up button arrow
https://texasinsurance.org is a privately owned website that is not owned or operated by any government agency

Buying Medicare Health Insurance in Texas

You can sign up for Medicare in Texas through any of the following ways:

You must enroll during your Initial Enrollment Period. This is a seven-month period that starts three months before you turn 65. It includes your birth month and ends three months after you turn 65 years. If you have certain disabilities, End-Stage Renal Disease (ESRD), or Amyotrophic Lateral Sclerosis (ALS), you can enroll for Medicare once you are eligible.

You can also check how to sign up by answering some questions on Medicare.

You can create a MyMedicare.gov account to manage your coverage once you have signed up for Medicare. You can:

  • Check your enrollment status.
  • Learn more about the plans you are enrolled in and the benefits they provide.
  • Make any necessary changes to your personal details.
  • Fill in your medical information and prescribed medications.
  • Check out the Medicare claims.
  • Print replacement Medicare cards
  • Share information with your healthcare providers

The process of signing up for Medicare in Texas can be rather complex. However, you can speak to a licensed insurance agent in Texas to help you when you are ready to enroll.

Do You Need Medicare Insurance?

Yes. Medicare provides quality health coverage at affordable rates for eligible persons. Usually, the people who qualify for Medicare experience premium surcharges. However, through Medicare, they get comprehensive health coverage at cost-effective rates. Also, you should enroll for Medicare if you are about to become 65 years old because when you do not sign up when you are first eligible, you may face late enrollment penalties. Consult a licensed insurance agent in Texas about why you need to sign up for Medicare insurance.

How to Pick Medicare Insurance in Texas?

You can get Medicare insurance by signing up for coverage through any of the following ways:

  • Filling out the online application on the Social Security Administration’s website.
  • Calling the Social Security Administration on (800) 772-1213
  • Consulting a local Social Security office around you

When you have signed up, you get to pick between getting Original Medicare (with or without Medigap and Prescription Coverage) or Medicare Advantage.

You need to decide which one is best for you by comparing their coverage and prices. That is, compare the coverage and prices of Medicare Advantages plans in your area with Original Medicare (with or without Medigap). Here are a few things to consider:


Original Medicare provides you with various inpatient (hospital) and outpatient (medical) services. They include hospitalization, doctor’s services, skilled nursing facility care, home health care, preventive and screening services, hospice care, and various other medical services and supplies. Medicare Advantage provides the same services covered by Original Medicare. However, they may also provide additional services excluded by Original Medicare like prescription drugs, eye exams, hearing aids, or dental care. Hence, if you need coverage for services excluded by Original Medicare, you might want to consider getting a Medicare Advantage plan. Ensure you confirm that the Medicare Advantage plan covers the services you want.

Access to services

Original Medicare allows you to receive services from any Medicare-approved provider in any part of the country. Medicare Advantage plans provide you with a network of providers where you can receive covered services. Thus, you may want to confirm if the list of providers in the network renders the services you want. Check the specialists, hospitals, home health agencies, and skilled nursing facilities in the plan’s network. Note that providers change networks regularly, so you may want to cross-check every year. In addition, some Medicare Advantage plans permit you to see physicians who are not in their network. Out-of-network emergency care must also be covered if it is medically essential. You'll need to find out under what conditions and at what additional cost.


Original Medicare requires premiums, deductibles, coinsurance, and copayments. Most people who receive Medicare Part A coverage pay no premiums. However, if you do not qualify for premium-free coverage, you pay up to $274 or $499 each month in 2022. Medicare Part A has a $1,556 deductible per benefit period. Monthly premiums for Medicare Part B in 2022 are $170.10 and $233 deductible every year. You normally pay 20% of the Medicare-approved fee for doctor treatments and other Medicare Part B benefits once you have met your deductible for the year. Note that premiums charges change every year. People with higher incomes may pay more. You can get a Medigap plan to cover your out-of-pockets Original Medicare costs.

