Medicare in Texas

Tamera Jackson by Tamera Jackson | Licensed since 2007
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This article was updated on: 09/16/2018

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Searching for a Medicare plan in Texas? Before joining any Medicare plan, it is recommended that you explore all of your options to make the most informed decision possible surrounding plan costs and details.

About Medicare in Texas

Beneficiaries in Texas can receive coverage through Original Medicare, Part A and Part B, and then add prescription drug coverage and/or a Medicare Supplement insurance policy for more comprehensive health insurance. Or they can join a private Medicare Advantage plan, also called Medicare Part C. These plans offer the at least the same amount of coverage as Medicare Part A and Part B (except for hospice care), but may include other benefits, such as routine vision and dental, hearing, or prescription drug coverage.

Types of Medicare coverage in Texas

Original Medicare, Part A and Part B, includes hospital coverage (Part A) and physician care (Part B).

Medicare Advantage plans, Part C, are Medicare insurance plans offered by private insurance companies. Medicare Advantage plan availability and costs may differ depending on location.

Medicare Part D Prescription Drug Plans (PDPs) provide stand-alone prescription drug coverage for beneficiaries with Original Medicare, Part A and Part B. These plans are sold by private insurance companies with Medicare’s approval. You can also get Medicare Part D coverage through a Medicare Advantage Prescription Drug plan.

Medicare Supplement insurance, also called Medigap, covers certain health care costs that Original Medicare does not, such as plan deductibles, copayments, and coinsurance.

Local resources for Medicare in Texas

Medicare Savings Programs in Texas: Low-income Medicare beneficiaries in Texas may be able to get help paying for health-care costs like premiums, coinsurance, and deductibles.

Texas State Health Insurance Counseling and Assistance Program (SHIP): Health Information Counseling & Advocacy Program of Texas (HICAP) is the Texas branch of SHIP. HICAP has 28 Area Agency on Aging offices where you can speak with benefits counselors who provide unbiased information and assistance for a wide range of Medicare issues.

How to apply for Medicare in Texas

The process for applying for Medicare in Texas is the same as any other state. To qualify for Medicare, you must be either a United States citizen or a legal permanent resident of at least five continuous years. Enrolling manually may be done by visiting your local Social Security Administration (SSA) office. Visit SSA.gov for office hours and to find the closest location to you.

It can also be done online at the Social Security website or over the phone.

  • Call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778), Monday through Friday, 7AM to 7PM.
  • If you worked for a railroad, call the Railroad Retirement Board to apply at 1-877-772-5772 (TTY users call 312-751-4701), Monday through Friday, 9AM to 3:30PM.

If you do not join Medicare when you are first eligible, it may result in a late-enrollment penalty if you decide to join the program later on.

Some people are enrolled automatically at age 65 if they already receive Social Security or Railroad Retirement Board benefits. Disabled residents under the age of 65 may also be enrolled automatically, provided they receive SSA disability benefits, or certain disability benefits through the RRB, for 24 consecutive months. If you qualify for Medicare because you have amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), you’ll be automatically enrolled in the first month of disability benefits. You may also qualify for Medicare if you have end-stage renal disease; in this situation, however, you’ll need to manually enroll in Medicare.

This article is intended as an overview. You may have more questions about the various types of Medicare insurance available to you, and I would be more than happy to get those answered. To learn a little more about my background and why I enjoy helping people to get the answers they need, see my profile using “View profile” link below. Once you’re ready, reach out to me for a phone discussion or an email containing plans that might work for you; the links for those are below too. To shop plans on your own, scroll up and use the Compare Plans button on the right side of this page.

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