Key Takeaways:
- Texas Medicare beneficiaries can choose from multiple coverage options – from Original Medicare to Medicare Advantage plans – with opportunities to customize their healthcare coverage through Part D and Medigap plans.
- Monthly premiums and out-of-pocket costs vary widely across Texas’s diverse insurance market, making it crucial to compare available plans in your county.
- Finding your ideal Medicare coverage means balancing provider networks, prescription drug needs, and monthly costs. Free local resources are available to help guide your decision.
With a wide range of plans and providers available, it’s easy to feel overwhelmed when navigating Medicare plans in Texas, the third-largest state for Medicare beneficiaries.
Whether in a major metropolitan area or a rural community, choosing the right plan options requires careful consideration to find the best fit for your healthcare needs and budget.
This comprehensive guide will help you understand your Medicare options in Texas, compare the various costs and benefits available, and equip you with the essential information needed to select coverage that best suits you.
Types of Medicare Plans Available in Texas
Texas residents have access to several Medicare plan options, each designed to meet different healthcare needs. Understanding each plan’s features is essential for choosing coverage that aligns with your medical requirements and budget.
Original Medicare (Part A and Part B)
Original Medicare covers many services across its two parts as the foundation of Medicare coverage. Let’s examine what each part covers and their associated costs:
Medicare Part A (Hospital Insurance) Coverage and Costs:
- Provides coverage for inpatient hospital stays, skilled nursing facility care, hospice services, and certain home healthcare services.
- Most Texas residents receive Part A without paying a premium, $0, if they’ve worked and paid Medicare taxes for at least 10 years. Based on their work history, those who still need to meet this requirement may pay $285 or $518 monthly.
- In 2025, there’s a $1,676 deductible per benefit period. Such a period begins the day you’re admitted as an inpatient and ends when you haven’t received inpatient hospital care for 60 days.
- Your copayments will change depending on how long you stay as an inpatient.
Medicare Part B (Medical Insurance) Coverage and Costs:
- Includes outpatient services, visits to your doctors, preventive care, and medical equipment.
- $185 monthly premium in 2025 (or higher, depending on your income).
- $257 (in 2025) deductible once each year. 2025.
- After meeting your deductible, expect to pay 20% of the Medicare-approved amount for covered services and items.
Data sourced from Medicare Basics
Medicare Advantage (Part C)
Many Texas residents turn to Medicare Advantage plans, which bundle traditional Medicare benefits with extra perks. These Part C plans, managed by private insurers under Medicare’s oversight, typically go beyond basic health coverage, frequently including benefits like prescription drug coverage and dental, hearing, and vision care.
Due to the state’s vast size, private insurance companies offer significant variations in their plan’s coverage and costs.
In 2025, there are 373 Medicare Advantage plans available in Texas. Anyone enrolled with Medicare currently has access to a Medicare Advantage plan.
- The average monthly Medicare Advantage plan premium went down from $9.15 in 2024 to $6.81 in 2025.
- The lowest monthly premium for a Medicare Advantage plan is $0; any Texas resident with Medicare can access such a plan.
Top Medicare Advantage Plans in Texas:
Insurance Carrier | CMS Star Rating | Network Availability | Monthly Premium | Deductible | In-Network Out-of-pocket Max |
---|---|---|---|---|---|
UnitedHealthcare (AARP Medicare Advantage Plan) | 3.82★ | 49 states and D.C. | $29 | $0 | $3,900 |
Humana (HumanaChoice Plan) | 3.63★ | 48 states, D.C., PR | $0 | $0 | $6,400 |
Aetna (Medicare Prime Plan) | 4.27★ | 44 states and D.C. | $0 | $0 | $3,800 |
Cigna (Preferred Medicare Plan) | 3.93★ | 29 states and D.C. | $0 | $0 | $2,600 |
Data gathered via CMS.gov and direct provider plans. Comparison of plans from Texas Zip Code 75080. Star ratings and plan information reflect publicly available data as of 2025.
Private insurers offering Medicare Advantage plans in Texas include:
- Aetna
- Cigna
- Devoted Health
- UnitedHealthcare
- KelseyCare Advantage
- Humana
- Clover Health
Find your perfect Medicare match in Texas.
Every Texas resident’s healthcare needs are unique from Houston to El Paso. At CoverRight, we know the Texas Medicare landscape inside and out. Our experienced advisors can help you cut through the complexity and find a plan that works for your lifestyle and wallet.
