The bottom line: Baylor Scott & White Health Plan Medicare Advantage plans are available in 50 Texas counties. It gets average government quality ratings, but scores well on measures of member experience. Competitors might offer more $0-premium options or plans available in more locations. Jump to: Full Review
Baylor Scott & White Medicare Advantage pros and cons
Pros
- Member experience: Baylor Scott & White Health Plan gets great member experience ratings on metrics including customer service and care coordination.
- Prescription drug deductibles: Baylor Scott & White Health Plan tends to offer more tiers of prescription drugs without a deductible than many competitors.
Cons
- Fewer $0-premium options: Baylor Scott & White Health Plan has fewer $0-premium plans than major Medicare Advantage companies.
- Limited availability: Baylor Scott & White plans are available only in 50 of the 254 counties in Texas.
Compare against other providers
🔍 UnitedHealthcare Medicare Advantage
» More options in our roundup of the best Medicare Advantage plans
Compare against other providers
🔍 UnitedHealthcare Medicare Advantage
» More options in our roundup of the best Medicare Advantage plans
Our full review
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NerdWallet star rating for Baylor Scott & White Medicare Advantage
Baylor Scott & White Medicare Advantage plans earned 3.8 out of 5 stars for overall performance. NerdWallet’s ratings are determined by our editorial team. The scoring formula takes into account premiums, out-of-pocket costs, government quality ratings, customer complaints, disenrollment survey data, third party quality accreditation and more.
NerdWallet star ratings are different from CMS ratings for Medicare plans.
Our data-driven, consumer-first scoring rubric for Medicare Advantage plans includes crucial metrics like cost and a wider range of data sources for quality and customer satisfaction in addition to the information incorporated into CMS ratings.
Government quality ratings for Baylor Scott & White Medicare Advantage
Average CMS rating, weighted by enrollment: 4
Baylor Scott & White Medicare Advantage plans are rated at the industry average, receiving an average rating of 4 stars out of 5 from CMS for 2026, weighted by enrollment. For comparison, the average weighted star rating for plans from all providers is 4.02.
Of Baylor Scott & White members who are in Medicare Advantage plans with a star rating, 100% are in plans that have been rated 4 stars or above for 2026.
CMS maintains its own database of star ratings, which rank each plan from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.
All Medicare Advantage plans are evaluated on health plan measures, and Medicare Advantage plans that include prescription drug coverage are also evaluated on drug plan measures.
You can find a plan’s rating with Medicare's plan finding tool.
How much does Baylor Scott & White Medicare Advantage cost?
About 50% of Baylor Scott & White Medicare Advantage plans have a $0 premium.
Baylor Scott & White plans with a monthly premium cost about $174.23 per month on average, weighted by enrollment.
Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $202.90 per month in 2026.
Most people pay this standard Part B amount, but if your income is above a certain threshold, you'll pay the income-related monthly adjustment amount (IRMAA). Some Medicare Advantage plans cover part or all of your Part B premium, but Baylor Scott & White plans don’t include this benefit.
Prescription drugs
About 71% of Baylor Scott & White Medicare Advantage plans include prescription drug coverage.
Here’s what you might pay for prescription drugs at some common price points.
Tier 1 (Preferred generics)
96.9% of Baylor Scott & White Medicare Advantage plans have $0 copays/coinsurance at this tier.
$3.75: Average out-of-pocket cost for a drug with a $15 retail price, among Baylor Scott & White plans with copays or coinsurance at Tier 1 (after deductible, if any).
Tier 2 (Most generics)
0% of Baylor Scott & White Medicare Advantage plans have $0 copays/coinsurance at this tier.
$10.11: Average out-of-pocket cost for a drug with a $50 retail price, among Baylor Scott & White plans with copays or coinsurance at Tier 2 (after deductible, if any).
Tier 3 (Preferred brands)
0% of Baylor Scott & White Medicare Advantage plans have $0 copays/coinsurance at this tier.
$46.55: Average out-of-pocket cost for a drug with a $200 retail price, among Baylor Scott & White plans with copays or coinsurance at Tier 3 (after deductible, if any).
Other out-of-pocket costs
Baylor Scott & White Medicare Advantage plans have an average maximum out-of-pocket (MOOP) spending cap of $5,518, weighted by enrollment. That’s a little lower than average among the companies NerdWallet reviews.
Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:
Whether the plan covers any part of your monthly Medicare Part B premium.
The plan’s yearly deductibles and any other deductibles, such as a drug deductible.
Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.
The plan’s in-network and out-of-network out-of-pocket maximums.
Whether your medical providers are in-network or out-of-network, or how often you may go out-of-network for care.
Whether you require extra benefits, and whether the plan charges for them.
