Texas Medicare questions, answered plainly

Nothing. Independent Medicare agents are paid by the insurance carriers when you enroll, so comparing plans, answering questions and reviewing your coverage each year is free to you. Your premium is the same whether you enroll through us, another agent or the carrier directly.

You get a Special Enrollment Period to choose a new plan and, because you lost coverage through no fault of your own, generally a guaranteed-issue right to buy a Medigap policy without health questions, usually within 63 days of the coverage ending. Texas has no birthday rule to fall back on later, so use the window. Call before the deadline on your notice.

No. Your six-month Medigap open enrollment at 65 is the guaranteed window, plus guaranteed-issue events such as a plan leaving your county. Outside those, Texas insurers can use medical underwriting.

Texas requires insurers to offer at least Plan A to people under 65 on Medicare, during a six-month window after Part B begins. Other plan letters may be underwritten or cost more. You get a fresh open enrollment for every plan at 65.

MD Anderson accepts Original Medicare and therefore every Medigap policy. It contracts with some Medicare Advantage plans and not others, and the list changes yearly. If MD Anderson — or UT Southwestern, Houston Methodist or a Mayo referral — is your care, we confirm the plan’s status in writing before you enroll.

A Medigap policy with Original Medicare works anywhere in the U.S. Most Medicare Advantage HMOs cover only emergencies out of area; some PPOs and travel benefits go further. See our Winter Texans guide, and our Minnesota sister site for the view from up north.

Usually neither. TFL pays secondary to Medicare and its pharmacy is creditable drug coverage. An MA-only Advantage plan can add dental or vision without duplicating the drug benefit. Our Fort Cavazos, Joint Base San Antonio and Fort Bliss pages walk through it.

In most cases, yes. VA medical care is not creditable coverage for Part B, so delaying it triggers a permanent penalty and leaves you without coverage at a non-VA hospital. VA pharmacy is creditable for Part D.

Your Initial Enrollment Period is the seven months around your 65th birthday. The Annual Election Period runs October 15 to December 7; Medicare Advantage Open Enrollment runs January 1 to March 31. Moving counties, losing a plan, or qualifying for Medicaid opens a Special Enrollment Period.

Part B premium $202.90 a month, Part B deductible $283, Part A hospital deductible $1,736 per benefit period, Part D out-of-pocket cap $2,100. Higher earners pay IRMAA surcharges above $109,000 (single) or $218,000 (joint) of 2024 income. Our costs page has the full chart and calculators.

Possibly. Texas’s Medicare Savings Programs (QMB, SLMB, QI), run by HHSC, pay the Part B premium for people with limited income and resources, and QMB also covers Medicare’s deductibles and copays. Apply at YourTexasBenefits.com, or call Texas HICAP at 800-252-9240.

Texas’s Medicaid managed-care program for adults 65 and over and people with disabilities. It coordinates the Medicaid side, including long-term services and supports, while Medicare pays first for medical care. Many STAR+PLUS carriers also offer Dual Special Needs Plans on the Medicare side.

Texas HICAP, the Health Information, Counseling and Advocacy Program, is Texas’s State Health Insurance Assistance Program: 800-252-9240, through your Area Agency on Aging. You can also call 1-800-MEDICARE or use Medicare.gov. We are an independent agency, not a government program, and we say so on every page.

No. We represent a number of insurance organizations and products in Texas, not all of them, and we will always say so. For the complete list, use Medicare.gov, 1-800-MEDICARE or Texas HICAP. For help choosing among the plans we do offer, call (702) 706-6564.

Darin Weidauer holds Texas insurance license #2514981 (NPN 18580338). You can verify it through the Texas Department of Insurance license lookup or through the NIPR.

We work with Texans statewide by phone and video, which is how most people prefer it across a state this size. Our sister agency has walk-in offices in Mesa and Sun City, Arizona.