Medicare in Houston: Your Complete Guide to Plans & Providers (2026)

Houston is home to more than 700,000 Medicare beneficiaries, making it one of the largest Medicare markets in the entire United States. With the world-renowned Texas Medical Center, dozens of Medicare Advantage plan options, and a vast network of providers, Houston seniors have access to some of the best healthcare in the country — but navigating all those choices can feel overwhelming.

Whether you’re turning 65, recently moved to Houston, or reviewing your coverage during Open Enrollment, this guide covers everything you need to know about Medicare in Houston for 2026: the top plans available, major hospital systems that accept Medicare, local counseling resources, and practical tips for getting the most out of your coverage.

Houston’s Medicare Landscape: Key Statistics for 2026

Before diving into plan options and providers, here’s a snapshot of Medicare in the Houston metropolitan area:

• Medicare beneficiaries in Harris County: Over 550,000 (with an additional 150,000+ in surrounding counties like Fort Bend, Montgomery, and Brazoria)
• Medicare Advantage penetration rate: Approximately 58%, well above the national average of 51%
• Number of Medicare Advantage plans available: 80+ plans from 15+ insurance carriers
• Average Medicare Advantage premium: $0–$45/month for HMO plans; $25–$89/month for PPO plans
• Part B premium (2026): $185.00/month (standard nationwide amount)
• Part D average premium in Houston: $32–$55/month depending on formulary and coverage level

Houston’s competitive insurance market means beneficiaries often have access to $0-premium Medicare Advantage plans with generous extra benefits — but not all plans are created equal.

Top Medicare Advantage Plans in Houston for 2026

The Houston area is served by all of the major national Medicare Advantage carriers, plus several regional plans. Here are the top-rated options for 2026:

1. Humana Gold Plus HMO (H0028-048)

Humana is the largest Medicare Advantage provider in the Houston area, covering Harris County and all surrounding counties.

• Monthly premium: $0
• Star rating: ★★★★½ (4.5 out of 5)
• In-network deductible: $0
• Maximum out-of-pocket: $4,500
• Primary care copay: $0
• Specialist copay: $30
• Key extras: Dental ($2,500 annual max), vision (annual exam + $250 eyewear allowance), hearing aids ($1,500/year), OTC allowance ($80/quarter), SilverSneakers fitness
• Network: Includes Houston Methodist, Memorial Hermann, HCA Houston Healthcare, and most major physician groups

Humana’s strong Houston network and comprehensive extras make it consistently one of the most popular choices among Houston Medicare beneficiaries.

2. UnitedHealthcare AARP Medicare Advantage (PPO)

UnitedHealthcare offers some of the broadest networks in Houston, including PPO options that allow out-of-network care.

• Monthly premium: $0–$27 (varies by specific plan)
• Star rating: ★★★★ (4.0 out of 5)
• In-network deductible: $0
• Maximum out-of-pocket: $5,900 in-network / $8,300 combined
• Primary care copay: $0
• Specialist copay: $40
• Key extras: Dental ($2,000 annual max), vision, hearing, $50/quarter OTC, Renew Active fitness program, $0 telehealth visits
• Network: Extensive — virtually all Houston-area hospitals and most physicians accept UnitedHealthcare Medicare Advantage

The PPO structure makes UnitedHealthcare a strong choice for Houston residents who travel frequently or want flexibility to see out-of-network specialists.

3. Aetna Medicare Eagle PPO (H5521-090)

Aetna has been expanding aggressively in the Houston market and offers competitive benefits.

