Turning 65 in Texas: your Medicare starter guide

Turning 65 comes with a stack of Medicare mail and a few decisions that matter for the rest of your life. Here is the plain-English version — what to do, when, and which deadlines you really don’t want to miss — with the Texas twists that most guides leave out. When you are ready, we walk through your specific options at no cost.

1. Your enrollment window: the 7-month Initial Enrollment Period

Your Initial Enrollment Period (IEP) is seven months long: the three months before the month you turn 65, your birthday month, and the three months after. Signing up in the three months before your birthday means coverage starts the first of your birthday month. You enroll through Social Security (online at ssa.gov, by phone, or at an office); if you already draw Social Security you are enrolled in A and B automatically.

• Part A (hospital) is premium-free for most people, so most enroll when first eligible.
• Part B (medical) carries the $202.90 standard monthly premium in 2026 — and a timing decision if you are still working (see below).

2. The parts of Medicare, briefly

• Part A — inpatient hospital, skilled nursing, hospice.
• Part B — doctors, outpatient care, preventive services.
• Part C (Medicare Advantage) — a private all-in-one alternative that bundles A, B and usually drug coverage, sold by county.
• Part D — prescription drug coverage.
• Medigap — a supplement that pairs with A and B and works anywhere in the country.

3. Your big decision: two paths

Where you live tilts the answer. In Houston, Dallas, San Antonio or Austin the Advantage menu is deep and the networks include most big systems. In the Panhandle, the Permian Basin, East Texas or the brush country the menu is short and got shorter for 2026, and a Medigap policy’s any-provider access is often the practical choice. If MD Anderson, UT Southwestern or a Mayo referral is in your future, a supplement removes the network question entirely. Military retirees with TRICARE For Life are a third case; see Veterans.

If you lean toward a supplement, there is a second deadline that is easy to miss: your Medigap open enrollment is its own six-month window, separate from the seven-month one above, and in Texas it does not repeat. Our research site sets the two side by side — turning 65 in Texas.

4. Deadlines that carry lifelong penalties

5. Still working at 65?

If you (or your spouse) have qualifying employer coverage, you may be able to delay Part B without penalty and get a Special Enrollment Period when that coverage ends. The rules depend on employer size (20 or more employees is the usual line) and whether the drug coverage is creditable. Texas’s big employers — the state, the universities, the school districts, the health systems, the oil majors — generally qualify; a small business, a retiree plan, or COBRA may not. It is worth a quick conversation before you decide, and a form (CMS-L564) from your employer when you do enroll. Teachers with TRS-Care have their own rules; ask us.

6. A simple checklist

• Mark your 7-month IEP on the calendar (it starts 3 months before your birthday month).
• Decide on Part B based on whether you have other creditable coverage.
• Find out how deep the Advantage menu is in your county, and whether it changed for 2026.
• Choose your path: Original Medicare + Medigap + Part D, or Medicare Advantage.
• Check that your doctors and prescriptions are covered before you enroll — especially if a specific institution is your care.
• If you travel or winter elsewhere, read the Winter Texans guide first; if you are a veteran, see how TRICARE or VA benefits coordinate; if you have Medicaid, see STAR+PLUS.
• Estimate your costs on our 2026 costs & IRMAA page.

None of this has to be done alone. We help Texans sort through it every day — clearly, patiently, and at no cost to you. Texas HICAP (800-252-9240) offers free, unbiased state counseling as well.