If you have a Medicare Advantage plan in Texas, the letter in your mailbox this fall may carry more news than usual. The 2027 Texas Medicare Advantage changes are bigger than most years. Three plan sponsors are leaving the counties they served. Many $0 premium plans now have higher drug deductibles. The limit on what you can pay out of pocket also went up. If you are worried your coverage is about to change and you are not sure how, that worry makes sense. Here is what is changing and how to check your own situation before the deadline.
Yes, many Texas Medicare Advantage plans change in 2027, and some are ending. Blue Cross Blue Shield of Texas, Christus Health Plan and Memorial Hermann are all leaving Medicare Advantage in the counties they served, and many remaining plans have higher drug deductibles and higher out-of-pocket limits. You have until December 7 to compare plans and choose coverage that starts January 1, 2027.
Start with your hospital copay, not your premium
Most people shop by monthly premium. That is the wrong place to start. A $0 premium does nothing for you once you are admitted to the hospital.
Inpatient hospital copay means this: the set dollar amount your Medicare Advantage plan charges you for each day you stay in the hospital, usually for the first several days of each stay.
Many plans charge $300 to $500 a day for the first several days of a stay. Those days add up fast. Here is an example (not a specific Texas plan):
- This year: a plan charges $295 a day. A five-day stay costs you $1,475.
- Next year: the same plan raises it to $395 a day. That same five-day stay now costs $1,975.
- A second admission in the same year adds another full block of copays. In this example, two stays come to $3,950.
With Blue Cross, Christus and Memorial Hermann all leaving, many Texans are being moved into new plans. Most have never checked those plans’ hospital networks or daily copays. Before you pick a plan, find two things: which hospitals near you are in network, and what the plan charges per day.
Hospital indemnity insurance means this: a separate policy that pays you a set cash amount when you are admitted to the hospital, which you can use toward those daily copays.
Hospital indemnity and cancer plans exist to cover this gap. There is a catch you should know about. These plans usually ask health questions. After a serious diagnosis, you may no longer qualify. If a hospital stay would strain your savings, look at this coverage while you are healthy. If you have plenty set aside, you may decide to cover the copays yourself. Either way, it is your call to make, and it is worth making on purpose. You can learn more on our hospital indemnity insurance page.
Your hospital copay matters more than your premium the day you are admitted.
The 2027 Texas Medicare Advantage changes, plan by plan
Plan non-renewal means this: your plan’s sponsor has decided not to offer that plan in your county next year, so your coverage under it ends December 31.
Blue Cross Blue Shield of Texas
Blue Cross Blue Shield of Texas is leaving Medicare Advantage in all 227 Texas counties it served. That includes its Medicare Advantage plans, its MedicareRx stand-alone drug plans and its Dual Care Plus D-SNPs (plans for people with both Medicare and Medicaid). Its parent company, HCSC, will still offer HealthSpring Medicare Advantage plans in 47 Texas counties.
Rural West Texas is hit hardest. In Kent, Sterling, Pecos and Andrews counties, Blue Cross plans made up most of the PPO choices. In Kent and Sterling, the 2026 PPO choices were four Blue Cross plans and one UnitedHealthcare regional PPO. If you live there and like having a PPO, your choices just got much smaller.
Christus Health Plan in East Texas
Christus Health Plan is leaving all 36 of its East Texas counties, including Bowie, Cass and Red River. Its Medicare Complete, Medicare Plus and Medicare Guardian HMOs end after 2026.
Memorial Hermann in the Houston area
Memorial Hermann is leaving its six Houston-area counties, including Harris and Fort Bend.
If your plan is on this list, you need to choose new coverage for 2027.
Drug deductibles are higher on $0 premium plans
Drug deductible means this: the amount you pay for your prescriptions each year before your plan starts sharing the cost.
According to news reports, the average Medicare Advantage drug deductible rose from about $434 to $525. Many $0 premium plans in Dallas and Harris counties now carry drug deductibles of $595 to $685, as reported. The most any Part D plan can charge as a deductible in 2027 is $700, up from $615.