• Monthly premium: $0
• Star rating: ★★★★ (4.0 out of 5)
• Maximum out-of-pocket: $5,500 in-network
• Primary care copay: $0
• Specialist copay: $35
• Key extras: Dental ($1,500 annual max), vision ($200 eyewear), hearing aids, $60/quarter OTC allowance, meal delivery post-hospitalization (14 meals)
• Network: Includes Houston Methodist, Memorial Hermann, most CHI St. Luke’s locations, and Kelsey-Seybold Clinic

4. Cigna True Choice Medicare Advantage (PPO)

• Monthly premium: $0–$35
• Star rating: ★★★★ (4.0 out of 5)
• Maximum out-of-pocket: $6,200
• Primary care copay: $0
• Specialist copay: $40
• Key extras: Dental, vision, hearing, OTC allowance, virtual care at $0
• Network: Broad PPO network across the Houston metro

5. WellCare by Health Net (HMO)

WellCare offers some of the most generous supplemental benefits for lower-income Houston beneficiaries.

• Monthly premium: $0
• Star rating: ★★★½ (3.5 out of 5)
• Maximum out-of-pocket: $4,200
• Primary care copay: $0
• Specialist copay: $25
• Key extras: Dental ($3,000 annual max), vision, hearing, $100/quarter OTC allowance, transportation (24 one-way trips/year), grocery allowance for those with chronic conditions
• Network: Selective — confirm your providers are in-network before enrolling

How to Choose the Right Plan in Houston

When comparing Medicare Advantage plans in Houston, focus on these factors:

1. Check your doctors: Make sure your primary care physician, specialists, and preferred hospital are in-network
2. Review drug coverage: Compare Part D formularies — the cheapest plan can become the most expensive if it doesn’t cover your medications
3. Consider your health needs: If you have chronic conditions, look at specialist copays and maximum out-of-pocket costs, not just premiums
4. Evaluate extras: Dental, vision, and hearing benefits vary dramatically between plans
5. Look at star ratings: Higher-rated plans typically deliver better care coordination and customer service

Major Hospital Systems Accepting Medicare in Houston

Houston’s healthcare infrastructure is among the best in the world, anchored by the Texas Medical Center — the largest medical complex on Earth. Here’s what Medicare beneficiaries need to know about the major systems:

Houston Methodist Hospital System

Houston Methodist operates 8 hospitals across the Greater Houston area and is consistently ranked the #1 hospital in Texas by U.S. News & World Report.

• Locations: Main campus (Texas Medical Center), Baytown, Clear Lake, Cypress, Sugar Land, The Woodlands, West Houston, Willowbrook
• Medicare acceptance: Original Medicare and most Medicare Advantage plans
• Specialties: Cardiology (#6 nationally), neurology, orthopedics, transplant surgery, cancer care
• Key for Medicare patients: Houston Methodist has dedicated Medicare navigators who help patients understand coverage, prior authorizations, and out-of-pocket costs. Call (713) 790-3333 for assistance.

MD Anderson Cancer Center

The University of Texas MD Anderson Cancer Center is ranked the #1 cancer hospital in the United States and is a critical resource for Houston Medicare beneficiaries facing a cancer diagnosis.

• Location: Texas Medical Center (main campus), plus satellite locations in Sugar Land, The Woodlands, Katy, and League City
• Medicare acceptance: Accepts Original Medicare (Parts A and B). Important: MD Anderson does NOT participate in most Medicare Advantage HMO networks. If you have or are at high risk for cancer, consider staying on Original Medicare with a Medigap supplement to ensure access.
• What to know: Some Medicare Advantage PPO plans provide partial out-of-network coverage at MD Anderson, but costs will be significantly higher than in-network care. Always verify coverage before scheduling treatment.

Memorial Hermann Health System

Memorial Hermann is the largest not-for-profit health system in Southeast Texas, with 17 hospitals and numerous specialty clinics.

