Medicare in Texas: Plans, Costs, and Local Help for 2026

Texas does everything big, and Medicare is no exception. Nearly 4.9 million Texans are enrolled in Medicare, making us the third-largest Medicare state in the country. If you’re turning 65, retiring, or wondering whether the plan you picked three years ago is still pulling its weight, you’ve got plenty of options, the average Texas beneficiary can choose from about 36 Medicare Advantage plans in 2026, plus 12 standalone drug plans and Medigap policies from 40 different insurers.

That’s a lot of choices, and if you’ve started getting the mailers and the dinner-time phone calls, you already know how overwhelming it gets. I’m Scott Bowling, an independent licensed agent based right here in Central Texas (TX License #2882146). This is my home state and my home turf. I help Texans compare their real options in plain English, over the phone, with zero pressure. If that sounds like the kind of help you want, call me at 512-844-3983.

How Medicare Works in Texas

The foundation is federal and works the same everywhere: Part A covers hospital care (premium-free for most people who worked 10+ years), and Part B covers doctors and outpatient care for a standard premium of $202.90 per month in 2026. The Texas-sized question is what you put on top of that foundation, and Texans split almost down the middle: as of early 2026, about 55% of Texas Medicare beneficiaries are in Medicare Advantage plans, while 45% stick with Original Medicare, most adding a Medigap supplement and a Part D drug plan.

Where you live in Texas matters more than in almost any other state. In the big metros, Dallas-Fort Worth, Houston, San Antonio, and Austin, plan competition is dense and $0-premium Advantage plans are everywhere; the average Texas MA premium is just a few dollars a month in 2026. In rural Texas, the Panhandle, and out west, choices thin out fast, and Original Medicare with a Medigap plan often deserves a harder look. That’s exactly the kind of county-by-county difference I sort out with clients every week.

Medicare Advantage in Texas

Texas Advantage plans are offered by a deep bench of carriers: UnitedHealthcare, Humana, Aetna, Blue Cross and Blue Shield of Texas, Wellcare, Devoted Health, Baylor Scott & White Health Plan, KelseyCare Advantage in the Houston area, and more. These plans bundle hospital, medical, and usually drug coverage, and nearly all add dental, vision, and hearing benefits. The tradeoff is the network: your plan works with its contracted doctors and hospitals, so the first question is never “what’s the premium?” — it’s “are my doctors in it?”

Medigap and Part D in Texas

Prefer to keep Original Medicare? Texas has one of the country’s biggest Medigap markets, with roughly 40 insurers offering the standardized plans, Plan G is the workhorse for new enrollees. Your guaranteed-issue window is the six months after you’re both 65 and enrolled in Part B, when no health questions can be used against you. Texas also has a rule worth knowing if you’re on Medicare before 65 due to disability: insurers here must offer at least Medigap Plan A to under-65 beneficiaries, and 2025 state legislation made all Medigap plans guaranteed-issue for Texans under 65 with ESRD or ALS. For prescriptions, 12 standalone Part D plans are available in 2026 with premiums starting at $0, all operating under the annual out-of-pocket cap on covered drugs [VERIFY: 2026 cap amount, $2,100].

Texas Health Systems and Your Coverage

Your plan and your hospital system have to work together, and Texas medicine is organized around powerhouse regional systems. In Dallas-Fort Worth it’s Baylor Scott & White, Texas Health Resources, Medical City, and UT Southwestern. Central Texas runs on St. David’s, Ascension Seton, and Baylor Scott & White’s Round Rock and Temple campuses. Houston is home to Houston Methodist, Memorial Hermann, and the Kelsey-Seybold clinics. San Antonio relies on Methodist Healthcare, Baptist Health System, and University Health. Not every plan includes every system, and networks change year to year, so if keeping your doctor matters, that’s where our conversation starts.

