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Texas Medicare Eligibility Requirements in 2023

Everything is bigger in Texas, and that’s certainly the case with the state’s retiree population. With Texas as a fast-growing destination for retirees, it’s time to take a quick look at the Medicare landscape in Texas. Read this short guide about the Texas Medicare eligibility requirements in 2023 and the implications for your coverage options.

Entering Medicare In Texas In 2023

The basic rules for Medicare eligibility are the same in Texas as in the other 49 states. However, there is a difference when it comes to private Medicare Supplement Insurance plans. In order to understand this difference, we have to first review the basic eligibility requirements for Medicare Part A and Part B of Original Medicare.

Every person who’s a citizen of the United States or a permanent legal resident (lawfully present for at least 5 years) will be eligible to participate in the Medicare program at some point in their lives. For those people who are eligible for the program, their actual entry won’t happen until they meet an entry requirement. The most common entry requirement is turning 65 years old, but you can actually enter Medicare early if:

  • You receive federal disability payments for 24 consecutive months, or
  • You’re diagnosed with End Stage Renal Disease, or
  • You’re diagnosed with Lou Gehrig’s Disease (ALS)

If you’re able to enter Medicare early due to the disability or illness provisions, your entry will be automatic.

Your entry into Medicare at age 65 will also be automatic if you’re receiving Social Security retirement benefits before you turn 65. However, many Americans are delaying Social Security until at least 66 to receive their full Social Security retirement benefit. In this case, your Medicare enrollment won’t be automatic; you’ll have to sign up manually.

You’ll be able to manually enroll in one of several convenient ways, including:

  • In-person at a Social Security Administration office
  • Online, through the Social Security Administration’s website
  • Over the phone with the Social Security Administration

You can start the enrollment process during your Initial Enrollment Period. This enrollment period will begin three months before you turn 65. It ends at the end of the third month after you turn 65. As long as you enroll during this seven month period, you’ll avoid any late enrollment penalty.

Texas Medicare Eligibility Requirements In 2023 For Private Medicare Insurance Plans

When you first become eligible for Medicare, you’ll also have the right to sign up for a private Medicare Insurance plan. This is the time to enroll in a Medicare Advantage (Part C) plan or a standalone Prescription Drug Plan (PDP). You can get either of these coverages at any age, even if you start Medicare before you turn 65.

The rules in Texas for Medicare Supplement Insurance, which is also called Medigap, are a little more complicated. The minimum age at which you can get Medigap isn’t regulated at the federal level, so each state can set its own rules. In some states, Medigap isn’t available at all to people under 65.

In Texas, all Medigap insurers are required to offer at least one standardized Medigap plan to people under 65. However, this means that there are very few options, and they can be very expensive for people under 65. If you enter Medicare before age 65 in Texas, you may want to consider using Medicare Advantage until you turn 65. Once you’re 65, you’ll have an Open Enrollment Period to enroll in any Medigap plan you choose, and you’ll have many more options at 65. Plus, the premiums will be more affordable.

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