• Locations: Texas Medical Center, Greater Heights, Katy, Memorial City, Northeast, Pearland, Southeast, Southwest, Sugar Land, The Woodlands, and more
• Medicare acceptance: Original Medicare and most major Medicare Advantage plans (Humana, UnitedHealthcare, Aetna, Cigna)
• Specialties: Trauma care (Level I trauma center), heart and vascular, joint replacement, neuroscience, women’s health
• Key for Medicare patients: Memorial Hermann offers a Senior Health Program with dedicated geriatric care coordinators and fall-prevention programs

Texas Medical Center Overview

The Texas Medical Center (TMC) is not a single hospital but a campus of 60+ institutions, including:

• Houston Methodist — #1 in Texas
• MD Anderson Cancer Center — #1 in cancer care nationally
• Baylor St. Luke’s Medical Center — heart transplant and cardiac surgery
• Texas Children’s Hospital — relevant for grandparents with custody
• Harris Health System (Ben Taub Hospital) — safety-net hospital serving low-income Medicare/Medicaid patients
• Michael E. DeBakey VA Medical Center — for veterans with Medicare

All TMC institutions accept Original Medicare. Medicare Advantage acceptance varies by plan — always verify before scheduling.

Other Notable Hospital Systems

• HCA Houston Healthcare: 13 hospitals across Greater Houston. Accepts most Medicare plans. Strong emergency and surgical services.
• CHI St. Luke’s Health: Part of CommonSpirit Health. Multiple locations including the TMC campus. Accepts Original Medicare and most MA plans.
• Kelsey-Seybold Clinic: Major multi-specialty clinic group with 40+ locations. Has its own Medicare Advantage plan (KelseyCare Advantage) and accepts several other MA plans.

Medicare Supplement (Medigap) Plans in Houston

If you prefer Original Medicare with the freedom to see any provider — including MD Anderson without restrictions — a Medicare Supplement (Medigap) plan can fill the coverage gaps.

Most Popular Medigap Plans Among Houston Seniors

Houston-specific tip: Medigap premiums in Houston tend to be 10–15% higher than rural Texas areas due to higher healthcare costs, but they’re still lower than many coastal cities. Shop around — premiums can vary by 40% or more between carriers for the exact same coverage.

Top Medigap Carriers in Houston

• AARP/UnitedHealthcare — Largest Medigap provider nationally, competitive rates
• Mutual of Omaha — Consistently low premiums, well-rated
• Cigna — Strong customer service, household discounts available
• Blue Cross Blue Shield of Texas — Preferred by many Houston physicians
• Aetna — Competitive, especially for younger enrollees

Part D Prescription Drug Coverage in Houston

Whether you have Original Medicare or a Medicare Advantage plan without drug coverage, you’ll need a standalone Part D plan. Houston is in the CMS Part D Region 28 (Texas).

Top Part D Plans in Houston for 2026

1. SilverScript Choice (CVS Health) — $7.90/month premium, strong formulary, preferred pharmacy at CVS and Walgreens
2. Humana Walmart Value Rx — $13.40/month, lowest copays at Walmart and Sam’s Club pharmacies
3. WellCare Value Script — $0 premium, but more limited formulary
4. AARP MedicareRx Preferred — $34.70/month, broadest formulary coverage and lowest copays at Costco

Houston pharmacy tip: H-E-B pharmacies participate in most Part D preferred pharmacy networks and often have the lowest copays for generic medications. If you have an H-E-B nearby, check which plans include it as a preferred pharmacy.

Free Medicare Counseling in Houston: HICAP/SHIP

Texas offers free, unbiased Medicare counseling through the Health Information, Counseling, and Advocacy Program (HICAP), part of the national State Health Insurance Assistance Program (SHIP).

Where to Get Free Medicare Help in Houston

Harris County Area Agency on Aging

• Phone: (832) 393-4301
• Website: www.houstontx.gov/health/Aging
• Services: One-on-one Medicare counseling, plan comparisons, enrollment assistance, help with appeals and billing issues
• Note: Counselors are trained volunteers — they do NOT sell insurance and have no financial interest in which plan you choose

BakerRipley (formerly Neighborhood Centers)

• Phone: (713) 667-9400
• Locations: Multiple sites across Houston, including East End, Gulfton, Pasadena, and Baytown
• Services: Medicare enrollment help, Extra Help/LIS applications, Medicaid screening, benefits checkup

AARP Houston Office

• Phone: 1-888-687-2277
• Services: Medicare information sessions, fraud prevention workshops, and online plan comparison tools

Medicare Enrollment Events in Houston

During the Annual Enrollment Period (October 15 – December 7), Houston hosts dozens of free Medicare events:

• Houston Public Library system: Free Medicare workshops at multiple branches (check hpl.lib.tx.us for schedule)
• Community centers: Listings available through Harris County Precinct offices
• Senior centers: West Gray Multi-Service Center, Acres Homes Multi-Service Center, and others host SHIP counselors weekly

Pro tip: Schedule your free SHIP counseling appointment early — slots fill up fast during Open Enrollment. Call at least 2–3 weeks before your desired appointment date.

