Medicare Enrollment in Texas: Dates, Deadlines & How to Sign Up

Medicare enrollment in Texas follows the same federal rules as the rest of the United States, but understanding the specific deadlines and enrollment periods is crucial for avoiding penalties and securing the best coverage. With over 4.2 million Texans enrolled in Medicare, navigating the enrollment process correctly can save you hundreds or thousands of dollars in penalties while ensuring you get the healthcare coverage you need.

This comprehensive Medicare enrollment guide for Texas will walk you through every enrollment period, important deadlines, how to sign up, and the resources available to help Texas seniors make informed Medicare decisions. Whether you’re approaching 65, retiring early, or need to make changes to existing coverage, this guide has everything you need to know about Medicare enrollment in Texas.

Understanding Medicare Enrollment Periods

Medicare has several distinct enrollment periods, each with specific rules about when you can enroll, what changes you can make, and what penalties might apply. Understanding these periods is essential for Texas Medicare beneficiaries.

Initial Enrollment Period (IEP)

Your Initial Enrollment Period is your first opportunity to enroll in Medicare. This is typically the most important enrollment period for new Medicare beneficiaries.

IEP Timeline:

• 3 months before your 65th birthday month
• Your birthday month
• 3 months after your 65th birthday month

Total IEP Duration: 7 months

Example: If your 65th birthday is in June, your IEP runs from March 1 through September 30.

What You Can Do During IEP

During your Initial Enrollment Period, you can:

• Enroll in Medicare Part A (Hospital Insurance)
• Enroll in Medicare Part B (Medical Insurance)
• Enroll in Medicare Part D (Prescription Drug Coverage)
• Choose a Medicare Advantage plan
• Purchase a Medigap (Medicare Supplement) policy

IEP Enrollment Timing and Effective Dates

When you enroll during your IEP affects when your coverage starts:

Enrolling in the 3 months before your birthday month:

• Coverage starts the first day of your birthday month
• Recommended timing to avoid coverage gaps

Enrolling during your birthday month:

• Coverage starts the first day of the following month

Enrolling in the 3 months after your birthday month:

• Coverage starts 1-3 months after enrollment
• May result in delayed coverage and potential penalties

Special Considerations for Working Texans

If you’re still working at 65 and have employer group health coverage, you may be able to delay Medicare enrollment without penalty. However, this requires careful consideration:

Employer Coverage Requirements:

• Must be “creditable coverage” (as good as Medicare)
• Employer must have 20 or more employees
• Coverage must be primary (not secondary to Medicare)

Texas-Specific Employment Considerations:

• Many Texas employers offer Medicare-eligible employees continued coverage
• Oil and gas industry often provides excellent retiree benefits
• State and local government employees may have special considerations
• Check with your HR department about Medicare coordination

General Enrollment Period (GEP)

If you miss your Initial Enrollment Period, you can enroll during the General Enrollment Period.

GEP Dates: January 1 - March 31 (annually) Coverage Effective Date: July 1

GEP Limitations and Penalties

Late Enrollment Penalties:

• Part A Penalty: 10% premium increase for twice the number of years you were eligible but not enrolled (if you must pay a Part A premium)
• Part B Penalty: 10% of current Part B premium for each 12-month period you were eligible but not enrolled
• Part D Penalty: 1% of national base premium for each month of delayed enrollment

Important: These penalties typically last for as long as you have Medicare coverage.

GEP Restrictions:

• Cannot enroll in Medicare Advantage during GEP
• Limited Medigap enrollment rights
• May face gaps in coverage

Annual Open Enrollment Period (OEP)

The Annual Open Enrollment Period is when most Medicare beneficiaries can make changes to their coverage.

OEP Dates: October 15 - December 7 (annually) Coverage Effective Date: January 1

What You Can Do During Open Enrollment

All Medicare beneficiaries can:

• Switch from Original Medicare to Medicare Advantage
• Switch from Medicare Advantage back to Original Medicare
• Change Medicare Advantage plans
• Add Medicare Part D prescription drug coverage
• Drop Medicare Part D coverage
• Switch Medicare Part D plans

Texas-Specific Open Enrollment Considerations:

• Over 300 Medicare Advantage plans available statewide
• Plan availability varies by county
• Major carriers frequently adjust plan offerings and service areas
• Premium and benefit changes take effect January 1

Open Enrollment Strategy for Texas Residents

Annual Plan Review Checklist:

1. Review Current Plan Performance:

   • Check if your doctors are still in-network
   • Verify your medications are still covered
   • Assess satisfaction with customer service
   • Review actual costs from the past year

2. Compare Available Options:

   • Use Medicare.gov Plan Finder tool
   • Review Texas-specific plan options
   • Compare total estimated annual costs
   • Check star ratings and quality measures

3. Consider Life Changes:

   • Health status changes
   • New medications
   • Different doctor preferences
   • Budget considerations

For detailed guidance on choosing plans, see our complete Medicare guide for Texas.