You should compare these standardized Original Medicare costs (and additional Medigap premium costs) with Medicare Advantage plans available in your area. Medicare Advantage plans usually have low or no premiums. However, they have deductibles, copayments, and coinsurance, which are different from Original Medicare. Also, you will probably pay more if you get services from an out-of-network provider. Generally, Medicare Advantage plans have an annual limit on how much members will pay in out-of-pocket costs.

Note that cost-sharing and benefits of Medicare Advantage plans change annually. Therefore, you should check your plan for any changes made during every Medicare open enrollment period.

You can check out Medicare Advantage plans based on your location to compare plans.

Drug coverage

If you opt for Original Medicare, you can also enroll in a Part D prescription drug coverage. You will have to pay a higher premium for the plan, and you will need to examine the coverage and cost of the policies available in your area. If you choose Medicare Advantage, your Part D prescription drug coverage is almost certainly included in the plans you are looking at. You can purchase Part D coverage separately if it is not included. Whether you are comparing stand-alone Part D plans or Medicare Advantage plans that incorporate Part D coverage, you will need to compare options carefully.

What are My Medicare Insurance Options?

Generally, there are two main Medicare options, including:

  • Original Medicare: It comprises Medicare Parts A and B. They cover inpatient and outpatient care by providing services like hospitalizations, skilled nursing facility care, home health care, preventive services, and hospice. The majority of Americans that qualify for Medicare sign up for Original Medicare. It does not cover prescription drugs under Medicare Part D. If you want prescription drugs coverage, you have to get a different plan from a private insurer that offers it. You can also get a Medicare Supplement Insurance (Medigap) policy to cover your out-of-pocket medical expenses from Original Medicare.

  • Medicare Advantage: Private insurance companies offer these substitutes for Original Medicare. They are considered Medicare Part C, a combination of Medicare Parts A and B and extra benefits. The private insurer decides the extra benefits, usually dental, hearing, vision, and prescription drugs (Part D) coverage. The insurer also determines the cost of coverage.

How to Qualify for Medicare Insurance?

You qualify for Medicare if you are a citizen or legal resident of the United States. Also, if you:

  • Are 65 years or older and qualified for Social Security or Railroad retirement benefits — Aged;
  • Are 65 years or older and entitled to monthly Social Security benefits based upon the spouse’s work record, and their spouse is not younger than 62 years;
  • Are below 65 years, but have been entitled to Social Security disability benefits for 24 months — Disabled;
  • Have End-Stage Renal Disease (ESRD) — permanent kidney failure that requires dialysis or a transplant; or
  • Have Amyotrophic Lateral Sclerosis (ALS), also called Lou Gehrig’s disease.

You can check your Medicare eligibility by using the Medicare.gov eligibility tool.

Where to Buy Medicare Insurance in Texas?

If you are just enrolling for Medicare, you can sign up through any of the following ways:

  • Filling out an online application on the Social Security Administration’s website.
  • By calling Social Security on (800) 772-1213
  • Visiting a local Social Security office located in your area
  • Sending a signed and dated letter with your name and Social Security Number by mail to Social Security that you want to enroll for Medicare.

If you are looking for a Medicare Advantage plan, you can get it through any of the following ways:

  • Calling Medicare on (800) 633-4227.
  • Using the Medicare Plan Finder to get a plan.
  • Contacting the plan provider by telephone or online.

You should reach out to an insurance agent in Texas to help clarify anything you do not understand. You can also use your MyMedicare.gov account to manage your coverage once you have enrolled for Medicare.

Where to Get Medicare Insurance?

If you are just getting started with Medicare, you can apply for Medicare through the Social Security Administration via one of the following ways:

  • Calling Social Security at (800) 772-1213
  • Submitting an online application using the Social Security Administration’s website.
  • Visiting a Social Security office in your neighborhood
  • Enrolling in Medicare by mailing a signed and dated letter to Social Security with your name and Social Security Number.

If you want to get a Medicare Advantage plan, you can do it in one of the following ways:

  • Call Medicare at (800) 633-4227.
  • Find a plan using the Medicare Plan Finder.
  • Get in touch with the plan provider via the phone or online.

You can contact a licensed insurance agent in Texas to help you get Medicare insurance. They can help you get the best coverage that meets your needs.

