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BSW SeniorCare Advantage Select (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BSW SeniorCare Advantage Select (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on BSW SeniorCare Advantage Select (HMO-POS) in 2026, please refer to our full plan details page.
BSW SeniorCare Advantage Select (HMO-POS) is a HMO-POS plan offered by Baylor Scott & White Health available for enrollment in 2025 to people living in Central Texas. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that BSW SeniorCare Advantage Select (HMO-POS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about BSW SeniorCare Advantage Select (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For BSW SeniorCare Advantage Select (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $50.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5900.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
Prescription drugs are not covered by BSW SeniorCare Advantage Select (HMO-POS).
Additional Benefits
The BSW SeniorCare Advantage Select (HMO-POS) plan offers comprehensive medical coverage featuring no copay for primary care visits, telehealth, and preventive services, while specialist visits require a $30 copay. For hospital care, inpatient stays carry a $325 daily copay for the first six days, and outpatient hospital services require a $325 copay plus 20% coinsurance. Emergency room visits are covered with a $130 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also provides valuable supplemental benefits, including preventive dental care with no copay up to a $3,000 annual limit and 50% coinsurance for comprehensive dental services. Additionally, members benefit from no copay on up to 24 one-way health-related transportation trips per year, a $1,000 hearing aid allowance every three years, and a $125 annual allowance for eyewear. Other perks include a $30 quarterly over-the-counter item allowance and no copay for home health services.
Inpatient Hospital See details
Inpatient hospital services are covered by BSW SeniorCare Advantage Select (HMO-POS) with no coinsurance, requiring a daily copay of $325 for days 1 to 6 of an acute stay and $318 for days 1 to 5 of a psychiatric stay, with no copay for remaining covered days up to day 90. Prior authorization is required for these stays, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
BSW SeniorCare Advantage Select (HMO-POS) covers outpatient hospital services with a $325 copay and 20% coinsurance, and ambulatory surgical center services with a $250 copay and no coinsurance. Outpatient substance abuse sessions require a $45 copay and no coinsurance, while outpatient blood services are covered with no copay and a 20% coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by BSW SeniorCare Advantage Select (HMO-POS) with a $40.00 copay and no coinsurance. Prior authorization is required to access these services.
Ambulance and Transportation Services See details
BSW SeniorCare Advantage Select (HMO-POS) covers ground and air ambulance services with a $265 copay and no coinsurance. Transportation services are partially covered, providing up to 24 one-way trips per year to plan-approved health-related locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
BSW SeniorCare Advantage Select (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay or coinsurance up to a $5,000 maximum limit.
Primary Care See details
BSW SeniorCare Advantage Select (HMO-POS) provides primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $30 copay and no coinsurance. Therapy services cost a $35 copay, mental health and psychiatric sessions cost a $30 copay, and opioid treatment costs a $45 copay, all with no coinsurance, though podiatry and routine chiropractic care are not covered.
Preventive Services See details
Preventive services under the BSW SeniorCare Advantage Select (HMO-POS) plan are covered with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive services are partially covered, offering physical and memory fitness benefits with no copay and no coinsurance, while sub-services such as health education, weight management, and in-home safety assessments are not covered.
Hearing Services See details
BSW SeniorCare Advantage Select (HMO-POS) hearing services are partially covered, offering routine exams and evaluations for a $40 copay and no coinsurance, and prescription or OTC hearing aids with no copay and no coinsurance up to a $1,000 allowance every three years. While prescription hearing aids are covered overall, specific types including inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services under the BSW SeniorCare Advantage Select (HMO-POS) plan are partially covered, offering one annual routine eye exam for a $40 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay or coinsurance up to a $125 yearly maximum for contacts or eyeglasses, though upgrades are not covered.
Dental Services See details
Dental services are partially covered by BSW SeniorCare Advantage Select (HMO-POS), offering up to a $3,000 annual maximum with no copay and no coinsurance for preventive care, and no copay with 50% coinsurance for comprehensive services. Fluoride treatment, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
BSW SeniorCare Advantage Select (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other Part B drugs carry no copay and a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered by BSW SeniorCare Advantage Select (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
BSW SeniorCare Advantage Select (HMO-POS) covers durable medical equipment and prosthetics with no copay and a 20% coinsurance. Diabetic equipment is partially covered with no copay and no coinsurance, but diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by BSW SeniorCare Advantage Select (HMO-POS) and require prior authorization. Diagnostic services and diagnostic radiological services are offered with no copay and no coinsurance, while therapeutic radiological services require a copay and 20% coinsurance. However, diagnostic procedures, tests, lab services, and outpatient X-ray services are not covered.
Home Health Services See details
BSW SeniorCare Advantage Select (HMO-POS) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
BSW SeniorCare Advantage Select (HMO-POS) features no copay and no coinsurance for Cardiac Rehabilitation Services, where some services are covered; however, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
BSW SeniorCare Advantage Select (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and no prior three-day hospital stay. There is no copay for days 1 through 20, and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare limit are not covered.
Other Services See details
BSW SeniorCare Advantage Select (HMO-POS) partially covers other services, offering over-the-counter (OTC) items up to $30 every three months and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and nicotine replacement therapy are not covered under these benefits.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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