,900.00 | $0.00 | 3 |
| Blue Cross Medicare Advantage Flex (PPO) | Local PPO | $238.00 | $0.00 | $545.00 | 3 |
| Blue Cross Medicare Advantage Dental Premier (PPO) | Local PPO | $0.00 | $6,700.00 | $545.00 | 3 |
| Blue Cross Medicare Advantage Health Choice (PPO) | Local PPO | $0.00 | $6,900.00 | $545.00 | 3 |
| Blue Cross Medicare Advantage Protect (PPO) | Local PPO | $0.00 | $6,350.00 | - | 3 |
| Blue Cross Medicare Advantage Value (HMO) | Local HMO | $0.00 | $3,850.00 | $0.00 | 3 |
| Blue Cross Medicare Advantage Dental Value (HMO) | Local HMO | $0.00 | $3,850.00 | $545.00 | 3 |
| Blue Cross Medicare Advantage Saver (HMO) | Local HMO | $0.00 | $6,900.00 | $0.00 | 3 |
Top 6 Medicare Advantage Plans with the Highest Star Ratings in De Kalb
The Centers for Medicare and Medicaid Services (CMS) rates all Medicare Advantage plans on a scale of 1 to 5 stars. Plans with one star are considered “poor,” while those with five stars are considered “excellent.” Any plan that is four stars and higher is a “top-rated” plan. These are the plans with the highest star ratings in De Kalb.
| # | Plan Name | Plan Type | Monthly Plan Premium | Maximum Out-of-Pocket | Rx Deductible | Medicare Star Rating |
|---|---|---|---|---|---|---|
| 1 | HumanaChoice H5216-043 (PPO) | Local PPO | $0.00 | $6,700.00 | $0.00 | 4.5 |
| 2 | Humana USAA Honor (PPO) | Local PPO | $0.00 | $5,400.00 | - | 4.5 |
| 3 | Humana USAA Honor (PPO) | Local PPO | $0.00 | $6,900.00 | - | 4.5 |
| 4 | HumanaChoice H5216-358 (PPO) | Local PPO | $0.00 | $7,500.00 | $395.00 | 4.5 |
| 5 | Humana Gold Plus H0028-043 (HMO) | Local HMO | $0.00 | $4,700.00 | $0.00 | 4 |
| 6 | AARP Medicare Advantage from UHC TX-0010 (HMO-POS) | Local HMO | $0.00 | $5,900.00 | $0.00 | 4 |
Find the right Medicare plan for you
Types of Medicare Advantage Plans Available in De Kalb
There are 3 Medicare Advantage plan types you can choose from in De Kalb. These include: Local HMO, Local PPO, Regional PPO. Not sure which is the best plan for your health needs and budget? We'll walk you through the most popular plan types: Local HMO, Local PPO, Regional PPO. At the end of this section, you'll understand the difference between these three most popular plan types.
Medicare Advantage HMO Plans
You have 8 Medicare Advantage HMO plans to choose from in De Kalb. An HMO, or Health Maintenance Organization, is a type of health plan that limits coverage to in-network care from doctors who work for or contract with the HMO. Typically, HMO plans won't cover out-of-network care except in an emergency.
Medicare Advantage PPO Plans
There are 15 Medicare Advantage PPO plans in De Kalb. A PPO, or Preferred Provider Organization, is a type of health plan where you pay less to use doctors in the plan's network. Unlike an HMO, you can see doctors and specialists and use a hospital outside the network without a referral for an additional cost.
Medicare Advantage Special Needs Plans (SNPs)
Special Needs Plans, or SNPs, are a type of Medicare Advantage plan. There are two types of Special Needs Plans that may be available to you: Chronic Special Needs Plans (C-SNP) and Dual Special Needs Plans (D-SNP).
Chronic Special Needs Plans (C-SNP) are limited to people with specific illnesses or characteristics. For example, you may qualify for a C-SNP if you have diabetes, End-Stage Renal Disease (ESRD), HIV/AIDS, dementia, chronic heart failure, or other qualifying illness. Medicare C-SNPs tailor benefits, provider choices, and drug formularies to meet the needs of the special needs groups they serve.
