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Baylor Scott & White Health Plan Medicare Advantage 2024-2025 Review
Baylor Scott & White has good star ratings and happy members, but its plans are only available in parts of Texas.
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Alex Rosenberg Lead Writer | Medicare, health care, legislation
Alex Rosenberg is a NerdWallet writer focusing on Medicare and information technology. He has more than 10 years of experience researching and writing about health care, insurance, technology, data privacy and public policy. His research has supported lawmakers in the Wisconsin State Legislature as well as health systems and national health authorities in the U.S. and more than 10 other countries. He is based in Eau Claire, Wisconsin.
Holly Carey joined NerdWallet in 2021 as an editor on the team responsible for expanding content to additional topics within personal finance. She currently leads the Medicare team. Previously, Holly wrote and edited content and developed digital media strategies as a public affairs officer for the U.S. Navy. She is based in Virginia Beach, Virginia.
The bottom line: Baylor Scott & White Health Plan Medicare Advantage plans are available in 49 Texas counties. It gets above-average star ratings, scoring especially well on measures of member experience. But competitors might offer more $0-premium options or plans available in more locations.
Jump to: Full Review
Baylor Scott & White Health Plan
4.41
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
Baylor Scott & White Medicare Advantage pros and cons
Pros
Star ratings: Baylor Scott & White gets above-average star ratings from the Centers for Medicare & Medicaid Services (CMS) for 2025.
Member experience: Baylor Scott & White Health Plan gets great member experience ratings on metrics including customer service and care coordination.
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 49 of the 254 counties in Texas.
Compare against other providers
UnitedHealthcare
3.82
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
NerdWallet’s Medicare content, including articles, reviews and recommendations, is produced by a team of writers and editors who specialize in Medicare. Their work has appeared in The Associated Press, Washington Post, Nasdaq, MSN, MarketWatch, Yahoo! Finance and other national and regional media outlets. They have been cited in publications including Healthline, and appeared on NerdWallet's "Smart Money" podcast.
Baylor Scott & White Medicare star ratings
Average star rating, weighted by enrollment: 4.41
Baylor Scott & White Medicare Advantage plans are rated above the industry average, receiving an average rating of 4.41 stars out of 5 from CMS for 2025, weighted by enrollment
CMS maintains star ratings for Medicare Advantage plans on a 5-point scale, ranking plans 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.
. Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $174.70 per month in 2024 ($185 in 2025).
(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.)
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.
Baylor Scott & White Medicare Advantage plan types
Baylor Scott & White offers HMO and PPO Medicare Advantage plans. About two-thirds of Baylor Scott & White Medicare Advantage plans include prescription drug coverage.
Plan offerings include the following types:
HMO plans
A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.
HMO-POS plans
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.
PPO plans
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 49 counties in Texas. The company covers about 30,000 Medicare Advantage beneficiaries
Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.
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 a preferred medical provider or 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).
Baylor Scott & White Health Plan
4.41
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Baylor Scott & White sells Medicare Advantage plans in 49 Texas counties. It gets above-average star ratings from CMS, scoring especially well for member experience, but offers fewer $0-premium plans than some competitors.
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
States available
1 state
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
High (85% to 100%)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
4.64 (Above average)
IS THIS PROVIDER AVAILABLE IN MY STATE?
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
Pros
Above-average star ratings.
High scores for measures of members' experience with Baylor Scott & White plans.
Cons
Fewer $0-premium plan options than some competitors.
Available only in 49 of Texas' 254 counties.
States available
1 state
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
High (85% to 100%)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
4.64 (Above average)
IS THIS PROVIDER AVAILABLE IN MY STATE?
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
PROS & CONS
Pros
Above-average star ratings.
High scores for measures of members' experience with Baylor Scott & White plans.
Cons
Fewer $0-premium plan options than some competitors.
