Here are details for HMO-POS Preferred

If you’d like help choosing a Medicare Advantage plan from Baylor Scott & White Health Plan, please call 1.833.975.08411.833.975.0841 (TTY: 711) to speak to a licensed insurance agent.

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Below are plan details for 2027.

BSW SeniorCare Advantage HMO-POS Preferred (Central Texas)

Best for members looking for a balance between premium and healthcare expenses. Offers a higher monthly premium in exchange for lower out-of-pocket costs for covered services and is a good fit for those with prescription drug coverage through another source.

Monthly Premium $65

Deductible $0

Out-of-Pocket Maximum $4,500

Annual Physical Exam $0 copay

Primary Care Physician (PCP) Office Visit $0 copay

Specialty Care Physician (SCP) Office Visit $30 copay

Telehealth Visit (PCP, SCP, urgent care, psychiatry and mental health services) $0 copay

Diagnostic Tests, X-rays, Lab Services(separate office visit copay may apply) $0 copay

Advanced Diagnostic Imaging Services (MRI, MRA, SPECT, CTA) $0-$15 copay

Physical/Occupational/Speech Therapy(per visit) $25 copay

Inpatient Hospital $700/stay

Inpatient Mental Health $700/stay

Skilled Nursing Facility (SNF) Day 1-20: $0/day
Day 21-100: $125/day

Outpatient Surgery(facility) $15 copay

Ambulatory Surgical Center(facility) $100 copay

Ambulance(ground and air) $75 copay

Emergency Care(within the U.S.; copay waived if admitted within 24 hours) $130 copay

Urgent Care(within the U.S.; copay waived if admitted within 24 hours) $40 copay

Durable Medical Equipment (DME) 20% coinsurance

Podiatry $15 copay

Chemotherapy Drugs 0%-20% coinsurance

Other Part B Drugs 0%-20% coinsurance

Heart Health Program* Not applicable

Deductible Not applicable

Tier 1 – Preferred Generic Drugs Not applicable

Tier 2 – Generic Drugs Not applicable

Tier 3 – Preferred Brand Drugs Not applicable

Tier 4 – Non-Preferred Drugs Not applicable

Tier 5 – Specialty Drugs Not applicable

Mail Order Copays Not applicable

Total Out-of-Pocket You Pay Before Catastrophic Coverage Not applicable

Catastrophic Coverage Amounts – You Pay Not applicable

Additional Monthly Premium $30

Deductible $0

Annual Dental Benefit Maximum $2,000

Dentures (every 5 years) 50% coinsurance

Fillings (One filling per surface, per tooth every 24 months) 50% coinsurance

Root Canals 75% coinsurance

Periodontal Maintenance (deep cleaning) 50% coinsurance

Extractions 50% coinsurance

Routine Eye Exam(one per year) $0 copay

Eyewear(annually) $125 allowance

Routine Hearing Exam(one per year) $0 copay

Hearing Aids(every 3 years) $1,000 allowance

Fitness Membership (Home fitness programs, activity tracker, and/or gym/fitness club membership at participating locations) $0

In-Home Meals(14 meals per hospital discharge to home; limit 3 discharges per year) $0 copay

Routine Transportation (up to 24 one-way trips per year, or 12 round trips up to 50 miles each way) $0 copay

*Special Supplemental Benefits for the Chronically Ill (SSBCI) are available only to qualifying members with chronic heart failure. Having chronic heart failure alone does not automatically qualify you for these benefits. Eligibility also depends on meeting the Centers for Medicare & Medicaid Services’ definition of a chronically ill enrollee and the Plan’s SSBCI eligibility criteria.

Want help comparing your plans and benefits—and finding the right choice for your needs? Are you ready to enroll?

Call 1.833.975.08411.833.975.0841 (TTY: 711) to speak with a licensed insurance agent.

October 1 – March 31: 7 days a week, 8:00 AM – 8:00 PM
April 1 – September 30: Monday – Friday, 8:00 AM – 5:00 PM
Closed on major holidays.

Para hablar con un representante en español, llame a 1.833.412.33201.833.412.3320.

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