Medicare Eligibility and Enrollment in Houston

When to Enroll

• Initial Enrollment Period (IEP): 7-month window around your 65th birthday (3 months before, your birthday month, 3 months after)
• Annual Enrollment Period (AEP): October 15 – December 7 each year to switch Medicare Advantage or Part D plans
• Medicare Advantage Open Enrollment: January 1 – March 31 (switch between MA plans or return to Original Medicare)
• Special Enrollment Periods (SEPs): Available if you lose employer coverage, move to a new area, qualify for Extra Help, or have other qualifying life events

Where to Enroll in Houston

1. Online: Medicare.gov — Create an account to compare plans and enroll
2. By phone: 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, available 24/7
3. In person at Social Security:
   • SSA Houston Downtown: 515 Rusk Ave, Suite 11001, Houston, TX 77002
   • SSA Houston Galleria: 8876 Gulf Freeway, Suite 100, Houston, TX 77017
   • SSA Pasadena: 3807 Shaver St, Pasadena, TX 77504
   • Additional offices in Humble, Baytown, Sugar Land, and The Woodlands
4. Through a licensed insurance agent: Many Houston-area agents offer free Medicare plan consultations. Ensure they are licensed in Texas and represent multiple carriers.

Houston-Specific Enrollment Considerations

• Hurricane season: If a federally declared disaster affects the Houston area, CMS may grant Special Enrollment Periods. This happened during Hurricane Harvey (2017) and Hurricane Beryl (2024).
• Military/VA: Houston’s large veteran population should know that VA benefits can be used alongside Medicare. The DeBakey VA Medical Center coordinates with Medicare for dual-eligible veterans.
• Employer coverage: Many Houston residents work past 65, especially in the energy sector. If your employer has 20+ employees, your group plan is primary and Medicare is secondary. You can delay Part B without penalty.

Medicare Costs and Savings Programs in Houston

What Houston Beneficiaries Pay in 2026

Programs to Reduce Your Medicare Costs

Many Houston seniors qualify for programs that lower Medicare costs but don’t know about them:

Medicare Savings Programs (MSPs)

• QMB: Pays Part A & B premiums, deductibles, and coinsurance. Income limit: ~$1,255/month (individual)
• SLMB: Pays Part B premium. Income limit: ~$1,504/month (individual)
• QI: Pays Part B premium. Income limit: ~$1,691/month (individual)
• Apply through Texas Health and Human Services: (211 or www.yourtexasbenefits.com)

Extra Help (Low-Income Subsidy)

• Reduces Part D drug costs dramatically
• Income limit: ~$22,590/year (individual) or ~$30,660/year (couple)
• Apply at ssa.gov or call 1-800-772-1213

Harris Health System Financial Assistance

• Harris Health (Ben Taub and Quentin Mease hospitals) offers financial assistance for Medicare patients with limited income
• Gold Card program provides discounted care at all Harris Health facilities

Houston-Specific Tips for Medicare Beneficiaries

1. Mind the Heat — Use Telehealth

Houston’s brutal summers can be dangerous for seniors. Take advantage of $0 telehealth visits offered by most Medicare Advantage plans. Original Medicare also covers telehealth services — a benefit that was expanded permanently after the COVID-19 pandemic.

2. Transportation Benefits Matter

Houston is a car-dependent city with limited public transit. If you no longer drive, prioritize Medicare Advantage plans with transportation benefits (many offer 24–48 one-way trips per year to medical appointments). Metro’s METROLift paratransit service is also available for Medicare beneficiaries with disabilities.

