Medicare Advantage plans in San Antonio & the Hill Country.

What is Medicare Advantage?

Medicare Advantage — also called Part C — is an all-in-one alternative to Original Medicare offered by private insurance carriers approved by Medicare. Instead of getting your hospital coverage (Part A) and medical coverage (Part B) directly from the federal government, you get both through a private plan that's required to cover everything Original Medicare covers — usually with extra benefits bundled in.

Most Medicare Advantage plans in San Antonio and the Texas Hill Country bundle in prescription drug coverage (Part D), and many include dental, vision, hearing, fitness memberships, and over-the-counter allowances — benefits Original Medicare doesn't cover.

How Medicare Advantage works in San Antonio

When you enroll in a Medicare Advantage plan, your Part A and Part B benefits are administered by the private carrier (like Humana, UnitedHealthcare, or Aetna) instead of CMS. You still pay your Part B premium to Medicare, plus any additional premium the plan charges — though many plans in Bexar, Kendall, and Comal counties charge $0/month beyond the Part B premium.

You'll get an insurance card from your Medicare Advantage carrier, and that's the card you'll show at every doctor visit, pharmacy, and hospital. Your red, white, and blue Medicare card stays in your drawer at home.

Types of Medicare Advantage plans

HMO (Health Maintenance Organization)

The most common type in San Antonio. You pick a primary care physician (PCP) and need referrals from them to see specialists. You must use in-network providers except for emergencies. Lower premiums, lower out-of-pocket costs — but less flexibility.

PPO (Preferred Provider Organization)

More flexibility than HMO. You can see out-of-network providers, but you'll pay more. No referrals needed for specialists. Common in the Hill Country if you travel between Texas counties or visit family in another state regularly.

HMO-POS (Point of Service)

An HMO with limited out-of-network coverage. You'll pay more to go outside the network, but you have the option. Less common, but worth comparing.

SNP (Special Needs Plan)

Designed for people with specific conditions (like diabetes or chronic heart failure), people who qualify for both Medicare and Medicaid (D-SNP), or people living in long-term care facilities. These plans are tailored to specific health situations.

Medicare Advantage vs. Medicare Supplement

The most common question Mark gets: "Should I go with Medicare Advantage or Medicare Supplement?" There's no universal right answer — it depends on your health, doctors, prescriptions, budget, and how much you travel.

Feature	Medicare Advantage	Medicare Supplement
Monthly premium	Often $0 (plus Part B)	$100–$300+ (plus Part B)
Network	Usually restricted	Any doctor that takes Medicare
Drug coverage	Usually included	Buy separate Part D plan
Dental/vision/hearing	Often included	Not included
Out-of-pocket maximum	Yes (federal cap)	Predictable, but no cap
Out-of-state travel	Limited (PPO better)	Excellent — works nationwide
Underwriting required	No (guaranteed issue)	Often yes (after open enrollment)

Who Medicare Advantage typically fits best

• People who want low monthly costs. A $0 premium plan is attractive if you're on a fixed income.
• People who stay in the San Antonio area. If your doctors are local and you don't travel much, network restrictions matter less.
• People who want all-in-one coverage. Drug, dental, vision, hearing bundled = one card, one plan, one renewal.
• People who use extra benefits. Gym memberships, OTC allowances, transportation to doctor appointments, meal delivery after hospital stays — these add real value if you'll use them.
• People healthier than average. Lower premiums work in your favor if you don't see doctors often. Higher copays only hit if you use care heavily.

Who should think twice about Medicare Advantage

• You see specialists across multiple states. Networks usually don't follow you out of Texas.
• You have a specialist you can't lose. If your cardiologist at Methodist Stone Oak or your oncologist at MD Anderson isn't in-network, the plan is wrong for you.
• You want completely predictable monthly costs. Medicare Advantage has lower premiums but variable copays. Medicare Supplement is the opposite.
• You travel internationally often. Most Medicare Advantage plans only cover emergency care abroad. Some Supplement plans (Plan G especially) cover foreign travel emergencies better.

Major carriers offering Medicare Advantage in San Antonio

Mark represents multiple carriers and compares plans across all of them. The major carriers active in Bexar, Kendall, and Comal counties include:

When can you enroll in Medicare Advantage?

Initial Enrollment Period (IEP)

The 7-month window around your 65th birthday — 3 months before your birth month, your birth month, and 3 months after. This is when most people first enroll.

Annual Enrollment Period (AEP)

October 15 – December 7 every year. Anyone with Medicare can join, switch, or drop a Medicare Advantage plan. Changes take effect January 1.

Medicare Advantage Open Enrollment Period (MA-OEP)

January 1 – March 31 every year. Only for people already enrolled in a Medicare Advantage plan. You can switch to a different Advantage plan or drop back to Original Medicare. One change allowed.

Special Enrollment Periods (SEPs)

Triggered by life events: moving out of your plan's service area, losing employer coverage, qualifying for Extra Help, etc. SEPs let you make changes outside the standard windows.

What does Medicare Advantage cost?

It varies. Here's what you'll pay:

• Part B premium: Always required. $185/month standard in 2026 (higher if your income is over $103,000 individual / $206,000 joint).
• Plan premium: $0 to $200+/month depending on the plan. Many San Antonio plans are $0.
• Copays and coinsurance: What you pay when you actually use care. Varies by service and plan.
• Out-of-pocket maximum: Federal law caps your annual out-of-pocket spending. 2026 cap is $9,350 for in-network care.

How Mark compares Medicare Advantage plans for you

Mark's process is straightforward and takes about 20 minutes:

1. You tell him what matters. Doctors you want to keep, medications you take, monthly budget, whether you travel.
2. He runs your specifics against every Advantage plan in your ZIP. He'll check if your cardiologist at Methodist Stone Oak is in-network, whether your prescriptions are on the formulary, what your real estimated annual cost will be.
3. He brings you the 2–3 that actually fit. Not a sales pitch — a comparison with the trade-offs spelled out.
4. You decide. If you want to enroll, he handles the paperwork. If you want to think, take your time.