Here is what that looks like in real life. Say you take a brand-name drug. On a plan with a $685 drug deductible, you could pay up to $685 early in the year before the plan helps. On a plan with a $595 deductible, you would pay up to $90 less. That gap matters more than it looks if you are on a tight monthly budget in January and February.
There is good news too. In 2027, your out-of-pocket cost for covered drugs is capped at $2,400 for the year. Covered insulin is capped at $35 a month.
A $0 premium plan can still cost you hundreds of dollars at the pharmacy counter early in the year.
Higher out-of-pocket limits and fewer $0 premium choices
Out-of-pocket maximum means this: the most you will pay in a year for covered medical care in your plan’s network, after which the plan pays 100% of covered services.
For 2027, a plan’s in-network out-of-pocket maximum can be as high as $9,850, up from $9,250. On a PPO, the combined in-network and out-of-network limit can be as high as $14,800, up from $13,900. Not every plan sets its limit that high. But you should know your plan’s number before you need it. Hospital copays count toward this limit, and that is often how people reach it.
Choices are also shrinking in parts of the state. According to news reports, in Hidalgo County, plans open to everyone drop from 47 to 35, and $0 premium plans drop from 34 to 26. Also as reported, there are no regular $0 premium stand-alone Part D plans for 2027.
Fewer choices and higher limits mean comparing plans carefully matters more this year than last.
What happens if your plan is leaving
If your plan is ending, you are not left without health coverage. If you do nothing, you go back to Original Medicare on January 1. That sounds fine, but there are two problems. First, you may have no drug coverage at all. Second, Original Medicare has no yearly limit on your out-of-pocket costs.
Annual Enrollment Period means this: the yearly window, October 15 to December 7, when anyone with Medicare can change Medicare Advantage or Part D plans for the next year.
People whose plans are leaving get some extra time to choose, but waiting has a cost. If you pick a plan by December 7, your new coverage starts January 1 with no gap. You also have a little more protection: when your Medicare Advantage plan leaves your area, federal rules give you a limited window to buy certain Medigap (Medicare Supplement) plans without answering health questions.
If you are already in a Medicare Advantage plan, there is a second window from January 1 to March 31. During it you can make one change. Treat that as a safety net, not a plan.
The cleanest move is to choose your 2027 coverage before December 7.
Honest tradeoffs: how to decide
There is no single right answer. Here is how the choices compare in plain terms.
- Medicare Advantage vs Original Medicare with a Medigap plan: Medicare Advantage often has a low or $0 premium, but you pay copays as you go, including daily hospital copays, and you use a network. Medigap costs more each month but leaves you with small, predictable bills and lets you see any doctor who takes Medicare. You also need a separate Part D plan.
- HMO vs PPO: An HMO usually costs less but keeps you in network. A PPO lets you go out of network for a higher cost. In rural West Texas, PPO choices are now limited.
- With hospital indemnity vs without: With it, you pay a premium and get cash back if admitted. Without it, you keep the premium but cover every daily copay from savings.
A simple test: look at the daily hospital copay and the out-of-pocket maximum on any plan you are considering. Ask yourself, “Could I write that check this year without stress?” If yes, a lower-premium plan may work for you. If no, look at stronger coverage or a hospital indemnity plan. You can read more on our Medicare Advantage help page.
The right plan is the one whose worst year you can afford.
Your next step before December 7
Start with three things: your doctors, your prescriptions and the hospital you would want to go to. Then check whether each plan you are considering covers all three. If that feels like a lot, it is, and you do not have to do it alone. No pressure. No jargon. Just clear answers.
Find out in 3 minutes if your plan has hidden risks.
Take the free Medicare Clarity Score. It shows where your coverage may leave you exposed, including hospital copays and drug costs, before the December 7 deadline.
Prefer to talk it through? Call Scott at 512-844-3983 or set up a time to talk. We work for you, not the insurance companies.
Checking your plan now costs you nothing, and waiting past December 7 can cost you choices.
About the author: Scott Bowling is an independent Medicare broker with Trusted SR Solutions in the Round Rock, Texas area, licensed in multiple states. TX License #2882146.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Trusted SR Solutions is not connected with or endorsed by the U.S. government or the federal Medicare program.