Local Medicare Help Across Texas

I’ve written detailed local guides for communities all over the state, the plans, hospitals, pharmacies, and deadlines that matter where you actually live. Find your community below:

Austin & Central Texas

Austin • Round Rock • Georgetown • Cedar Park • Leander • Pflugerville • Hutto • Taylor • Jarrell • Manor • Lakeway • Bastrop • Elgin • Buda • Kyle • San Marcos • Marble Falls

Dallas–Fort Worth Metroplex

Dallas • Arlington • Allen • Bedford • Carrollton • Denton • Euless • Flower Mound • Frisco • Garland • Grand Prairie • Grapevine • Hurst • Irving • Keller • Lewisville • McKinney • Mesquite • North Richland Hills • Plano • Richardson • Southlake

Greater Houston

Houston • Baytown • Conroe • Cypress • Deer Park • Friendswood • Kingwood • League City • Missouri City • Pasadena • Pearland • Spring • Sugar Land • The Woodlands

San Antonio & Hill Country

San Antonio • New Braunfels • Boerne • Cibolo • Converse • Schertz

Killeen, Temple & Waco

Killeen • Harker Heights • Copperas Cove • Belton • Temple • Salado • Waco • Woodway • Hewitt • Bellmead • Robinson

Don’t see your town? I help Texans statewide by phone and email, from El Paso to Texarkana, the guidance is the same. You can also browse all the areas I serve.

A Texas Advisor Who Actually Lives Here

Plenty of the people calling you about Medicare are dialing from call centers a thousand miles away, reading scripts, paid to close you today. I’m a Texan helping Texans, and I work differently: we talk by phone about your doctors, your prescriptions, and your budget. I compare the plans actually available in your county, Advantage, Medigap, and Part D, across carriers, and explain the honest tradeoffs. You decide. I handle the paperwork, and I answer the phone next year when something changes. My help costs you nothing: I’m paid by the carriers, and your premium is identical whether you enroll through me or on your own. Special situations are welcome, I regularly help veterans coordinate TRICARE for Life and CHAMPVA with Medicare, a combination most agents fumble.

Want to start on your own terms? Take my free Medicare Clarity Score™ — a 3-minute checkup that flags penalty exposure, coverage gaps, and signs you’re overpaying. Instant results, no obligation.

Texas Medicare Questions I Hear Most

When can I enroll in Medicare in Texas?

Your Initial Enrollment Period is a 7-month window: three months before your 65th birthday month, the birthday month itself, and three months after. Missing it without other qualifying coverage can mean permanent penalties. Everyone can change plans during the Annual Enrollment Period, October 15 through December 7. Full details in my guide to Medicare enrollment periods.

What’s the best Medicare plan in Texas?

There’s no single answer, and anyone who names one plan before asking about your doctors and medications is selling, not advising. Texas plan quality and availability vary dramatically by county. The right process: confirm your providers are in-network, run your drug list against each plan’s formulary, and compare total annual cost, premium plus copays plus the out-of-pocket maximum. That’s the comparison I build for every client.

Should I choose Medicare Advantage or Medigap in Texas?

Both paths work well in Texas, and Texans use both, with roughly a 55/45 split. Advantage wins on monthly cost and bundled extras; Medigap wins on predictability and go-anywhere provider freedom, which matters if you travel or split time between homes. My honest breakdowns: Medicare Advantage guide and Medicare Supplement guide.

Is there free Medicare counseling in Texas besides agents?

Yes. Texas HICAP (Health Information, Counseling and Advocacy Program) is the state’s free, unbiased Medicare counseling service, and the Texas Department of Insurance publishes consumer guides. I’ll always point you to those resources, the more you understand, the better our conversation gets.

Ready for Clear Answers?

Take the free Medicare Clarity Score™ to see where your coverage stands in 3 minutes, or call me directly at 512-844-3983. Scott Bowling, independent licensed agent, TX License #2882146 — based in Central Texas, serving the whole state.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not affiliated with or endorsed by the U.S. government or the federal Medicare program.

Navigating Medicare in the Lone Star State requires a local expert who understands the Texas healthcare landscape, from Houston’s Medical Center to the rural reaches of West Texas. Whether you are aging into Medicare or looking to optimize your current coverage, finding the right plan comes down to your specific doctors, prescriptions, and budget.