Where Can I Buy Affordable Medicare Insurance?

If you are applying for Original Medicare, you have to apply through the Social Security Administration. Use the method that is most convenient for you to contact the Social Security Administration:

  • You can book an appointment with your local Social Security office - in person or over the phone. You may call Social Security at (800) 772-1213.
  • During regular business hours, go to your local Social Security Administration office.
  • Book an appointment with your local Social Security Administration office.
  • Visit the official Social Security website for further information.

If you are looking for an affordable Medicare Advantage plan, you can use the Medicare Plan Finder to compare the rates of different plans available in your area. In addition, insurance agents in Texas can show you the different plans from different insurers and advise you on the right pick based on your health needs and income.

How to Apply for Medicare Insurance in Texas?

You can apply for Medicare by contacting the Social Security Administration through any of the following means:

  • Call Social Security at (800) 772-1213 to fix an in-person or telephone appointment with your local Social Security Administration office.
  • Visit your local Social Security Administration office at the regular business time.
  • Contact your local Social Security Administration office directly to schedule an appointment.
  • Make an application through the Social Security Administration website.

Who Can Help with Application for Medicare Insurance?

An agent or helper in your neighborhood can assist you in applying for Medicare in Texas. An agent sells the Medicare Advantage plans on behalf of insurance companies. As a result, an agent can provide you with information regarding each company’s Medicare coverage. An agent can either be a captive agent or an independent agent (broker).

A captive agent sells insurance plans of just one insurance company, while an independent agent (or broker) sells plans of different companies. You can choose a plan from the various plans a broker sells

Anyone in your neighborhood familiar with health insurance may be helpful. For example, it could be someone who has been buying health insurance for a long time and appears to be familiar with the procedure. They can provide you with as much information as they know.

You should consider enrolling for Medicare insurance with the help of an agent. An agent will give you all the necessary information about the various Medicare plans available in your area and help you get the best coverage from these options.

Should I Use an Insurance Agent to Buy Medicare Insurance?

Yes. When you want to purchase Medicare insurance, you should work with a Medicare insurance agent in Texas. They can assist you with deciding the plan that suits your health needs.

Can You Purchase Medicare Insurance Through an Agent?

Yes, you can buy Medicare insurance in Texas through an agent. If this is your first time purchasing Medicare insurance, an agent can provide you with the required information and assist you in selecting the best plan for your health needs. Even though this is not your first time, an agent can still assist you by giving you updates on the Medicare insurance application process. This can include getting savings, new healthcare plans that may be more suitable for you, or an interpretation of your policy's conditions.

Why Do I Need an Agent for Medicare Insurance?

You may require the services of a Medicare agent in Texas for various reasons. Here are a few examples:

  • There are no extra charges, and your premium will be the same as if you purchased the policy directly from the provider.
  • An agent can save you money on your monthly premiums by reviewing plans from all carriers vs. just one carrier.
  • Agents can keep you updated about any changes that occur every year.
  • They may be able to assist you with Medicare claims.
  • They will assist you in obtaining a better bargain than you might obtain on your own.
  • They can provide you with an unbiased view of all of your Medicare choices.

Medicare is riddled with jargon, plans that sound alike, deadlines, and hidden expenses. If you have never dealt with anything like this before, you're in for a steep learning curve. This is when the role of an agent comes into play.

A licensed agent in Texas can search hundreds of policies from several insurers quickly and efficiently, saving you time. Many Medicare subscribers are unaware that various companies charge varying premiums for the same coverage.

Agents can assist you in determining the appropriate level of coverage for your needs and budget. This is something they do daily. They will be able to identify problems and provide you with suggestions based on their own experiences.

Why is an Insurance Agent Important for Medicare Insurance?

An insurance agent in Texas is important for Medicare because they help discover your healthcare needs and deliver the best coverage that suits you. They can also assist with explaining the workings of Medicare and update you about changes annually.

What Kind of Insurance Agents Work with Medicare Insurance?

There are two kinds of agents that work with Medicare — captive agents and independent agents. A captive agent works with just one insurance company and sells the company’s plans only. An independent agent works for and sells the plans of different insurance companies. An independent agent is also called a broker.

How to Choose an Agent for Medicare Insurance?

You can choose a Medicare insurance agent in Texas, depending on your preferences. There are two types of agents: captive and independent. A captive agent sells the plans of only one company or group of companies. An independent agent represents various insurance companies and sells a wide range of insurance products. An independent agent is a great option if you want to look at all plan options before deciding on a plan. If you already know which provider you want coverage from, you can contact their agent directly.

How Can I Find an Agent Who is Proficient in Medicare?

You can find an insurance agent in Texas who is proficient in Medicare around you by using the HealthCare.Gov’s Find Local Help search tool. The Texas Department of Insurance (TDI) also provides a list of Medicare agents in Texas - name, address, and phone number. When choosing an agent, you should consider their experience.

What Do Insurance Agents Do for You in Medicare Insurance?

An insurance agent in Texas can help you review different health plans or evaluate your present health plan. You save a lot of time and effort in the process. They can also help with medical underwriting. Usually, when you get a Medigap plan outside your open enrollment, the insurer does not provide you the same premium rates as your open enrollment period. Instead, they determine your premium through medical underwriting. Medical underwriting involves assessing your present state of health to decide your premium for coverage. Because of underlying health conditions, the insurer may decide not to enroll you in the plan at all. A Medicare agent or broker can help you figure out whether you will be able to meet the underwriting standards for the plans you are considering.

What Should Your Insurance Agent Do for You?

Under Medicare in Texas, there are rules regarding what your insurance agent can do for you before, during, and after meeting with them. They include:


  • To meet in person, the agent must first obtain your permission and document the plan options you intend to talk about.
  • The agent would not come to your home without scheduling an appointment

DURING the meeting, your agent may do any of the following:

  • Provide you with plan materials.
  • Tell you where you may find out more about the plan.
  • Tell you about the plan choices you agreed to talk about.
  • Provide you with an enrollment form.
  • Get your filled-out enrollment form.
  • Give you their business card to offer to your friends and family.

AFTER you decide to join the plan:

  • The insurance company will call you to confirm that you intend to join and that you are familiar with the plan’s coverage and terms.
  • The agent who assisted you in enrolling in the plan can contact you to discuss additional plan options.

How Important is to Have a Local Agent for Medicare Insurance?

All you need is an insurance agent who is licensed in Texas. They will provide you with all the plan options that suit your needs. The locality of your agent is not relevant.

Does it Cost Me Extra to Use an Insurance Agent for Medicare Insurance?

No, it does not cost you extra to get the help of a Medicare insurance agent. Their services are free. They get paid by the insurance companies that they represent.

How Does a Medicare Insurance Agent Get Paid?

An agent is paid by the insurance company whose product they sell. The payment is usually in the form of a commission based on an agreement. They get paid for the number of persons they enroll in a plan for the first year. They also get paid for each year the person remains on that plan.

How to Compare Medicare Insurance Quotes?

Comparing Medicare quotes is very easy. You can compare Medicare quotes based on your location online through the Medicare Plan Finder. You can also contact insurance companies you know that sell Medicare plans to get quotes. The benefit of comparing quotes yourself is that you will have adequate information about the available plans and will be able to choose the most cost-effective option. However, if you compare quotes without professional help, you may end up selecting a low-cost plan that does not give you the coverage you require. Because you did not properly comprehend or verify the plan’s terms. Thus, a more reliable option to compare quotes is using a Texas licensed insurance agent.

How Many Medicare Insurance Quotes Should I Compare?

You should compare at least two - three quotes. However, there is no standard for the number of quotes you should compare. Just know that the more quotes you get, the more options you have. In this situation, you will need the help of an insurance agent in Texas to help you go through these quotes and the benefits of the plans. You save a lot of time and effort when you engage the services of a licensed insurance agent in Texas.

Can I Buy Medicare Coverage Online?

Yes. You can sign up for Medicare by making an online application on the Social Security Administration’s website. You can also assess plans through the Medicare Plan Finder portal.

Can Anyone Get Medicare Insurance in Texas?

No. You have to be qualified to get Medicare insurance. A person qualified for Medicare is a citizen or legal resident of the U.S. that is any of the following:

  • Aged 65 or older
  • Below 65 years with disabilities
  • With End-Stage Renal Disease.

Can You Obtain Medicare Insurance at Any Time?

There are three enrollment periods for persons who qualify and are interested in getting Medicare in Texas:

  • Initial enrollment period: This is the period when you initially qualify for Medicare. It is a seven-period that begins three months before you turn 65 and ends three months after you become 65. You have to register during your initial enrollment period; else there may be late enrollment penalties;
  • General enrollment period: This is between January 1 and March 31 every year;
  • Special enrollment period: This can happen at any time of the year when you or your spouse is still employed and have group health coverage.

Can I Over Insure Medicare in Texas?

Yes, you can over-insure Medicare. When you get more insurance than you need, this is known as over-insurance. As a result, the coverage extends beyond your medical needs. In the end, you will not get the full value of your policy, and you will lose money in the process. You can overinsure Medicare when you buy a Medicare Advantage or drug plan that does not fit your medical needs. For example, you enroll for a plan that covers medical services that you do not need and makes you pay high premiums. You will be paying for coverage that you will not fully enjoy.

You can save money by purchasing a Medicare plan tailored to your specific medical needs. Contact a Texas-licensed health insurance agent to learn more about how you can do this.

What Happens if I Over Insure My Medicare?

The goal of insurance is to restore you to the position you were in before the loss occurred. Insurance is not designed to help you improve your situation. As a result, if you over-insure your Medicare, you will pay more than you need for your coverage and will not receive the full benefits. Instead, it is a waste of your money because you do not require that level of insurance coverage. You have the option of saving the money or investing it in more profitable projects.

Should I Over Insure My Medicare?

No, you should not over-insure your Medicare coverage. In general, no form of insurance coverage should be over-insured. You can speak with a Texas agent about the over insurance of Medicare coverage and what you can do to avoid it.

Is Buying too Much Medicare Insurance a Smart Decision?

No, purchasing too much Medicare coverage or any health care insurance is not a smart decision. To find out how much Medicare you should get, speak with a registered insurance agent in Texas.

How Do I Renew My Medicare Insurance?

In most cases, once you have signed up for Medicare, you will not need to renew your coverage every year. This goes for Original Medicare, Medicare Advantage plans, Prescription Drugs plans, or Medigap plans. All you have to do is ensure that you pay your premiums on time, and your coverage will automatically be renewed every year. However, there are a few situations where you will be required to take action to continue your coverage. They mostly have to do with plans provided by Medicare-approved private insurers for Medicare Advantage, Prescription Drugs Coverage, and Medigap. These situations include:

  • When your plan reduces its service area, which no longer includes where you live.
  • Your insurance company’s contract with Medicare is expiring in the coming year.
  • Your insurance company intends to leave the Medicare program in the middle of the year.
  • Medicare terminates your insurance company’s contract.

You will get a Medicare plan non-renewal notice in October of that year if any of the above happens. Note that while your Medicare coverage is automatically renewed every year, you should try to review your coverage every year with a licensed insurance agent in Texas.

What Kind of Medicare Insurance is Best in Texas?

You have two main options when deciding what Medicare coverage you want. They are Original Medicare (with or without the help of Medigap) and Medicare Advantage. Deciding which one is best for you depends on some factors, such as:

Cost: You need to consider how much you can pay for health coverage because both Original Medicare and Medicare Advantage have premiums and out-of-pocket costs.

Coverage: You should figure out your health needs. The level of coverage you need can fit into any of the six options below:

  • Original Medicare alone: Provides you with in-patient and out-patient services.
  • Original Medicare and Medicare Supplemental (Medigap) coverage covers costs that Medicare does not cover.
  • Original Medicare, Medigap, and Prescription Drug Plan
  • Original Medicare and Prescription Drug Plan
  • Medicare Advantage with Prescription Drugs Coverage.
  • Medicare Advantage without Prescription Drugs Coverage.

Access to Benefits: With Original Medicare, you can access medical services from all over the country. Access to services under a Medicare Advantage plan is limited to your insurance provider's network.