Medicare Advantage Open Enrollment Period

This is an additional enrollment period specifically for Medicare Advantage plan members.

MA OEP Dates: January 1 - March 31 (annually) Who Qualifies: Current Medicare Advantage plan members only

What You Can Do During MA OEP

• Switch from your Medicare Advantage plan to Original Medicare
• Switch to a different Medicare Advantage plan (one change allowed)
• Add a Medicare Part D plan if switching to Original Medicare

Texas MA OEP Considerations:

• Good opportunity to reassess Medicare Advantage choice after trying it for a year
• Can address network or coverage issues discovered during the first year
• Popular among Texas beneficiaries who initially chose Medicare Advantage

Special Enrollment Periods (SEP)

Special Enrollment Periods allow you to make Medicare changes outside of regular enrollment periods when certain qualifying events occur.

Common SEP Triggers

Moving-Related SEPs:

• Moving outside your current plan’s service area
• Moving to a new county or state
• Moving into or out of an institution (nursing home, etc.)

Coverage Change SEPs:

• Losing employer or union health coverage
• Losing COBRA coverage
• Changes in employer coverage that affect Medicare eligibility

Program-Related SEPs:

• Gaining or losing Medicaid eligibility
• Qualifying for Low-Income Subsidy (Extra Help)
• Changes in dual-eligible special needs plan qualification

Plan-Related SEPs:

• Your plan leaves Medicare or stops serving your area
• You move outside your plan’s service area
• Your plan violates its contract with Medicare

Texas-Specific SEP Considerations

Hurricane/Disaster SEPs:

• Texas frequently receives federal disaster declarations
• CMS often grants special enrollment periods for affected areas
• May allow plan changes outside normal enrollment periods

Military-Related SEPs:

• Large military population in Texas
• Special enrollment rights for veterans gaining VA coverage
• Military spouse considerations for coverage changes

Dual-Eligible SEPs:

• Texas has significant Medicaid-eligible Medicare population
• Monthly enrollment opportunities for dual special needs plans
• Coordination with Texas Medicaid programs

How to Enroll in Medicare in Texas

There are several ways to enroll in Medicare, depending on your situation and the type of coverage you need.

Enrolling in Original Medicare (Parts A & B)

Automatic Enrollment:

• You’re automatically enrolled if you receive Social Security or Railroad Retirement benefits
• Medicare cards are mailed approximately 3 months before your 65th birthday
• Part A starts automatically; you can decline Part B if you have other coverage

Manual Enrollment Methods:

1. Online at ssa.gov:

• Create a my Social Security account
• Complete Medicare enrollment application
• Fastest and most convenient method
• Available 24/7

2. By Phone:

• Call Social Security: 1-800-772-1213
• TTY users: 1-800-325-0778
• Monday-Friday, 8 AM to 7 PM local time

3. In Person:

• Visit your local Social Security office
• Find Texas locations at ssa.gov/locator
• Appointment recommended

Enrolling in Medicare Advantage Plans

Enrollment Methods:

• Directly through insurance company websites or phone numbers
• Through licensed insurance agents
• Via Medicare.gov
• At Medicare educational events

Required Information:

• Medicare Number (from your red, white, and blue Medicare card)
• Effective date of Medicare Parts A and B
• Current prescription medications
• Preferred doctors and hospitals

Enrolling in Medicare Part D

Enrollment Options:

• Directly with Part D plan sponsors
• Through Medicare.gov
• Via licensed insurance agents
• By calling 1-800-MEDICARE

Important Considerations:

• Compare formularies to ensure your medications are covered
• Consider pharmacy networks and locations
• Review costs including premiums, deductibles, and copays

Enrolling in Medicare Supplement (Medigap) Plans

Open Enrollment Period:

• 6 months starting when you first enroll in Medicare Part B at age 65 or older
• Guaranteed acceptance regardless of health conditions
• Cannot be denied coverage or charged higher premiums based on health

Application Process:

• Contact insurance companies directly
• Work with licensed insurance agents
• Compare multiple companies and plans
• No need to use Medicare.gov for Medigap enrollment

For comprehensive Medigap information, see our Medicare Supplement plans guide for Texas.

Medicare Enrollment Resources in Texas

State Health Insurance Assistance Program (SHIP)

Texas SHIP provides free, unbiased Medicare counseling statewide.