Get started, and let CoverRight help you choose with confidence today.
Medicare Prescription Drug Plans (Part D)
Prescription drug coverage is crucial to your Medicare plans in Texas, especially if you regularly take medications. You have two main ways to get this coverage. Either you take a standalone Part D plan alongside your Original Medicare, or you get prescription drug coverage bundled within a Medicare Advantage plan.
Each Part D plan has its own formulary of covered medications. These formularies organize drugs into different price tiers — much like how you might pay different prices for generic versus brand-name medications at your local pharmacy. The lowest tiers typically include low-cost generic drugs, while higher tiers cover more expensive brand-name and specialty medications.
Don’t just look at the monthly premiums when choosing a Part D plan. Consider the total costs, including yearly deductibles and what you’ll pay for your specific medication at the pharmacy counter.
In 2025, Texas residents can choose from 17 stand-alone Medicare prescription drug plans. If you are enrolled in Medicare, no matter your location, you have guaranteed access to at least one plan.
- Over 70% (71.24%) of beneficiaries with a stand-alone Medicare prescription drug plan can switch to a plan with lower premiums than they paid in 2024.
- Approximately 26% of stand-alone Medicare Plan D beneficiaries are eligible for Extra Help, an extra source of financial support.
- The lowest monthly premium for a Medicare prescription drug plan is $0.
Plan Name | Monthly Premium | Deductible | CMS Rating |
---|---|---|---|
WellCare Value Script | $0 | $590 | 3.0★ |
Cigna Healthcare Saver Rx | $20 | $590 | 2.0★ |
AARP MedicareRx Preferred from UHC | $89.20 | $0 | 2.0★ |
Blue Cross Medicare Rx Choice | $60.60 | $590 | 3.0★ |
Data gathered via CMS.gov and direct provider plans. Star ratings and plan information reflects publicly available data as of 2025.Note: Data from MedicareWire
Medigap (Medicare Supplement) Plans
Medigap plans act like a safety net, covering many out-of-pocket expenses that might not be covered by your Original Medicare coverage.
Among the ten standardized Medigap plans, Plans G and N are among the most preferred choices for the millions of Medicare enrollees in Texas.
- Plan G covers nearly every Medicare-approved expense except your Part B deductible.
- Plan N, meanwhile, lets you save on monthly premiums but requires you to handle certain minor copays and potential Part B excess charges yourself.
In Texas, typical premiums vary widely due to regional differences, age, gender, and health status. Plan G can be $150 to $200 per month, and Plan N can be $120 to $170 per month.
The highest-rated Medigap providers in Texas, for both Plan G and Plan N, include:
- AARP
- Pekin Insurance
- Bankers Fidelity
- United American
Learn more: How to Compare Medicare Supplement Plans
Average Costs of Medicare Plans in Texas
Healthcare costs can vary significantly across Texas’s diverse regions, from the bustling Dallas-Fort Worth metroplex to rural West Texas communities. To help you budget effectively, we’ve compiled a comprehensive breakdown of typical Medicare costs throughout the state.
Keep in mind that your actual costs may vary based on factors such as your location, income level, and chosen insurance provider.
Plan Type | Average Monthly Premium | Deductible | What it Covers |
---|---|---|---|
Original Medicare Part A | $0 (if you do not qualify: $285 or $518) | $1,676 | Inpatient care, such as hospital stays, skilled nursing facility care, and hospice care |
Original Medicare Part B | $185 | $257 | Outpatient care, preventative services, and medical equipment |
Medicare Advantage | $6.81 | Varies per plan/region ($0 – $590) | All Original Medicare + extra benefits like vision, hearing, and dental care |
Part D | $63.09 | $495 | Prescription drugs |
Medigap Plan G and N | $120 – $200 | N/A | Fills gaps in Original Medicare out-of-pocket costs |
Note: All data reflect 2025 averages sourced from Medicare.gov, CMS.gov, and MedicareWire and may vary by provider.
Top Medicare Advantage and Medigap Providers in Texas
Each Medicare provider in Texas offers distinct advantages and coverage options. The right provider can significantly improve your healthcare experience, whether through extended coverage or vastly reduced costs, making it necessary to have a comprehensive understanding of available options.
Let’s examine the top-rated insurance companies serving Texan Medicare beneficiaries.