You may qualify for a Dual Special Needs Plan (D-SNP) if you are eligible for Medicare and Medicaid. With a D-SNP, the State of Texas may cover your Medicare costs, depending on your eligibility.
Veteran Benefits & Medicare
If you or your spouse are veterans, you likely have VA benefits. However, the U.S. Department of Veteran Affairs encourages you to sign up for Medicare as soon as you are eligible. Here are three reasons you should speak to a local licensed agent about how VA benefits and Medicare work together:
- Having Medicare means you're covered when you need care from a non-VA hospital or doctor, which also offers you greater health options.
- VA benefits and health care could change in the future, so you should enroll in every health care benefit that you are eligible for.
- If you lose VA benefits and aren't enrolled in Medicare, you could face Medicare Part B and Part D lifetime late enrollment penalties.
Speak with a local licensed insurance agent
(Monday-Saturday 8am - 8pm, Sunday 9am - 5pm)
No obligation to enroll
1-888-813-8911(TTY: 711)
When to Enroll in a Medicare Advantage Plan in De Kalb
Knowing when to enroll or make plan changes can help you save money.
Enrolling in a Medicare Advantage plan for the first time, or are you interested in making a plan change? Skip to the section that applies to you - and mark the dates in your calendar.
Enroll for the First Time
If you're new to Medicare, the best time to enroll in a Medicare Advantage plan is during your Initial Enrollment Period. If you miss that, you can still enroll during the General Enrollment Period (January 1 - March 31) or Special Enrollment Period, but likely with penalties.
Make a Plan Change
The best time to make a plan change is during the Medicare Annual Enrollment Period (October 15 - December 7). During this time, anyone enrolled in Medicare can review their plan options for the coming year and ensure that their plan choice meets their health and budget needs.
If you need to make a plan change because you moved to a new service area or lost coverage, among other reasons, you could qualify for a Special Enrollment Period.
Whether you're enrolling for the first time or making a plan change, a Medicare Advantage plan could fit your health and budget needs. Medicare in Texas can be confusing, and you don't have to sift through your options alone.
Medicare Doctors Near Me in De Kalb, Texas
Struggling to find a trustworthy doctor who accepts your Medicare plan? It can be a daunting task but don't worry. With Connie Health, you can easily locate Medicare doctors near you.
No more endless phone calls or web searches. Our platform lets you enter your address and plan information (if you have it), and we'll do the rest. Let us help you eliminate the stress of finding a physician who accepts Medicare.
Why Connie Health
Local licensed insurance agents:
Independent agents, who live and work in your community, can help you access the best care for you in your area.
Compare all major insurance:
Our technology will help you find the plan that best fits your budget and health needs.
Our service is free:
You receive unbiased advice since our agents receive the same commission regardless of the insurance plan selected.
Ongoing support:
Once you have selected an insurance plan, your dedicated team will help you use your benefits and answer your questions.
Speak with a local licensed insurance agent
(Monday-Saturday 8am - 8pm, Sunday 9am - 5pm)
No obligation to enroll
1-888-813-8911(TTY: 711)
Frequently Asked Questions
Let us help you eliminate the stress of finding a physician who accepts Medicare. Find your Medicare doctor today.
- Compare the costs, including premiums, deductibles, co-pays, and out-of-pocket maximums.
- Look into the plan's network of doctors and hospitals.
- Review the additional benefits offered, such as dental, vision, and hearing coverage.
- Check the plan's star rating, which indicates its quality and performance.
- Ensure the plan covers your medications if you need prescription drug coverage.
- Compare costs, coverage options, and additional benefits.
- Review each plan’s network of providers.
- Check the star ratings for quality and performance.
- Evaluate customer reviews and feedback.
Medicare Advantage plans may be available in the following zip codes in De Kalb, Texas: 75559.
Sources
“Explore your Medicare coverage options.” Medicare.gov.
“MA State/County Penetration.” CMS.gov.
“Monthly MA Enrollment by State/County/Contract.” CMS.gov.
“Prescription Drug Coverage - General Information.” CMS.gov.
“VA healthcare and other insurance.” U.S. Department of Veterans Affairs (VA.gov).
Last updated: November 5, 2024