Texas SHIP Services:

• Medicare enrollment assistance
• Plan comparison help
• Claims and billing support
• Medicare fraud education
• Long-term care insurance counseling

Contact Information:

• Phone: 1-800-252-9240
• Website: tdi.texas.gov/consumer/hicap
• Local Offices: Available in all 254 Texas counties

Texas SHIP Office Locations:

Major Metropolitan Areas:

• Houston: Multiple locations including Harris County and surrounding areas
• Dallas-Fort Worth: Offices throughout the metroplex
• San Antonio: Bexar County and surrounding areas
• Austin: Travis County and Central Texas region

Regional Coverage:

• East Texas: Tyler, Longview, Marshall areas
• West Texas: Lubbock, Amarillo, Midland-Odessa areas
• South Texas: Corpus Christi, McAllen, Brownsville areas
• Central Texas: Waco, Temple, College Station areas

Area Agencies on Aging

Texas has 28 Area Agencies on Aging (AAAs) that provide Medicare enrollment assistance:

Services Provided:

• Medicare education seminars
• Individual enrollment counseling
• Benefits application assistance
• Long-term care planning
• Transportation assistance

Major Texas AAAs:

• Houston: Harris County Department of Education
• Dallas: Dallas Area Agency on Aging
• San Antonio: Alamo Area Agency on Aging
• Austin: Capital Area Agency on Aging
• Fort Worth: Tarrant County**

Licensed Insurance Agents in Texas

Working with licensed insurance agents can provide personalized assistance with Medicare enrollment.

Benefits of Using Licensed Agents:

• No cost for consultation and enrollment assistance
• Expertise in plan comparisons
• Ongoing customer service and support
• Help with claims and billing issues
• Annual plan reviews and recommendations

What to Look for in a Texas Medicare Agent:

• Texas insurance license verification
• Experience with Medicare products
• Represents multiple insurance companies
• Good local reputation and references
• Provides ongoing service, not just enrollment

Medicare.gov Resources

The official Medicare website offers comprehensive enrollment tools:

Key Features:

• Plan Finder Tool: Compare all available plans by ZIP code
• Medicare Account: Manage your Medicare information online
• Enrollment Centers: Direct links to plan enrollment
• Provider Directory: Find participating doctors and hospitals
• Formulary Checker: Verify prescription drug coverage

Texas Department of Insurance

The Texas Department of Insurance provides consumer protection and assistance:

Services:

• Insurance company licensing oversight
• Consumer complaint resolution
• Medicare fraud prevention education
• Insurance counseling and education

Contact Information:

• Phone: 1-800-252-3439
• Website: tdi.texas.gov
• Consumer Help Line: Available for insurance-related questions and complaints

Avoiding Medicare Enrollment Penalties

Understanding and avoiding Medicare enrollment penalties can save Texas beneficiaries significant money over time.

Part A Late Enrollment Penalty

Who Pays Part A Premiums:

• People who didn’t work or pay Medicare taxes for at least 10 years
• People who worked but didn’t pay Medicare taxes for the full 40 quarters

Penalty Calculation:

• 10% increase in monthly premium
• Duration: Twice the number of years you were eligible but didn’t enroll
• Example: If you were eligible for 2 years but didn’t enroll, you’d pay the penalty for 4 years

Part B Late Enrollment Penalty

The Part B penalty is more common and affects most people who delay enrollment.

Penalty Calculation:

• 10% of current Part B premium for each full 12-month period you were eligible but didn’t enroll
• 2026 Standard Part B Premium: $185/month
• Example: If you delayed enrollment for 2 full years, your monthly penalty would be $37 (20% of $185)

Penalty Duration: For as long as you have Part B coverage

Exceptions to Part B Penalties:

• Having creditable employer coverage while working
• Active military service
• Living outside the United States
• Qualifying for a Special Enrollment Period

Part D Late Enrollment Penalty

Penalty Calculation:

• 1% of the national base beneficiary premium for each month of delayed enrollment
• 2026 National Base Premium: $34.70
• Added to your monthly Part D premium

Avoiding Part D Penalties:

• Enroll when first eligible for Medicare
• Maintain creditable prescription drug coverage
• Enroll within 63 days of losing creditable coverage

Creditable Coverage Examples:

• Employer or union prescription drug coverage
• TRICARE
• Indian Health Service
• VA prescription drug coverage

For comprehensive prescription drug coverage information, see our Medicare Part D guide for Texas.

Common Medicare Enrollment Mistakes in Texas

Learning from common mistakes can help Texas Medicare beneficiaries avoid problems with their enrollment.

