Medicare in Texas

Medicare enrollment in Texas

The number of Medicare beneficiaries in Texas stood at over 4.9 million as of January 2026.¹

Although most people become eligible for Medicare coverage when they turn 65, people can also become eligible for Medicare after receiving Social Security disability benefits for two years or following a diagnosis of end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). About 9% of Medicare beneficiaries in Texas were under the age of 65 as of early 2026.¹

Learn more about Medicare Advantage, Medicare’s annual open enrollment period, and the Medicare Advantage open enrollment period.

Medicare Advantage plan availability and enrollment in Texas

Medicare Advantage plans are marketed in all counties in Texas in 2026, but plan availability ranges from county to county. The average Medicare beneficiary in Texas can choose from among 36 Medicare Advantage plans in 2026.²

As of January 2026, almost 55% of Texas Medicare beneficiaries were enrolled in Medicare Advantage plans.¹ The other 45% of Medicare beneficiaries in Texas were enrolled in Original Medicare.¹

Medicare supplement (Medigap) enrollment and regulations in Texas

According to AHIP, 945,247 Texas residents had Medigap coverage as of 2023³ to supplement their Original Medicare coverage. In Texas, 40 insurers offer Medigap plans.⁴

Unlike other Medicare plan coverage (Medicare Advantage and Medicare Part D prescription drug plans), there is no annual open enrollment window for Medigap plans. Instead, federal rules provide a one-time six-month window when Medigap coverage is guaranteed issue. This window opens when a person is at least 65 and enrolled in Medicare Part B. (You must be enrolled in both Part A and Part B to purchase a Medigap plan.)

Although disabled Americans under the age of 65 are eligible for Medicare, federal rules do not guarantee access to Medigap plans for people who are under 65. But the majority of the states – including Texas – have implemented rules to ensure that disabled Medicare beneficiaries have at least some access to Medigap plans.

Texas law requires Medigap insurers to offer at least Medigap Plan A to disabled enrollees under age 65, during the six-month period that begins when they’re enrolled in Medicare Part B.⁵ Medigap Plan A is the least comprehensive of the Medigap plans, but it will cover the 20% Part B coinsurance that the enrollee would otherwise have to pay out-of-pocket.⁶

When a disabled Medicare beneficiary turns 65, they have a six-month window during which they can switch to any available Medigap plan. So at that point, they are no longer limited to only Plan A.

Although only Medigap Plan A is guaranteed-issue for most under-65 Medicare beneficiaries in Texas, state legislation enacted in 2025 requires all Medigap plans to be guaranteed-issue for people under 65 who have ESRD or ALS. The new legislation also limits how high premiums can be for Medigap enrollees with ESRD or ALS.⁷ (This is quite unusual. It’s much more common to see state Medigap protections not apply to people with ESRD, as opposed to stronger protections for people with ESRD.)

Learn how Medigap plans are regulated and standardized.

Medicare Part D plan availability and enrollment in Texas

In Texas, there are 12 stand-alone Medicare Part D prescription drug plans for 2026, with premiums starting at $0.⁸

As of early 2026, there were more than 1.7 million Medicare beneficiaries in Texas with stand-alone Medicare Part D prescription drug plans.¹ More than 2.2 million Texas residents had Medicare Part D prescription drug coverage integrated with their Medicare Advantage plans.¹

Learn how Medicare Part D prescription drug coverage works, what it pays for, how and when to enroll.