Medicare Advantage Plans in Texas: 2026 Best Plans by Region

The Medicare Advantage market in Texas is one of the most competitive in the United States, offering over 250 plan options across the state and over 25 carriers offering Medicare Advantage plans in Texas's 254 counties for 2026. There are 40+ Medicare Advantage plans in the Dallas-Fort Worth metro area alone, among the most competitive MA markets in the country. In Travis County (Austin), the two largest plans – UnitedHealthcare and Humana – have a combined share of 77% of Medicare Advantage enrollment, one of the highest concentration rates in the nation, according to KFF's analysis of Medicare Advantage enrollment in 2025.

This guide covers what's on offer in Texas for 2026, the CMS Star Ratings of the carriers, the unique Medicaid policy in Texas and its impact on dual-eligible beneficiaries, and how to select among competing plans in your county. Data for information is provided in CMS 2026 Star Ratings, KFF, Medicare.gov and Texas Department of Insurance. 

The Texas Medicare Advantage market in 2026

Texas has approximately 4.5 million Medicare beneficiaries, with about 53% enrolled in Medicare Advantage as of 2025. The market has several distinctive features:

Multiple competing carriers. Medicare.org's 2026 Texas plan list includes Aetna, Anthem Blue Cross Blue Shield (in some counties), Baylor Scott & White Health Plan, Devoted Health, Humana, KelseyCare Advantage, Mutual of Omaha, UnitedHealthcare, Wellcare, and several specialty regional carriers. Cigna sold its Medicare business to Health Care Service Corporation (HCSC, the BCBS Texas parent) in early 2024, consolidating market presence.

Geographic variation. Urban Texas (DFW, Houston, San Antonio, Austin) has dense plan competition. Rural Texas (West Texas, the Panhandle, deep South Texas) has limited options, with some counties offering fewer than 5 plans.

Texas does not expand Medicaid. Unlike 41 expansion states, Texas operates a non-expanded Medicaid program. This affects dual-eligible beneficiaries differently than in expansion states, with stricter income and asset rules and narrower categorical eligibility. The practical impact: D-SNP (dual-eligible Special Needs Plan) eligibility is harder to qualify for in Texas than in expansion states.

HCSC concentration in Blue Cross. Blue Cross and Blue Shield of Illinois, New Mexico, Oklahoma, and Texas (collectively HCSC) operate as a single Medicare Advantage entity. CMS rated this combined contract at 2 stars (the lowest tier) for 2026, per Healthcare Finance News reporting, creating shopping caution for Texas BCBS members.

Top-rated Medicare Advantage plans in Texas 2026

Per NerdWallet's analysis of CMS 2026 Star Ratings data, the highest-rated Medicare Advantage plans available in Texas:

5-star plans (the only ones in Texas for 2026):

• Devoted Health

• UnitedHealthcare (specific contracts only, not all UHC plans)

4.5-star plans:

• Alignment Health Plan

• Humana (specific contracts)

• KelseyCare Advantage (Houston-area only)

• Prominence

• UnitedHealthcare (additional contracts)

A practical observation: only 34 plans nationwide earned 5 stars from CMS for 2026, so having two 5-star options available in Texas is meaningful. Devoted Health is a relatively new MA carrier (founded 2017) that's rapidly expanded in Texas; KelseyCare Advantage is a Houston-area plan affiliated with the Kelsey-Seybold Clinic system that's particularly strong for members in the Texas Medical Center area.

J.D. Power 2025 satisfaction scores tell a different story than Star Ratings. UnitedHealthcare scored 617 in Texas; Humana scored 616. Both fall on the lower end of J.D. Power's regional MA scoring, suggesting Texas members have more service complaints than members in some other states. Star Ratings measure clinical and operational quality. J.D. Power measures member experience. The two often diverge.

