Texas residents become eligible for Medicare at age 65, or earlier if they qualify due to a disability or end-stage renal disease. The Texas Department of Insurance regulates insurance products sold in the state, including Medicare Supplement plans. Texas does not have a Medigap Birthday Rule, so switching Medicare Supplement plans outside of guaranteed-issue windows typically requires medical underwriting.

Texas's Medicare landscape includes both Medicare Advantage plan options and a strong market for Medicare Supplement plans. The right choice depends on your health needs, preferred providers, prescription drug use, and budget. An independent broker can compare options across carriers rather than steering you toward a single company's products.

Texas's State Health Insurance Assistance Program (SHIP) — called the Health Information Counseling and Advocacy Program (HICAP) — provides free, unbiased Medicare counseling to Texas residents. HICAP counselors are trained volunteers who can help you understand your options, though they do not sell insurance products.

Medicare Supplement plans — also called Medigap — are standardized by the federal government and sold by private insurance companies licensed in Texas. Because the benefits of each lettered plan (Plan G, Plan N, etc.) are identical regardless of which company sells them, the primary variable is premium. An independent broker can compare premiums across multiple carriers for the same plan letter.

Plan G is currently one of the most comprehensive Medigap options available to new Medicare enrollees in Texas, covering most Medicare-approved costs after the Part B deductible. Plan N offers a lower premium in exchange for copays on some office and emergency room visits. The best plan depends on your individual health use patterns and budget.

Texas does not have a Medigap Birthday Rule. Federal guaranteed-issue rights apply in specific circumstances, such as losing employer coverage or your current plan leaving the market. Outside of these windows, switching Medigap plans typically requires answering health questions.

Medicare Advantage (Part C) plans are offered by private insurers approved by Medicare and must cover at least the same benefits as Original Medicare Parts A and B. Many Texas Medicare Advantage plans include additional benefits such as dental, vision, hearing, and prescription drug coverage. Plan availability and network coverage vary by county.

Medicare Advantage plans use provider networks — HMO, PPO, or other structures — that may limit which doctors and hospitals you can use at in-network rates. Texas's major metro areas (Houston, Dallas-Fort Worth, San Antonio, Austin) have broad plan availability, while rural areas of the state may have fewer options.

Medicare Advantage plans can change their premiums, cost-sharing, and covered benefits each year. Reviewing your plan annually during the Annual Enrollment Period (October 15 – December 7) is important to ensure your coverage still fits your needs.

Part D prescription drug plans are sold by private insurers approved by Medicare. If you have Original Medicare and a Medicare Supplement plan, you will typically need a standalone Part D plan for prescription coverage. If you have Medicare Advantage, drug coverage is often included.

Part D plans have formularies — lists of covered drugs — that vary by plan. Premiums, deductibles, and cost-sharing also vary. The Medicare Plan Finder tool at Medicare.gov allows you to compare Part D plans based on your specific medications.

Enrolling in Part D when you first become eligible for Medicare helps you avoid a late enrollment penalty, which is a permanent premium increase applied if you go without creditable drug coverage for 63 or more consecutive days after your initial enrollment window.

Moving to Texas can affect Medicare Advantage and Part D availability because plan availability is geographically dependent. Medicare beneficiaries moving into Texas should review their current coverage and determine whether the move creates an applicable Special Enrollment Period. Medicare Advantage plans are tied to a geographic service area — a plan that covered you in another state may not provide in-network coverage in Texas.

Medicare Supplement plans are portable — if you move within Texas or from another state, your Medigap plan typically continues to cover you anywhere Medicare is accepted in the United States. Medicare Advantage plans, by contrast, are geographically tied to a service area and may not provide in-network coverage if you move to a new county or state. Texas does not have a Medigap Birthday Rule, so a move may not automatically create a guaranteed-issue window for switching Medigap plans.