Texas Medicare Plans

Medicare is a federally sponsored health insurance program available to those over the age of 65, as well as to individuals who have certain disabilities. At the state level, however, there exist specific organizations that help beneficiaries better understand the Medicare process, and Medicare recipients may even qualify to receive state subsidies, depending on their circumstances. Consider the following information if you are interested in obtaining Medicare coverage in the state of Texas.

Medicare Supplement Insurance (Medigap) Policies

The state flag of Texas | Texas Medicare Insurance Plans

Though Federal law doesn’t require insurance companies to sell Medigap policies to people under the age of 65, some states do. Texas is a state that requires insurers to sell Medicare Supplement Insurance policies to people under the age of 65.

Mini-COBRA Policies (Small Group)

In the state of Texas, if you work for an employer with less than 20 full-time employees and meet certain criteria you may be able to continue your coverage for six months if you lose your job due to certain circumstances.

Texas has four Medicare Savings Programs:

*In some cases, Medicare beneficiaries may qualify to receive additional financial assistance from the state government to cover the costs of premiums, co-payments, and other expenses. Texas participates in the following four Medicare Savings Programs.

  • *Qualified Medicare Beneficiaries (QMBs): For individuals with a monthly income under $1,010 and couples with monthly income under $1,355, the state pays all premiums for Medicare Part B and all co-payments and deductibles for Medicare Parts A and B.
  • *Specified Low-Income Medicare Beneficiaries (SLMBs): For individuals with a monthly income under $1,208 or couples with monthly income under $1,622, the state pays premiums for Medicare Part B.
  • *Qualified Individuals (QIs): For individuals with a monthly income under $1,357 or couples with monthly income under $1,823, the state pays premiums for Medicare Part B.
  • *Qualified Disabled and Working Individuals (QDWIs): For individuals with a monthly income under $4,045 a month and couples with monthly income under $5,425, the state pays premiums for Medicare Part A.

*Data from Medicare.gov

Health Information Counseling and Advocacy Program of Texas (HICAP)

Your local Texas HICAP service exists to help you understand your Medicare benefits. Texas HICAP provides confidential and one-on-one Medicare beneficiary counseling for residents in the state.

Texas HICAP provides eligibility, program benefit, and appeals rights information concerning:

  • Medicare Parts A and B
  • Medicare Part C – Medicare Advantage Plans
  • Medicare Part D – Prescription Drug Plans
  • Medicare Supplement Insurance (Medigap)
  • Long-term care insurance options
  • Health care rights and protections
  • Low-income assistance programs

Texas HICAP volunteers and staff are committed to work with you to provide assistance in meeting your Medicare needs through any one of 28 Area Agency on Aging offices throughout the state. Texas HICAP is partially funded by a grant from the Centers for Medicare and Medicaid Services (CMS).

Low-Income Subsidy (Extra Help) for Prescription Drugs

In 2017, you may qualify if you have up to $17,820 in yearly income ($24,030 for a married couple).

Texas residents seeking assistance with their health benefits may consult with one of our MedicareSolutions.com licensed sales agents. A licensed sales agent can help you by comparing plans available in your area and assist you in finding the Medicare insurance benefits that best fit your needs.