Mistake #1: Missing the Initial Enrollment Period

Impact:

• Late enrollment penalties
• Delayed coverage start dates
• Limited plan options (cannot choose Medicare Advantage during General Enrollment)
• Restricted Medigap rights

Prevention:

• Mark your calendar 3 months before your 65th birthday
• Set reminders to review Medicare options
• Contact SHIP counselors early for guidance

Mistake #2: Assuming Employer Coverage is Always Better

Common Issues:

• Some employer plans become secondary to Medicare at age 65
• COBRA is not creditable coverage for Medicare purposes
• Retiree plans may require Medicare enrollment

Solution:

• Contact your HR department to understand how your employer plan works with Medicare
• Get documentation about creditable coverage
• Consider costs and benefits of all options

Mistake #3: Not Comparing Plans During Open Enrollment

Consequences:

• Missing out on better plan options
• Paying more than necessary
• Inadequate coverage for changing health needs
• Network changes affecting provider access

Best Practice:

• Review your coverage annually
• Use Medicare.gov tools to compare options
• Consider working with licensed agents for complex situations

Mistake #4: Choosing Plans Based Only on Premium Costs

Hidden Costs:

• High deductibles and out-of-pocket maximums
• Limited provider networks
• Prescription drug coverage gaps
• Lack of supplemental benefits

Better Approach:

• Calculate total estimated annual costs
• Consider your actual healthcare usage patterns
• Evaluate provider networks and access
• Review prescription drug formularies

Mistake #5: Not Understanding Medicare Advantage Limitations

Common Misunderstandings:

• Network restrictions
• Prior authorization requirements
• Limited coverage while traveling
• Annual plan changes

Education Resources:

• Attend Medicare educational seminars
• Read plan documents carefully
• Ask detailed questions during enrollment
• Work with knowledgeable licensed agents

Special Situations for Texas Medicare Enrollment

Military Retirees and Veterans

Texas has a large military and veteran population with special Medicare considerations.

TRICARE and Medicare:

• TRICARE becomes secondary when you become eligible for Medicare
• Must enroll in Medicare Part A and Part B to keep TRICARE coverage
• TRICARE provides creditable prescription drug coverage

Veterans Affairs (VA) Benefits:

• VA benefits are not Medicare coverage
• VA prescription drug coverage is creditable for Medicare Part D purposes
• Can delay Medicare Part B if only using VA benefits, but this may not be advisable

Dual-Eligible Beneficiaries (Medicare and Medicaid)

Texas Medicaid Integration:

• Medicaid helps pay Medicare premiums and cost-sharing
• Special enrollment opportunities throughout the year
• Dual Eligible Special Needs Plans (D-SNPs) available
• Coordination with Texas Health and Human Services Commission (HHSC)

Low-Income Subsidies:

• Extra Help with Medicare Part D costs
• Automatic qualification for those receiving Medicaid
• Applications through Social Security Administration

People with Disabilities Under 65

24-Month SSDI Waiting Period:

• Medicare eligibility begins after 24 months of SSDI benefits
• Automatic enrollment in Parts A and B
• Can decline Part B if you have other creditable coverage

End-Stage Renal Disease (ESRD):

• Immediate Medicare eligibility upon diagnosis
• Coordination with employer coverage for first 30 months
• Special enrollment and coverage rules apply

International Residents

Living Outside the United States:

• Can delay Part B enrollment without penalty while living abroad
• Special Enrollment Period when returning to the US
• Limited Medicare coverage while overseas

Returning to Texas:

• Special Enrollment Period for returning US residents
• May need to provide documentation of residence abroad
• Consider timing of return for optimal enrollment periods

Medicare Enrollment Timeline and Checklist

6 Months Before Age 65

Action Items:

• Learn about Medicare basics and options
• Contact employer HR about coverage coordination
• Begin researching Medicare Advantage and Medigap options
• Locate Texas SHIP counseling resources

3 Months Before Age 65

Action Items:

• Apply for Medicare Parts A and B (if not automatically enrolled)
• Compare Medicare Advantage plans in your Texas county
• Research Medicare Part D prescription drug plans
• Shop for Medicare Supplement (Medigap) policies
• Schedule consultation with licensed insurance agent

Month You Turn 65

Action Items:

• Finalize Medicare plan selections
• Complete all enrollment applications
• Verify coverage effective dates
• Update healthcare providers about new coverage
• Cancel any duplicate coverage appropriately

3 Months After Age 65

Final Deadline:

• Complete any remaining Medicare enrollments
• Confirm all coverage is in place
• Begin using new Medicare benefits
• Keep enrollment documents for your records

Annual Review (Every October-December)

