BSW SeniorCare Advantage Select Rx (HMO-POS)

SCOTT AND WHITE HEALTH PLAN · 2027 plan year

Plan ID H8142-007-000

HMOPOS★ 4.5 CMS Stars
MOOP (in-network)
$7,150
MOOP (combined)
—
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H8142-007-000
Medical deductible
$0 — no deductible
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$500/yr
Also owed
Your Medicare Part B premium, paid separately

More SCOTT AND WHITE HEALTH PLAN plans in TX

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Psychiatric$318/day for days 1–5, $0 after
Inpatient Hospital — Acute$305/day for days 1–6, $0 after

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions$30
Mental Health — Group Sessions$30

Other

BenefitIn-network
Skilled Nursing Facility (SNF)$0/day for days 1–20, $221/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional SessionsNo charge
Intensive Cardiac Rehabilitation — Additional SessionsNo charge
Pulmonary Rehabilitation — Additional SessionsNo charge
Supervised Exercise Therapy (SET)No charge
Emergency Services$130
Urgently Needed Services$50
Partial Hospitalization Program$40
Intensive Outpatient Program (IOP)$40
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$15
Occupational Therapy Services$35
Physician Specialist Services$25
Podiatry Services$40
Other Health Care Professional Services$45
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$30
Psychiatric Services — Group Sessions$30
Physical Therapy & Speech-Language Pathology$35
Additional Telehealth Services (Part B)No charge
Opioid Treatment Program Services$45
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & TestsNo charge
Radiological ServicesSee plan details
Diagnostic Radiology$0-$200
Therapeutic Radiology20% coinsurance
X-Ray ServicesNo charge
Outpatient Hospital Services$275 copay + 20% coinsurance
Hospital Observation Services20% coinsurance
Ambulatory Surgical Center (ASC)$250
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$45
Substance Abuse — Group Sessions$45
Outpatient Blood Services20% coinsurance
Ambulance ServicesSee plan details
Ground Ambulance$300
Air Ambulance$300
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)20% coinsurance
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & InsertsNo charge
Diabetic MonitorsNo charge
Dialysis Services20% coinsurance
Meal BenefitNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)$35
Dental — Medicare-Covered ServicesNo charge
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Hearing — Hearing Aids (All Types)No charge
Dental — Other Preventive ServicesNo charge
Vision — Eye Exams$40
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Hearing — Exams$40
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Laboratory ServicesNo charge
Prosthetics & OrthoticsSee plan details
Hearing — OTC Hearing AidsNo charge

Service area

  • TX: 7 counties

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