3. Watch for Balance Billing

Texas has a surprise billing law (effective since 2019, reinforced by the federal No Surprises Act in 2022) that protects you from unexpected out-of-network bills at in-network facilities. If you receive a surprise bill, contact the Texas Department of Insurance at 1-800-252-3439.

4. Pharmacy Shopping Saves Money

Houston has an abundance of pharmacies, and costs can vary significantly:

• Costco (no membership needed for pharmacy): Often lowest prices on generics
• H-E-B: Competitive pricing, preferred network for many Part D plans
• Mark Cuban’s Cost Plus Drugs: Online pharmacy with transparent, low pricing
• Walmart: $4 generic program still active, preferred pharmacy for Humana plans

5. Bilingual Resources

Houston has a large Spanish-speaking population. Medicare resources in Spanish:

• 1-800-MEDICARE has Spanish-speaking representatives (press 2)
• BakerRipley offers counseling in Spanish, Vietnamese, Chinese, and other languages
• Medicare.gov has a full Spanish-language version (es.medicare.gov)

Related Articles

• Best Medicare Advantage Plans in Texas 2026: Compared — Statewide comparison of the top Medicare Advantage plans
• Complete Guide to Medicare in Texas — Everything Texas seniors need to know about Medicare
• Medicare Enrollment in Texas: Dates, Deadlines & How to Sign Up — Step-by-step enrollment guide for Texas residents

Frequently Asked Questions About Medicare in Houston

Does MD Anderson accept Medicare Advantage plans?

MD Anderson Cancer Center accepts Original Medicare (Parts A and B) but does not participate in most Medicare Advantage HMO networks. Some PPO plans may offer partial out-of-network coverage, but you’ll pay significantly more. If cancer care at MD Anderson is important to you, consider staying on Original Medicare with a Medigap supplement plan for full access.

What is the best Medicare Advantage plan in Houston for 2026?

The “best” plan depends on your individual needs, but the most popular options include Humana Gold Plus HMO ($0 premium, 4.5-star rating, broad network), UnitedHealthcare AARP Medicare Advantage PPO (flexibility to see out-of-network providers), and Aetna Medicare Eagle PPO. Compare plans based on your specific doctors, medications, and healthcare needs at Medicare.gov.

How do I find a Medicare counselor in Houston?

Contact the Harris County Area Agency on Aging at (832) 393-4301 for free, unbiased Medicare counseling through the SHIP/HICAP program. BakerRipley also offers multilingual Medicare assistance at multiple Houston locations. These counselors do not sell insurance and provide completely impartial guidance.

Can I use my Medicare in The Woodlands, Sugar Land, or Katy?

Yes. Original Medicare is accepted by virtually all providers nationwide. Medicare Advantage plans sold in the Houston metro area typically include providers in The Woodlands (Montgomery County), Sugar Land (Fort Bend County), Katy (Harris/Waller County), and other suburban areas. Always verify your specific plan’s network before scheduling appointments.

What happens to my Medicare if a hurricane hits Houston?

When a federally declared disaster affects the Houston area, the Centers for Medicare & Medicaid Services (CMS) typically grants Special Enrollment Periods, extends coverage for displaced beneficiaries, and relaxes certain prior authorization requirements. Keep your Medicare card and a list of medications in your emergency go-bag.

Is Medicare more expensive in Houston than other parts of Texas?

Medicare Part A and Part B premiums are the same nationwide. However, Medicare Advantage premiums and benefits vary by county, and Medigap premiums tend to be 10–15% higher in Houston than in rural Texas due to higher healthcare utilization. On the other hand, Houston beneficiaries have access to more $0-premium Medicare Advantage plans with richer benefits due to the competitive market.

This article was last updated on February 13, 2026. Medicare plan details, premiums, and benefits change annually. Always verify current information at Medicare.gov or by calling 1-800-MEDICARE. This content is for informational purposes only and does not constitute medical or insurance advice.