Best Medicare Advantage Providers
When choosing a Medicare Advantage plan in Texas, you’re selecting more than just an insurance policy — you’re choosing a healthcare partner. These plans can offer substantial savings and added benefits beyond Original Medicare, such as dental care, vision services, and prescription drug coverage, often with $0 premiums in many Texas counties.
Finding the right provider ensures you get these extra benefits while maintaining access to your preferred doctors and hospitals.
Carrier | Highest Rating | Lowest Rating | Median Rating | Total Number of MA Contracts |
---|---|---|---|---|
Aetna | 4.5 | 2.5 | 4.0 | 45 |
Centene | 4.0 | 2.0 | 3.0 | 106 |
Cigna | 4.5 | 3.0 | 3.5 | 17 |
Elevance (Anthem BCBS) | 5.0 | 2.5 | 3.5 | 46 |
Humana | 5.0 | 3.0 | 4.0 | 48 |
United Healthcare | 5.0 | 3.0 | 4.0 | 75 |
Note: Medicare Advantage CMS Star Ratings: 6 Major Carriers (Updated 11/15/24).
Best Medigap Providers
When evaluating Medigap providers in Texas, cost and customer service track records are the critical factors in your decision. The best insurance companies consistently demonstrate reliable claims processing, transparent pricing, and responsive customer support.
These top-rated providers have earned their reputation by maintaining high customer satisfaction scores, offering competitive rates, and providing straightforward policies that Texas beneficiaries can count on.
Here’s how the top providers compare for both Plan G and Plan N coverage:
Plan G Medigap Providers in Texas
Carrier | Average Monthly Premium | Fee | A.M. Best Rating |
---|---|---|---|
Pekin Insurance | $97.80 | $25.00 | A- |
AARP | $115.26 | None | A |
Bankers Fidelity | $138.33 | $25.00 | A- |
Thrivent | $147.28 | None | A++ |
United American | $179.00 | None | A+ |
Philadelphia American | $93.22 | $20.00 | B++ |
Western United Life | $93.67 | $25.00 | B+ |
Guarantee Trust Life | $95.61 | $25.00 | B++ |
Unified Life | $95.70 | $25.00 | B++ |
Everest | $96.70 | $25.00 | A+ |
Plan N Medigap Providers in Texas
Carrier | Average Monthly Premium | Fee | A.M. Best Rating |
---|---|---|---|
Pekin Insurance | $80.47 | $25.00 | A- |
Bankers Fidelity | $85.09 | $25.00 | A- |
AARP | $95.49 | None | A |
United American | $139.00 | None | A+ |
Guarantee Trust Life | $78.55 | $25.00 | B++ |
Cigna | $80.21 | None | A |
Unified Life | $80.41 | $25.00 | B++ |
Western United Life | $81.58 | $25.00 | B+ |
Everest | $83.01 | $25.00 | A+ |
USAA Life | $84.83 | None | A++ |
Note: Data for Plan G and Plan N from MedicareWire
How to Choose the Right Medicare Plan in Texas
The right Medicare plan in Texas can significantly impact your life for the better. With many options available, it’s essential to take a thoughtful approach, plan ahead, and consider your individual needs and preferences.
To guide you through this process, here are some key factors to evaluate when comparing Medicare plans:
- Coverage: Carefully review what each plan covers and what it doesn’t. Consider your current health status, any chronic conditions, and your anticipated healthcare needs for the coming year.
- Costs: Pay close attention to the various costs associated with each plan, including monthly premiums, deductibles, copayments, and coinsurance. Factor in your budget and how much you can comfortably afford to spend on healthcare.
- Provider Network: Ensure your plan’s network includes your preferred doctors, specialists, and hospitals. If you require specialized care or have preferred providers, confirm their participation in the plan. Additionally, if you expect to travel, check the wider provider network.
- Prescription Drug Coverage: If you take prescription medications, carefully compare Part D plans or Medicare Advantage plans that include drug coverage. Evaluate your plan’s formulary to check for your required medications. While a lower premium might seem attractive, your overall costs might be higher if the formulary doesn’t include your medications at a reasonable cost.
- Extra Benefits: Some Medicare Advantage plans offer additional benefits that Original Medicare doesn’t cover, such as dental, vision, and hearing care. Consider whether these benefits are important enough for you and factor them into your decision.
How to Enroll in a Medicare Plan in Texas
Understanding the enrollment periods and processes for Medicare plans in Texas ensures you have the right plan at the right time.