To get a sense of costs, use Medicare’s plan finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Baylor Scott & White plans or compare across carriers.
Why do people leave Baylor Scott & White Medicare Advantage plans?
CMS surveys people who voluntarily leave their Medicare plans about their reasons for leaving. Here’s the breakdown of problems people identified with their former Baylor Scott & White Medicare plans.
Problems getting covered care: 13% (All-company average: 11%).
Problems with doctor/hospital networks: 19% (All-company average: 17%).
Financial issues: 20% (All-company average: 17%).
Problems with prescription drug benefits: 6% (All-company average: 3%).
Problems getting information from the plan: 5% (All-company average: 9%).
(Members can give more than one reason for leaving on the survey and might leave plans for other reasons, so the categories won’t add up to 100%.)
Baylor Scott & White Medicare Advantage plan types
Baylor Scott & White Medicare Advantage plan offerings include the following types:.
Health maintenance organization (HMO) point of service (POS) plans are HMO plans that allow members to get some out-of-network services, but they’ll pay more for those services.
Preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.
Baylor Scott & White Medicare Advantage service area
Baylor Scott & White Health Plan offers Medicare Advantage plans in 50 counties in Texas. The company covers just over 46,000 Medicare Advantage beneficiaries.
Compare Medicare Advantage providers
Get more information below about some of the major Medicare Advantage insurance companies. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.
Find the right Medicare Advantage plan
It’s important to do your research before selecting a Medicare Advantage plan for yourself. Here are some questions to consider asking:
What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?
Is your doctor in-network? If you have preferred medical providers, make sure they participate in the plan’s network.
Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?
Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?
Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
- High scores for measures of members' experience with Baylor Scott & White plans.
- More tiers of prescription drugs without a deductible than many competitors.
- Fewer $0-premium plan options than some competitors.
- Available only in 50 of Texas' 254 counties.
NerdWallet writers are subject matter authorities who use primary, trustworthy sources to inform their work, including peer-reviewed studies, government websites, academic research and interviews with industry experts. All content is fact-checked for accuracy, timeliness and relevance. You can learn more about NerdWallet's high standards for journalism by reading our editorial guidelines.
- 1.Centers for Medicare & Medicaid Services. 2026 Star Ratings Data Tables (ZIP). Accessed Apr 27, 2026.
- 2.Centers for Medicare & Medicaid Services. Monthly Enrollment by Plan. Accessed Apr 27, 2026.
- 3.NerdWallet analysis of CMS data. CY2026 Landscape 202603. Accessed Apr 27, 2026.
- 4.NerdWallet analysis of CMS data. Beneficiary Cost File. Accessed Apr 27, 2026.
- 5.NerdWallet analysis of CMS data. 2026 Star Ratings Data Table - Disenrollment Reasons (Oct 8 2025). Accessed Apr 27, 2026.
Medicare Advantage review methodology
NerdWallet’s Medicare Advantage ratings are based on premiums, out-of-pocket costs, prescription drug coverage, quality data from the Centers for Medicare & Medicaid Services, consumer experience and more. We calculate each health insurance company’s rating on a curved 5-point scale.
NerdWallet’s editorial team analyzed companies covering about 87% of all Medicare Advantage beneficiaries in the United States. We reviewed 25 Medicare Advantage brands, with some insurance companies having more than one brand under their umbrella. (For example, Blue Cross Blue Shield includes the brands Anthem and Highmark.)
The Medicare Advantage marketplace is concentrated among just a handful of companies. In many places, one company serves more than half of the market. At the national level, NerdWallet’s reviews include each of the 10 largest brands by enrollment.
At the state level, our research includes at least one major insurer in every state where Medicare Advantage plans are sold, and includes the top two insurers in 40 of those 49 states. (Alaska doesn't offer Medicare Advantage plans.) We also look at online search volume to identify regional and other notable players in the space.
These reviews are a guide, but we encourage you to shop around and compare several plans to find the best coverage and rate for you. NerdWallet does not receive compensation for any reviews. Read our editorial guidelines for additional information.
Compare Medicare Advantage plans
Insurance company | CMS star rating | States available | Members in high-rated plans | Member experience | Learn more | |
|---|---|---|---|---|---|---|
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 4.11 | 4.11/5 | 48 states and Washington, D.C. | Medium (50% to 84%) | 3.74 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 3.79 | 3.79/5 | 46 states and Washington, D.C. | Low (49% or less) | 3.82 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on http://askchapter.org on NerdWallet | 4.20 | 4.20/5 | 43 states and Washington, D.C. | Medium (50% to 84%) | 3.89 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on http://askchapter.org on NerdWallet |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 3.76 | 3.76/5 | 29 states and Washington, D.C. | Medium (50% to 84%) | 3.96 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet |