Texas Medicare Supplement Plans: What You Need to Know
Texas has one of the largest and fastest-growing Medicare populations in the country. With its vast geographic size spanning urban centers like Houston, Dallas, San Antonio, and Austin to rural communities, having the right Medicare coverage is essential. That's where unbiased, fee-only guidance makes a difference.
Unlike Medicare Advantage plans that vary by county, Medigap plans in Texas are standardized by letter (A, B, C, D, F, G, K, L, M, N). This means a Plan G from one company covers exactly the same benefits as a Plan G from another company. The only differences are the premium you pay and the company's customer service.
Texas Medigap Open Enrollment Period
In Texas, your Medigap Open Enrollment Period begins on the first day of the month you turn 65 and are enrolled in Medicare Part B. This 6-month window is critical because:
- Insurance companies cannot deny you coverage for any reason
- They cannot charge you more due to health conditions
- You have guaranteed issue rights to any Medigap plan sold in Texas
Texas-Specific Protection
Texas law requires insurance companies to offer a 30-day "free look" period for all Medigap policies. During this time, you can review the policy and cancel for a full refund if you're not satisfied, no questions asked.
Most Popular Medigap Plans in Texas
While 10 standardized Medigap plans are available in Texas, the most popular choices are:
| Plan | Coverage Level | Best For | TX Monthly Premium* |
|---|---|---|---|
| Plan G | Comprehensive | Most new enrollees (best value) | $100 - $220 |
| Plan N | High with copays | Those wanting lower premiums | $75 - $160 |
| Plan F | Most comprehensive | Those eligible before 2020 | $130 - $270 |
*Premium ranges are estimates and vary by age, location within Texas, gender, and tobacco use. Contact us for personalized quotes.
Plan G vs Plan N in Texas
For most Texas residents new to Medicare, the choice comes down to Plan G or Plan N:
- Plan G covers everything except the Part B deductible ($240 in 2024). No copays, no surprises. Ideal if you want predictable costs and visit doctors frequently.
- Plan N has lower premiums but requires up to $20 copays for office visits and up to $50 for ER visits (waived if admitted). Good choice if you're healthy and want to save on monthly costs.
Texas Medicare Supplement vs Medicare Advantage
Texas has a robust Medicare Advantage market, especially in major metro areas. But these are very different products. Here's how they compare:
| Feature | Medigap (Supplement) | Medicare Advantage |
|---|---|---|
| Monthly Premium | $75 - $270+ | $0 - $50 (some higher) |
| Out-of-Pocket Maximum | Very low (predictable) | Up to $8,850/year |
| Doctor Network | Any doctor accepting Medicare | Network restrictions |
| Referrals Needed | No | Often yes (HMO plans) |
| Prescription Drug Coverage | Separate Part D plan needed | Usually included |
| Extra Benefits | None | May include dental, vision, gym |
Read our complete Medigap vs Medicare Advantage guide to understand which option might be better for your situation.
Texas-Specific Medicare Considerations
Rural Texas Coverage
Texas has vast rural areas where Medicare Advantage plan networks can be limited. If you live in or frequently travel to rural Texas, Medigap offers a significant advantage: any doctor or hospital that accepts Medicare will accept your Medigap plan. This is critical in areas where specialist care may require traveling to larger cities.
Winter Texans and Snowbirds
Many people split their time between Texas and other states (or Canada). If you're a "Winter Texan" who lives part of the year elsewhere, Medigap provides nationwide coverage. Your plan works the same whether you're in Houston, Phoenix, or anywhere in between. Medicare Advantage plans often have network restrictions that can be problematic when traveling.
Texas HICAP Program
Texas offers a free counseling program called HICAP (Health Information, Counseling & Advocacy Program) through the Area Agencies on Aging. While HICAP counselors can provide general Medicare information, they cannot recommend specific plans or companies. That's where a fee-only Medicare advisor adds value: we can make specific recommendations based on your individual situation.
Border Region Considerations
If you live along the Texas-Mexico border, be aware that Medicare generally does not cover healthcare received outside the United States. Some Medigap plans (C, D, F, G, M, and N) provide limited foreign travel emergency coverage, which can be valuable if you cross the border frequently.
Frequently Asked Questions: Texas Medicare
The best time is during your 6-month Medigap Open Enrollment Period, which starts the month you turn 65 and are enrolled in Part B. During this time, you have guaranteed issue rights and cannot be denied coverage or charged more due to health conditions.
Yes, but you'll need to go through medical underwriting, which means the insurance company can deny you coverage or charge higher premiums based on your health. Some situations trigger "guaranteed issue" rights outside of open enrollment, such as losing employer coverage or moving out of your plan's service area.
Medigap premiums in Texas typically range from $75-$270+ per month depending on the plan letter, your age, location (Houston and Dallas are often more expensive than rural areas), gender, and tobacco use. Texas generally has competitive Medigap rates compared to many other states.
Plan F is only available to those who became eligible for Medicare before January 1, 2020. If you turned 65 before that date, you can still enroll in Plan F. However, Plan G offers nearly identical coverage (minus the Part B deductible) and often has lower premiums.
Yes. Medigap plans do not include prescription drug coverage. You'll need to enroll in a standalone Medicare Part D plan separately. Texas has many Part D options, and we can help you compare them based on your specific medications.