You should consider talking to a licensed insurance agent in Texas when deciding what Medicare coverage you should get. An agent will provide you with all the relevant information and variables to consider to make the best decision.

What Kind of Medicare Insurance Plans are Available?

There are two main Medicare plans:

  1. Original Medicare: This is a combination of Medicare Part A (hospital insurance) and Part B (medical insurance). It excludes services relating to ear, eye, dental, and drug coverage. You can get a stand-alone prescription drugs plan. You can also get a Medicare Supplemental (Medigap) plan to cover your Original Medicare out-of-pocket costs.

  2. Medicare Advantage: It covers the benefits of Original Medicare and provides extra benefits. They are offered by private health insurance companies, who decide what extra benefits they will provide. It usually includes regular ear, eye, dental checkups and drug coverage.

Can I Bundle Medicare and Other Health Coverages?

Yes. Your Medicare coverage can operate with any other major health coverage you have. Each coverage is a “payer.” The “coordination of benefits” rules come to play when you have more than one payer. Your “primary payer” will settle what it owes on your bill first, then the rest will be taken care of by your “secondary payer.” For example, if you have Medicare and Medicaid, the former will pay first, and the latter will pay second. If you are under 65, disabled, retired, and have group health coverage from your previous job, your Medicare plan will pay first, and your retiree coverage will pay second.

The Benefits Coordination & Recovery Center answers all inquiries about who pays first. You can call them at (855) 798-2627, TTY users can call (855) 797-2627. You can also speak to a licensed health insurance agent in Texas about this issue.

Can Medicare Insurance Be Combined with Other Insurance, to Become More Affordable?

You can have Medicare with other insurance plans, for example, a job plan, COBRA, or TRICARE. When this happens, some rules decide which health coverage will first cover your health costs and which one will cover the rest. This is called coordination of benefits. Both plans must only cover your incurred costs to the extent of your plan limits. They are not to reimburse you more than 100% of the incurred cost. The plan that pays first is the primary payer, and the plan that pays the rest is the secondary payer.

How to Reinstate Medicare Insurance That You Stopped Paying?

You can reinstate or re-enroll for your Medicare Part B, Medicare Advantage plan, or drug plan that got canceled because you stopped paying premiums. However, you will have to pay the outstanding premiums owed before your enrollment request is approved. In addition, you can re-enroll only during a valid enrollment period because payment of past premiums does not automatically mean you can be reinstated into the plan.

To re-enroll in Medicare Part B, you will have to pay the late enrollment penalty, which means your monthly premium may go up 10% for each 12-month period you went without Part B coverage. You can re-enroll for Medicare Part B by following the instructions below:

To re-enroll in your previous Medicare Advantage or drug plan, contact the insurance provider. They will provide you with instructions on what to do.

You can also request to be re-enrolled under Medicare’s “Good Cause” policy if you have a good reason for not paying your premiums within the grace period. The reason could be an emergency or an unexpected event that prevented you from paying your premiums when due. It could be because you were hospitalized, had a serious illness, lost your spouse or a close family member, or experienced a house fire. If your previous plan accepts your request, you will be allowed to pay the outstanding premiums within the three months of disenrollment to have the coverage back. You have to request Good Cause within 60 days after the plan disenrolled you.

How to Find Out What Medicare Insurance I Have?

You can check what Medicare plan you have on your MyMedicare.gov account. It gives you information about the plan you have and the benefits it provides. If you have not created an account, you can create an account after enrolling for Medicare through the Social Security Administration.

Is Medicare Insurance a Good Deal?

Yes. Healthcare is really expensive, and getting good health insurance is costly when you are older or have a pre-existing condition. Leaving the people that qualify for Medicare to find health insurance themselves or pay their healthcare costs will be giving them a huge financial burden, which is the last thing they need at that point in their lives. Medicare provides comprehensive health coverage at very cost-effective rates. People who qualify for Medicare also have access to a wide network of providers, depending on their insurance plans.

Make sure to discuss all your Medicare questions with knowledgeable and experienced health insurance agents licensed to operate in Texas.