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Best Medicare Advantage Plans for 2019 Rating is from U.S. News and World Report, a leading publisher of annual authoritative rankings including Best Medicare Plans. Our plan does not have a direct relationship with U.S. News. This award was not given by Medicare. Our overall rating from Medicare for 2019 is 5.0. Our plan’s official CMS Star Rating can be found at www.Medicare.gov.

You must live in the following counties to enroll into one of these 2 plans:

Liberty, San Jacinto, Waller, Walker, Austin, Wharton, Grimes and Chambers 

 

Our Plans

Coverage that offers peace of mind

Shopping for a Medicare plan can be challenging and confusing, but it doesn’t have to be.  With KelseyCare Advantage, you’ll have care delivered by the doctors of Kelsey-Seybold Clinic, Houston’s largest and most renowned private multi-specialty physician group.   KelseyCare Advantage was designed by the doctors of Kelsey-Seybold Clinic to provide Medicare beneficiaries with benefit plans that offer high quality care, financial protection and highly-rated customer service.  
 

KelseyCare Advantage Plans

KelseyCare Advantage offers 2 Medicare Advantage plans, each offering all of the benefits of Medicare without all of the cost.  You’ll have low copayments or coinsurance, worldwide emergency coverage, $0 copayment for Primary Care vists, routine vision exams, transportation to medical appointments and the protection of out-of-pocket maximums for in-network and out-of-network services.   An out-of-pocket maximum is the most you will have to pay for Medicare-covered services during a year for health care services you receive. Once you have reached your out-of-pocket maximum, KelseyCare Advantage begins to pay 100 percent of your Medicare-covered benefits.
 
 
Please refer to the Summary of Benefits for a list of copayments and cost-sharing.  
Monthly PremiumIncludes Part D Drug Coverage
Includes
Point-of-Service Coverage
Summary of Benefits (PDF)Evidence of Coverage (PDF)
Rx Select
(HMO-POS)
Learn-RX.png 
$15   English 
Español (Coming Soon)

English
Esp​añol

Essential Select
(HMO-POS)
Learn-RXChoice.png 
$0                English 
Español (Coming Soon)
 
 
Benefits-At-A-Glance
Our plan covers benefits that are important to you, such as doctor office visits, inpatient hospital care, outpatient surgery and more. Please see below for a listing of some of the benefits covered by KelseyCare Advantage.
 

Note: This is just a summary. A complete benefit description is available by viewing a Summary of Benefits or Evidence of Coverage (Member Handbook).

  Rx SelectEssential Select
 Copayment or Coinsurance AmountCopayment or Coinsurance Amount
Physician and Lab Services
Physician office visitComing Soon Coming Soon
Specialist office visitComing Soon Coming Soon
E-VisitComing SoonComing Soon
Video VisitComing SoonComing Soon
Routine physical examsComing SoonComing Soon
Fitness BenefitComing SoonComing Soon
Diagnostic x-rays, mammography, and lab testsComing SoonComing Soon
High Tech Radiology (ex MRI, CT)Coming SoonComing Soon
ImmunizationsComing SoonComing Soon
Well woman examComing SoonComing Soon
Hearing TestingComing SoonComing Soon
Hearing Aid AllowanceComing SoonComing Soon
Speech, Physical and Occupational TherapyComing SoonComing Soon
Allergy TestingComing SoonComing Soon
Allergy serumComing SoonComing Soon
Allergy serum administrationComing SoonComing Soon
Routine eye examComing SoonComing Soon
Eyewear AllowanceComing SoonComing Soon
Hospital Services
Inpatient Hospital CareComing SoonComing Soon
Outpatient/Services surgeryComing SoonComing Soon
Emergency CareComing SoonComing Soon
Urgent CareComing SoonComing Soon
Extended Care Services
Skilled nursing facilityComing SoonComing Soon
Home HealthComing SoonComing Soon
Other Medical Services
Durable Medical EquipmentComing SoonComing Soon
ProsthesisComing SoonComing Soon
AmbulanceComing SoonComing Soon
Behavioral Health
Inpatient mental healthComing SoonComing Soon
Outpatient Mental Health Hospital Care Coming Soon Coming Soon
Outpatient Mental Health CareComing SoonComing Soon

 

 
Our Service Area
Our service area includes the following counties in Texas:
Our Service Area Liberty, San Jacinto, Waller, Walker, Austin, Wharton, Chamber and Grimes                
If you are unsure if your residential address falls into one of these four counties, please contact our Sales department for more information.
    
Document Request
If you would like an Evidence of Coverage, Abridged Formulary or Provider/Pharmacy Directory mailed to you here are your options: We can also give you information in Braille, in large print, other languages or other alternate formats, upon request.
 

Find the plan that’s right for you

Often when potential KelseyCare Advantage members contact us, they are worried about all of their choices. We look out for them with a local team that is happy to take the time to explain exactly what they can expect from us AND how much it’s going to cost. That’s where the KelseyCare Advantage plan really shines. We treat potential members the way we would want our own loved ones to be treated. And if we’re not a good fit, we’ll tell you. To learn more about KelseyCare Advantage, call one of our knowledgeable Health Plan Specialists at 713-442-JOIN (5646). 

We’re available:

From October 1 through March 31, seven days a week from 8:00 a.m. to 8:00 p.m.
From April 1 through September 30, Monday through Friday from 8:00 a.m. to 8:00 p.m. 
Medicare & You Handbook
Medicare & You Medicare's Official Medicare & You Handbook

Learn as much as possible about the coverage available to you through Medicare.

Medicare & You

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