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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 North 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 $5550.00 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 robust medical coverage featuring no copays or coinsurance for primary care visits, preventive services, and home health care. Specialist visits require a $25 copay, while inpatient hospital stays carry a daily copay of $225 for the first six days of an acute stay. Emergency room visits have a $130 copay and urgent care visits require a $50 copay, with both fees waived if you are admitted to the hospital within 24 hours. This plan also includes essential supplemental benefits, such as preventive dental care with no copay and comprehensive dental services up to a $3,000 annual limit with a 50% coinsurance. Routine hearing and vision exams require a $40 copay, but members receive a $1,000 hearing aid allowance every three years and a $125 annual eyewear allowance with no copays. Additionally, the plan provides up to 24 one-way rides to approved health locations and a $30 quarterly over-the-counter allowance with no copays.
Inpatient Hospital See details
BSW SeniorCare Advantage Select (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a daily copay of $225 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. Prior authorization is required, 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 $275 copay and 20% coinsurance, and ambulatory surgical center services with a $250 copay and no coinsurance. Outpatient substance abuse sessions require a $45 copay with no coinsurance, while outpatient blood services have no copay and a 20% coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered under the BSW SeniorCare Advantage Select (HMO-POS) plan with a $40.00 copay and no coinsurance, though prior authorization may be required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under the BSW SeniorCare Advantage Select (HMO-POS) plan, featuring a $265 copay and no coinsurance for both ground and air ambulance trips. The plan also partially covers transportation by offering up to 24 one-way rides per year to plan-approved health-related locations with no copay or 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, and urgently needed services with a $50 copay and no coinsurance, with both copays waived if admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered with no copay or coinsurance up to a maximum benefit limit of $5,000.
Primary Care See details
BSW SeniorCare Advantage Select (HMO-POS) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $25 copay and no coinsurance. Therapy services require a $35 copay, mental health sessions require a $30 copay, podiatry is not covered, and some chiropractic services are covered though routine and other chiropractic services are not covered, all with no coinsurance.
Preventive Services See details
BSW SeniorCare Advantage Select (HMO-POS) covers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. Additional preventive services are partially covered with no copay and no coinsurance for fitness benefits, but health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, home safety devices, and counseling are not covered.
Hearing Services See details
Hearing services are covered by the BSW SeniorCare Advantage Select (HMO-POS) plan, featuring routine exams and fitting evaluations for a $40 copay and no coinsurance. Prescription and over-the-counter hearing aids are covered with no copay and no coinsurance up to a $1,000 maximum every three years, though inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
BSW SeniorCare Advantage Select (HMO-POS) covers one routine eye exam per year with a $40 copay and no coinsurance, while other eye exam services are not covered. Eyewear is partially covered with no copay and no coinsurance up to a $125 annual 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) up to a $3,000 annual maximum, offering preventive care with no copay and no 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 Select (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the BSW SeniorCare Advantage Select (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
BSW SeniorCare Advantage Select (HMO-POS) partially covers medical equipment with no copays, though prior authorization is required. Durable medical equipment and prosthetics or medical supplies carry a 20% coinsurance, while diabetic equipment features no coinsurance, but diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
BSW SeniorCare Advantage Select (HMO-POS) partially covers diagnostic and radiological services with prior authorization required, though diagnostic procedures, lab services, and outpatient X-ray services are not covered. Covered diagnostic and diagnostic radiological services require no copay and no coinsurance, while therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by BSW SeniorCare Advantage Select (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the BSW SeniorCare Advantage Select (HMO-POS) plan. Under this plan, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
BSW SeniorCare Advantage Select (HMO-POS) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. Patients pay no copay for days 1 through 20, followed by a $218 copay per day for days 21 through 100, with no coverage provided for additional days.
Other Services See details
BSW SeniorCare Advantage Select (HMO-POS) partially covers other services, offering a chronic illness meal benefit and a $30 quarterly allowance for over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture is not covered under this plan benefit.
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