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BSW SeniorCare Advantage Preferred (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BSW SeniorCare Advantage Preferred (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 Preferred (HMO-POS) in 2026, please refer to our full plan details page.
BSW SeniorCare Advantage Preferred (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 Preferred (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 Preferred (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 Preferred (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 $4500.00 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 Preferred (HMO-POS).
Additional Benefits
The BSW SeniorCare Advantage Preferred (HMO-POS) plan offers robust medical coverage with affordable out-of-pocket costs, featuring no copays for primary care visits, preventive services, and home health care. Specialist visits require a $30 copay, while inpatient hospital stays carry a $700 copay per stay with no coinsurance. Emergency care is covered with a $130 copay, and urgent care visits require a $40 copay. Supplemental benefits include preventive dental services with no copay and comprehensive dental coverage up to a $3,000 annual limit with 50% coinsurance. Routine vision and hearing exams require a $15 copay, with additional allowances for eyewear and hearing aids that feature no copay. Members also receive up to 24 one-way transportation trips per year to approved locations and a $30 quarterly over-the-counter allowance with no copay.
Inpatient Hospital See details
Inpatient hospital services are covered by BSW SeniorCare Advantage Preferred (HMO-POS) with a $700 copay per stay and no coinsurance for both acute and psychiatric care, subject to prior authorization. This benefit is partially covered as unlimited additional acute days are included with no copay, while upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by BSW SeniorCare Advantage Preferred (HMO-POS) with no coinsurance, featuring a $15 copay for outpatient hospital, daily observation, and substance abuse sessions. Ambulatory surgical center services require a $100 copay with no coinsurance, while outpatient blood services are provided with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
BSW SeniorCare Advantage Preferred (HMO-POS) covers partial hospitalization services with a $15.00 copay and no coinsurance. Prior authorization is required for some of these covered services.
Ambulance and Transportation Services See details
BSW SeniorCare Advantage Preferred (HMO-POS) covers ground and air ambulance services with a $75 copay and no coinsurance. Transportation services are partially covered with no copay or coinsurance for up to 24 one-way trips per year to plan-approved health-related locations, while transportation to any health-related location is not covered.
Emergency Services See details
BSW SeniorCare Advantage Preferred (HMO-POS) covers emergency services with a $130 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance, with both copays waived if you are admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance, up to a maximum plan benefit of $5,000.
Primary Care See details
BSW SeniorCare Advantage Preferred (HMO-POS) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $30 copay and no coinsurance. Other covered benefits, including physical therapy, occupational therapy, and mental health services, feature copays ranging from $15 to $25 with no coinsurance, though podiatry and routine chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by BSW SeniorCare Advantage Preferred (HMO-POS) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes screenings. Additional preventive benefits are partially covered with no copay and no coinsurance for physical and memory fitness, but exclude health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, tobacco cessation, disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
BSW SeniorCare Advantage Preferred (HMO-POS) covers annual routine hearing exams and fitting evaluations for a $15 copay and no coinsurance. Prescription hearing aids are partially covered, excluding inner ear, outer ear, and over the ear types, while OTC hearing aids are covered, both offering no copay, no coinsurance, and a $1,000 maximum benefit every three years.
Vision Services See details
BSW SeniorCare Advantage Preferred (HMO-POS) provides partially covered vision services, featuring one routine eye exam per year for a $15 copay and no coinsurance, while other eye exam services are not covered. Covered eyewear options like contacts, lenses, and frames have no copay and no coinsurance up to a $125 annual maximum, though eyewear upgrades are not covered.
Dental Services See details
BSW SeniorCare Advantage Preferred (HMO-POS) partially covers dental services up to a $3,000 annual limit, featuring preventive care with no copay or coinsurance and comprehensive services with no copay and 50% coinsurance. Fluoride treatments, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
BSW SeniorCare Advantage Preferred (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy and other 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 under the BSW SeniorCare Advantage Preferred (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
BSW SeniorCare Advantage Preferred (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 diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by BSW SeniorCare Advantage Preferred (HMO-POS) with no coinsurance, though prior authorization is required. Covered diagnostic radiological services have no copay and therapeutic radiological services require a minimum $15 copay, while diagnostic procedures, lab services, and outpatient X-ray services are not covered.
Home Health Services See details
Home Health Services are covered under the BSW SeniorCare Advantage Preferred (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under BSW SeniorCare Advantage Preferred (HMO-POS), as cardiac, intensive cardiac, pulmonary, and SET for PAD services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
BSW SeniorCare Advantage Preferred (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, while days 21 through 100 require a $100 daily copay, with no coverage provided for additional days beyond the Medicare-covered limit.
Other Services See details
Other services are partially covered by BSW SeniorCare Advantage Preferred (HMO-POS), which offers a meal benefit for chronic illness and a $30 quarterly over-the-counter (OTC) allowance with no copay and no coinsurance. Acupuncture is not covered under this plan's other services benefit.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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