Medicare in Texas – Licensed Independent Agent Help
Navigating Medicare in Texas doesn't have to be confusing. As independent licensed agents, we help you compare top carriers, understand local rules, and find a plan that fits your doctors and budget — all at zero cost to you.
Medicare Basics for Texas Residents
When you turn 65 or first become eligible for Medicare in Texas, you have important decisions to make. Original Medicare (Parts A and B) covers hospital and medical services, but it doesn't cover everything. Many Texas residents choose to add a Medicare Supplement (Medigap) policy or enroll in a Medicare Advantage (Part C) plan to limit out-of-pocket costs.
Medicare Advantage in Texas
Medicare Advantage plans are offered by private insurance companies approved by Medicare. In Texas, you have access to plans from major carriers like UnitedHealthcare, Humana, Aetna, Cigna, and regional providers. These plans often include Part D prescription drug coverage and extra benefits like dental, vision, and hearing.
Medicare Supplement (Medigap) in Texas
A Medicare Supplement (Medigap) policy helps cover the out-of-pocket costs that Original Medicare leaves behind, such as deductibles, copayments, and coinsurance. If you live in Texas, there are a few specific state rules you need to know when considering a Medigap plan.
First, it is crucial to understand that Texas does not have a Medigap "birthday rule" or "anniversary rule." In some states, these rules allow you to switch Medigap plans each year around your birthday without answering health questions. Because Texas doesn't offer this protection, it is especially important to choose the right plan from the start.
The best time to buy a Medigap policy in Texas is during your 6-month Medigap Open Enrollment Period. This period begins the month you are 65 or older and enrolled in Medicare Part B. During this window, you have a guaranteed right to buy any Medigap policy sold in Texas, regardless of your health history. If you apply for a Medigap plan outside of this window, insurance companies are generally allowed to use medical underwriting. This means they can ask questions about your health, charge you a higher premium, or even deny you coverage based on pre-existing conditions.
Texas law provides a few safety nets. For instance, you are entitled to a 30-day "free-look" period. If you buy a Medigap policy and decide you don't like it, you can cancel within the first 30 days and get a full refund of your premium (minus any claims paid).
Additionally, you may qualify for Guaranteed Issue rights in certain specific scenarios. If you lose your employer group coverage, move out of your Medicare Advantage plan's service area, or if your plan stops operating in your area, you have a limited window to buy a Medigap plan without medical underwriting. Navigating these rules can be tricky, which is why working with a licensed independent agent can help ensure you don't miss your enrollment windows or overpay for your coverage.
Medicare Part D in Texas
If you choose Original Medicare, you'll need a standalone Part D plan for prescription drug coverage. We can help you check your specific medications against the formularies of plans available in Texas to find the lowest overall cost.
State-Specific Assistance Programs
Texas residents can access free, unbiased local Medicare counseling through the HICAP / Texas Health Information, Counseling and Advocacy Program. This program helps seniors understand their benefits, rights, and protections.
Cities We Serve in Texas
Helpful Medicare Guides
Frequently Asked Questions
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