Best Medicare Advantage by Texas region

Texas's geography creates meaningfully different MA decision-making by region. Here's what 2026 looks like by metro area:

Dallas-Fort Worth metroplex. Most competitive market in Texas. Counties like Collin (McKinney, Plano, Frisco, Allen) typically have 40+ plan options. UnitedHealthcare, Aetna, Humana, and Baylor Scott & White Health Plan dominate. PPO availability is strong; HMO networks are deep.

Houston metro. Major carriers include UnitedHealthcare, Humana, KelseyCare Advantage, Aetna, Cigna (now under HCSC), and Wellcare. Houston's medical center concentration creates strong specialty network options. KelseyCare Advantage's affiliation with the Kelsey-Seybold Clinic and Memorial Hermann gives it particular strength in southwest Houston and Sugar Land.

Austin/Travis County. Highly concentrated market. UnitedHealthcare and Humana hold 77% combined market share. Other carriers exist (Aetna, Devoted) but face provider network challenges in the Austin Regional Clinic and Ascension Seton dominated medical landscape. Original Medicare with Medigap is often the better path in Travis County for those wanting maximum provider flexibility.

San Antonio/Bexar County. Strong Humana presence (San Antonio is Humana's historic strength market). UnitedHealthcare, Wellcare, and Aetna offer competitive alternatives. Methodist Healthcare and Baptist Health System dominate the provider landscape.

Rural Texas. Limited options outside major metros. Some counties in West Texas, the Panhandle, and the Texas-Mexico border region have only 3 to 5 MA plans. Original Medicare with a Medigap supplement often makes more sense in rural areas where MA networks are thin.

How Texas's non-Medicaid-expansion stance affects MA

Texas's decision not to expand Medicaid under the ACA has practical implications for Medicare Advantage shoppers, particularly older adults near retirement age:

• Dual-eligible (D-SNP) eligibility is narrower than in expansion states. Texas Medicaid for adults requires very low income (often below 17% of FPL for adults without dependent children) plus categorical eligibility (disability, age 65+ with stricter asset tests, etc.). Many Texans who would qualify for Medicaid in California or New York don't qualify in Texas

• D-SNP plan availability is correspondingly narrower. Carriers offer D-SNPs in Texas counties where dual-eligible populations are large enough to support them, mostly urban counties

• C-SNP options matter more. For Texans with chronic conditions who don't qualify for D-SNPs, C-SNPs (Chronic Condition Special Needs Plans) become a more important pathway to specialized coverage. Aetna's C-SNP expansion to 18 states in 2026 includes Texas, providing options for members with diabetes, chronic heart failure, or certain cardiovascular conditions

For Texas Medicare beneficiaries with limited income who fall into the gap between Medicare and full Medicaid, Medicare Savings Programs (which Texas operates separately from full Medicaid) can help with Part B premium and cost-sharing. The Texas Health and Human Services Commission administers these programs.

How to choose a Medicare Advantage plan in Texas

The practical broker-recommended process for Texas:

1. Check your specific county. Texas plan availability varies by county more than by state. Use Medicare.gov's plan finder with your ZIP code, not the general Texas list

2. Verify your providers. Major Texas hospital systems (Baylor Scott & White, Memorial Hermann, Methodist, HCA, Ascension) negotiate with each MA carrier separately. Confirm your specific doctors and hospital are in-network for the plan you're considering

3. Run your prescriptions through each plan's formulary. A 5-star plan with high-tier costs for your specific medications can cost more than a 4-star plan with better drug coverage

4. Compare total annual cost. Premium plus deductible plus expected copays plus prescription costs. The lowest-premium plan is rarely the lowest-cost plan

5. Consider Original Medicare with Medigap as an alternative. Texas Medigap pricing is competitive nationally. For someone wanting unrestricted access to any Medicare-accepting provider statewide and beyond, Plan G or Plan N often makes more sense than Medicare Advantage

For specific carrier comparisons relevant to Texas, see our AARP Medicare Advantage breakdown and Aetna Medicare Advantage analysis. For state-specific Medigap shopping, see our Florida Medicare Supplement guide, which discusses similar regional considerations.