BSW SeniorCare Advantage Preferred Rx (HMO-POS) Medicare Advantage Plan H8142-002 • 2027 • Lee County, TX
- Monthly Premium
- $152.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $5400.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $250.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Lee County, TX
- Local Enrollment
- 28 beneficiaries in Lee County
BSW SeniorCare Advantage Preferred Rx (HMO-POS) Introduction
This Medicare Advantage HMO-POS plan, BSW SeniorCare Advantage Preferred Rx, is offered by Baylor Scott & White Health Plan and uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network. It comes with prescription drug coverage. For the 2027 plan year, the monthly premium is $152.00, the medical deductible is $0.00, and the in-network maximum out-of-pocket is $5400.00. The plan is identified by CMS Plan ID H8142-002. The 2027 Part D prescription drug deductible is $250.00.
Qualifying residents of Lee County, Texas may enroll in this plan. CMS enrollment data reports 28 plan members in Lee County. New members can call the plan directly at (866)334-3141 (TTY 711) for assistance.
Compare Similar Plans in Lee County
Compare this plan with the two most-enrolled HMO-POS plans available in Lee County, Texas. Enrollment is based on CMS local enrollment data.
| Plan Detail | BSW SeniorCare Advantage Preferred Rx | BSW SeniorCare Advantage Select Rx | BSW SeniorCare Advantage Premium Rx |
|---|---|---|---|
| CMS Plan ID | H8142-002-0 |
H8142-001-0 |
H8142-003-0 |
| Local Enrollment | 28 | 97 | 27 |
| Monthly Premium | $152.00 | $0.00 | $258.00 |
| Medical Deductible | $0.00 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $5,400.00 | $7,150.00 | $5,000.00 |
| Part B Giveback | Not offered | Not offered | Not offered |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $30 copay | $30 copay | $0 copay |
| Part D Deductible | $250.00 | $500.00 | $250.00 |
| CMS Star Rating | 4.5 | 4.5 | 4.5 |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | $0 copay | $0 copay | $0 copay |
Plan Benefits
BSW SeniorCare Advantage Preferred Rx includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H8142-002.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H8142-002-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $30 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- Telehealth benefit
- In-network: $0 copay
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- Not covered
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $15 copay
- Lab services
- In-network: $0 copay
- Outpatient x-rays
- In-network: $0 copay
- Diagnostic tests and procedures
- In-network: $0 copay
Emergency and Urgent Care Services
- Emergency room care
- $130 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $40 copay
- Inpatient hospital care
- In-network:
Tier 1
$700 per stay - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$125 per day for days 21-100 - Ground ambulance
- In-network: $75 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $15 copay
- Outpatient group therapy
- In-network: $15 copay
- Inpatient psychiatric hospital care
- In-network:
Tier 1
$700 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $25 copay
- Occupational therapy
- In-network: $25 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
- Durable medical equipment
- In-network: 20% coinsurance
- Prosthetics
- In-network: 20% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
- Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Dental x-rays
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Cleaning
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Periodontics
- Not covered
- Endodontics
- Not covered
- Restorative services
- Not covered
- Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- Not covered
Vision Services
- Routine eye exam
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Contact lenses
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Eyeglass frames only
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Eyeglass lenses only
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Eyeglasses (frames & lenses)
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Upgrades
- Not covered
Hearing Services
- Hearing exam
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Fitting/evaluation
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Prescription hearing aids
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - OTC hearing aids
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by BSW SeniorCare Advantage Preferred Rx as a Part B benefit.
Prescription Drug Coverage
BSW SeniorCare Advantage Preferred Rx includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $86.30 |
| Supplemental Part D Premium: | $$0.00 |
| Total Part D Premium: | $86.30 |
| Low-Income Premium Subsidy: | $6.27 |
| Low-Income Premium Subsidy Paid by CMS: | $6.30 |
| Low-Income Subsidy Premium: | $80.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $250.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Baylor Scott & White Health Plan starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, BSW SeniorCare Advantage Preferred Rx may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $5.00 copay | Coming soon |
| Preferred Brand | $47.00 copay | Coming soon |
| Non-Preferred Drug | 35% coinsurance | Coming soon |
| Specialty Tier | 30% coinsurance | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H8142)
CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for Baylor Scott & White Health Plan
- Website
- Baylor Scott & White Health Plan Plan Page
- Providers
- Baylor Scott & White Health Plan Providers Page
- Formulary
- Baylor Scott & White Health Plan Formulary Page
- Pharmacy
- Baylor Scott & White Health Plan Pharmacy Page
- New Member Health Plan Help
- (866)334-3141
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (866)334-3141
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | CY2027 Landscape (202609.1) |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2027 Star Ratings Data Tables |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | PBP Benefits-2027 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-09 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Baylor Scott & White Health Plan (official source) | http://BSWHealthPlan.com/Medicare | October 4, 2026 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |
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