Action Items:

• Review current plan performance and satisfaction
• Check for plan changes affecting coverage or costs
• Compare available alternatives during Open Enrollment
• Make necessary changes before December 7 deadline

Getting Help with Medicare Enrollment in Texas

Free Resources

Texas SHIP Program:

• Unbiased Medicare counseling
• Enrollment assistance
• Plan comparisons
• Claims and billing help
• Medicare fraud protection

Medicare.gov:

• Official Medicare information
• Plan comparison tools
• Provider directories
• Enrollment applications

1-800-MEDICARE:

• Official Medicare customer service
• Available 24/7
• TTY services available
• Multiple languages supported

Professional Assistance

Licensed Insurance Agents:

• Personalized plan recommendations
• Enrollment assistance
• Ongoing customer service
• No cost to Medicare beneficiaries

Benefits of Professional Help:

• Expertise in Medicare rules and regulations
• Knowledge of Texas-specific plan options
• Assistance with complex situations
• Ongoing support and annual reviews

Frequently Asked Questions About Medicare Enrollment in Texas

When should I enroll in Medicare if I’m still working at 65?

If you have creditable employer coverage, you may be able to delay Medicare Part B enrollment without penalty. However, you should still enroll in Part A if it’s premium-free. Contact your HR department and consider consulting with a SHIP counselor to understand your specific situation.

What happens if I miss my Initial Enrollment Period?

You can enroll during the General Enrollment Period (January 1 - March 31), but you may face late enrollment penalties and delayed coverage. You also cannot enroll in Medicare Advantage until the next Open Enrollment Period.

Can I change my Medicare plan after I enroll?

Yes, you can make changes during the Annual Open Enrollment Period (October 15 - December 7) each year. Some beneficiaries may also qualify for Special Enrollment Periods that allow changes at other times.

Do I need to enroll in Medicare Part D if I don’t take any medications?

While Part D enrollment is voluntary, it’s generally recommended because you’ll face late enrollment penalties if you need prescription coverage later. The penalty increases the longer you wait to enroll.

How do I know if my employer coverage is creditable for Medicare purposes?

Your employer should provide you with a “Notice of Creditable Coverage” annually. This document will specify whether your coverage meets Medicare’s creditable coverage requirements. Contact your HR department if you haven’t received this notice.

Can I enroll in both Medicare Advantage and Medigap?

No, you cannot have both Medicare Advantage and Medigap coverage at the same time. Medicare Advantage replaces Original Medicare, while Medigap supplements Original Medicare.

What should I do if I move to a different county in Texas?

Moving may trigger a Special Enrollment Period that allows you to change your Medicare Advantage or Part D plan if your current plan isn’t available in your new location. Contact your plan or Medicare to understand your options.

How do I find doctors who accept Medicare in Texas?

Use the Medicare.gov provider directory to find participating providers in your area. You can also call providers directly or check with your specific Medicare plan about their network.

Take Action: Get Help with Your Medicare Enrollment in Texas

Medicare enrollment doesn’t have to be overwhelming. With the right guidance and resources, you can navigate the enrollment process successfully and find coverage that meets your healthcare needs and budget.

Get Your Free Medicare Enrollment Consultation:

Our licensed Texas Medicare specialists provide:

• Personalized Enrollment Guidance: We’ll walk you through each step of the Medicare enrollment process
• Plan Comparisons: Compare all available Medicare options in your Texas county
• Deadline Tracking: Ensure you meet all enrollment deadlines to avoid penalties
• Ongoing Support: Receive help throughout the year with questions and plan changes
• Local Expertise: Knowledge of Texas-specific Medicare considerations and resources

Why Choose Professional Enrollment Assistance:

• Avoid costly enrollment mistakes and penalties
• Understand complex Medicare rules and regulations
• Get unbiased advice on all your coverage options
• Receive ongoing support beyond initial enrollment
• Access to exclusive plan information and insights

Ready to Enroll in Medicare?

Don’t wait until the last minute to understand your Medicare options. Contact our Texas Medicare enrollment specialists today for a free consultation. We’ll help you navigate the enrollment process, compare your options, and ensure you get the Medicare coverage that’s right for your situation.

Whether you’re approaching your Initial Enrollment Period, need to make changes during Open Enrollment, or qualify for a Special Enrollment Period, we’re here to help. Call now to speak with a licensed Texas Medicare specialist who can guide you through every step of the Medicare enrollment process.

Medicare enrollment in Texas is an important decision that affects your healthcare and finances for years to come. Make sure you have the expert guidance you need to make the best choice for your situation. Contact us today for your free Medicare enrollment consultation.