Key Enrollment Periods:
- Initial Enrollment Period (IEP): This is your first opportunity to enroll in Medicare Parts A and B. It begins three months before your 65th birthday, includes your birth month, and extends three months after. During this period, you can also enroll in Medicare Advantage (Part C) and Part D prescription drug plans.
- Annual Open Enrollment Period: From October 15th to December 7th each year, you can make changes to your Medicare coverage. This includes switching between Original Medicare and Medicare Advantage, changing Medicare Advantage plans, or enrolling in or changing Part D plans.
- Medicare Advantage Open Enrollment Period (MA OEP): If you’re already enrolled in a Medicare Advantage plan, you can switch to a different Medicare Advantage plan or return to Original Medicare (and join a Part D plan) from January 1st to March 31st.
- Medigap Open Enrollment Period: This six-month period starts when you turn 65 and are enrolled in Medicare Part B. During this time, you can enroll in any Medigap plan without medical underwriting. That means insurers can’t charge you extra based on pre-existing health conditions. This is known as guaranteed issue rights.
- Special Enrollment Periods (SEPs): Certain life events, such as moving, losing employer coverage, or qualifying for Medicaid, may trigger a Special Enrollment Period, allowing you to enroll in Medicare outside the standard enrollment periods.
Steps to Enroll:
- Gather Your Information: You’ll need your Medicare number, Social Security number, proof of citizenship or legal residency, and information about your current health coverage (if any). You may also need tax information, bank account information, and existing prescription medication (depending on various options).
- Explore Your Options: Research the different Medicare plans available in Texas, comparing costs, coverage, and provider networks. Use the Medicare Plan Finder tool on Medicare.gov to help you compare plans side-by-side.
- Enroll Online or By Phone: You can enroll in a Medicare plan online through the Medicare.gov website. This is often the quickest and easiest method. Alternatively, you can call 1-800-MEDICARE (1-800-633-4227) to enroll by phone.
- Enroll with an Insurance Agent: A licensed insurance agent, such as CoverRight, can provide personalized guidance and help you enroll in a plan that meets your needs.
Medicare Resources for Texas Residents
Getting expert help with your Medicare decisions doesn’t have to be expensive or complicated. Texas offers several free resources to help you confidently navigate your Medicare journey.
Health Information, Counseling and Advocacy Program (HICAP)
As Texas’s State Health Insurance Assistance Program (SHIP), HICAP offers personalized Medicare guidance at no cost. Their trained counselors can:
- Walk you through your Medicare options face-to-face.
- Help compare plans and understand costs.
- Explain how Medicare works with other insurance.
Texas Department of Insurance
This is your go-to source for verifying insurance information and understanding your rights.
The Texas Department of Insurance:
- Maintains up-to-date Medicare resources.
- Provides consumer protection guides.
- Offers tools to check insurance company ratings.
- Handles insurance-related complaints.
Texas Area Agencies on Aging
Supporting Texans aged 60 and older, these local organizations provide information to help access a variety of community services. You can find your local Area Agencies on Aging (AAA) by calling their toll-free line (1-800-252-9240).
Ready to find your ideal Medicare coverage in Texas?
Medicare choices can feel as vast as Texas itself. At CoverRight, we specialize in making these big decisions manageable. Our licensed experts take the time to understand your unique needs and guide you to coverage that truly fits.
No more second-guessing your Medicare choices. Let CoverRight help you find the right plan today.
Sources
- Centers for Medicare & Medicaid Services (CMS)
- Medicare Open Enrollment Partner Resources. Published 2024. Available at: cms.gov. Last Accessed November 20, 2024
- Centers for Medicare & Medicaid Services (CMS)
- 2024 Medicare Advantage and Part D Ratings Fact Sheet. Published October 13, 2023. Available at: cms.gov. Last Accessed November 20, 2024
- Medicare.gov
- Medigap Coverage Information: When to Buy. Available at: medicare.gov. Last Accessed November 20, 2024
- Medicare.gov
- Medigap Overview. Available at: medicare.gov. Last Accessed November 25, 2024
- Medicare.gov
- What Does Medicare Cost? Available at: medicare.gov. Last Accessed November 26, 2024.
- Medicare.gov
- When Does Medicare Coverage Start? Available at: medicare.gov. Last Accessed November 26, 2024.
- Medicare.gov
- What Does Medicare Cost? Available at: medicare.gov. Last Accessed November 26, 2024.
- Kaiser Family Foundation (KFF)
- Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2024. Available at: kff.org. Last Accessed November 26, 2024.