Medicare Advantage

Scott & White Health Plan – 2019 Medicare Advantage Plan Overview

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Scott and White Health Plan offers Medicare Advantage and other health plans in 77 counties throughout the state of Texas. The company covered about 220,000 members with its individual, group, Medicare Advantage and Medicaid health plans in 2018. This number will increase to about 400,000 covered members in 2019 when Scott and White’s acquisition of FirstCare Health Plans gets finalized.

Scott and White Health Plan is a division of Baylor Scott & White Health. After a 2013 merger between Scott and White Healthcare and Baylor Health Care System, the resulting company became the Lone Star State’s biggest not-for-profit healthcare system. The insurance portion of the company has been in operation since 1982, beginning as an HMO with the name Centroplex Health Plan.

Today, Scott and White’s Medicare Advantage plans include both HMO and PPO options. Some of these plans include dental or prescription drug coverage. Members may have access to Medicare Advantage plans with $0 premiums. In addition to the basic benefits of Medicare Advantage, members can take advantage of online tools for account management and a 24/7 nurse line.

The Centers for Medicare and Medicaid Services (CMS) issued Scott and White’s SeniorCare Advantage HMO an overall rating of 4.5 stars out of 5.0 for 2019. The plan received 4.5 stars for its coverage of medical services and 4.0 stars for prescription drugs.

Scott and White Medicare Advantage Plans For 2019

U.S. News & World Report included Scott and White on its 2019 list of the Best Insurance Companies for Medicare Advantage. Only one other Texas insurer was awarded this distinction. On a 5.0 scale, the National Committee for Quality Assurance (NCQA) gave Scott and White’s 2017-2018 plans a score of 4.0 for customer satisfaction.

As with any Medicare Advantage plan, availability and pricing will depend on where you live, your age and gender, and other factors. But to give you an idea of what you might find with Scott and White in 2019, we’ve compared three of the company’s plans below using information for a 65-year-old man living in Bell County, Texas.

Scott and White Medicare Advantage (2019)
SeniorCare Advantage Basic PPO SeniorCare Advantage Platinum PPO SeniorCare Advantage Select HMO
Monthly premium $43 $150 $0
Copay (primary) $0 (in network) $0 (in network) $0
Deductibles $750 for medical $250 for drug (tiers 3-5) $0 for medical (in network) $50 for drug (tiers 3-5) $0 for medical $300 for drug (tiers 3-5)
Network Coverage for network and non-network care Coverage for network and non-network care In-network coverage only
Rx coverage? Yes Yes Yes
Rx cost $3 copay for tier 1 $0 copay for tier 1 $6 copay for tier 1
Special features Hearing aids, $125 for eyewear each year, and gym membership Routine dental, hearing aids, $125 for eyewear each year, and gym membership Routine dental, hearing aids, $125 for eyewear each year, and gym membership
Out-of-pocket max $6,200 (in network) $3,500 (in network) $5,300
CMS Star Rating N/A (too new) N/A (too new) 4.5

Many Medicare Advantage plans come with added benefits and features, like gym memberships or credits for over-the-counter purchases. Scott and White may offer these or other benefits depending on plan type, though the ones outlined above don’t appear to cover many added perks. When you’re shopping for a Medicare Advantage plan in 2019, look for these added benefits as a bonus. Since many Advantage plans cover the same kinds of care – and all Advantage plans cover at least what original Medicare covers – these added perks could make or break a plan for you.

If you’re not quite sure which Medicare Advantage plan will fit your needs for next year, let us help. We’re pros at helping people find the right plan for their life and budget. Get a customized quote today to see what’s available in your area.

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