Texas is the second-largest US State, with more than 25 million residents, most of whom are older adults. About 12% of this population is 65 and above. Texas, the third largest State for Medicare beneficiaries in the US has about 4.5 million Medicare enrollees as of 2024.
Medicare is a well-established fee-for-service health insurance program in the United States. It is administered by the federal government and funded by the General Revenue and Federal Insurance Contributions Act.
Medicare in Texas aims to meet the ever-growing healthcare needs of senior adults aged 65 and above, those with certain disabilities, and people with end-stage renal disease (ESRD).
The federal government directly administers Original Medicare. In contrast, plans such as Medicare Advantage plans and Medicare Supplement plans in Texas are administered by private health insurance companies.
As of 2024, 18.5% of the US population is on Medicare. This comprehensive health insurance program consists of various plans, such as Original Medicare, Medicare Advantage, and Medicare Supplement plans.
The Medicare Supplement Plan is also popularly known as Medigap. Medigap is an optional plan that covers what’s not covered under Medicare Parts A and B. These plans provide additional health insurance for your out-of-pocket expenses. Let us look into Medigap Supplement plans and what they offer to beneficiaries in Texas.
What Is a Medicare Supplement Plan (Medigap)?
Medicare Supplement Plan, or Medigap, is a secondary coverage plan offered by private companies. The primary purpose of a Medigap policy is to lower out-of-pocket costs such as deductibles, copayments, and coinsurance associated with Medicare plans.
These costs aren’t covered by Original Medicare Parts A and B. This means that Medigap only covers what isn’t covered by Original Medicare.
Unlike Medicare Advantage plans, enrolling in Medigap only provides insurance for what’s not covered by Original Medicare without any additional benefits.
You must have an Original Medicare plan with supplemental Medicare, as it is not a stand-alone insurance policy. Private health insurance companies offer Medigap plans.
According to the rules and regulations set by the Centers for Medicare and Medicaid Services (CMS), every plan must provide beneficiaries with the same coverage under the same plan.
However, the premium set for Medigap varies from State to State and provider to provider. Let us look into the Medicare Supplement plans in Texas.
Medicare Supplement Plans in Texas
More than 21% of Texas residents are enrolled in Medigap plans as of 2024. Texas’s average life expectancy is 76 years, which makes senior healthcare programs necessary in the State.
Health insurance after retirement is vital for mental, physical, and financial well-being as growing medical needs with age often result in unmanageable healthcare finances.
About 40 private health insurance providers in Texas offer Medicare Supplement plans to residents. Senior Texas residents prefer to have Medicare Supplement insurance to fill the gaps in Original Medicare.
However, beneficiaries cannot have Medigap coverage with Medicare Advantage plans. Choosing a Medicare Advantage plan works as an alternative to Part A and Part B, with additional coverage for hearing, vision, and dental care.
In contrast, Medicare Supplement plans cover out-of-pocket expenses, including copayments, coinsurance, and deductibles.
- Deductibles are costs that you cover before Medicare provides coverage for health services. Thus, deductibles apply to all Medicare Parts.
- A copayment is like a fixed payment for a doctor’s visit. This amount is paid after you pay your deductibles.
- Coinsurance is an effective cost-sharing method in which you pay a small percentage of the total amount for specific services after paying your deductibles. Your Medicare insurance plan covers the rest of the cost.
General Analysis of Medicare Supplement Plan Providers in Texas
| Insurance Company | Plan types offered | NAIC complaint rate | Premium discounts available | Share of Texas Medigap members |
| BlueCross BlueShield | A, B, C, D, F, G, K, L, M and N. | Close to expected | Average | 17%. |
| Humana | A, B, C, F, G, K, L and N. | Far more than expected | Below average | — |
| UnitedHealthcare | A, B, C, F, G, K, L and N. | Far fewer than expected | Above average | 21.2%. |
| Aetna | A, B, C, D, F, G and N. | Far more than expected | Average | 9.5%. |
| Cigna | A, F, G and N. | More than expected | Above average | — |
Types of Medicare Supplement Plans in Texas
As of 2024, Texas offers ten standard types of Medigap plans. Medigap Plans C and F are not available to new members.
Besides Plans C and F, three plans are the most popular Medigap policies, providing coverage for 95% of Texas beneficiaries. These are Medigap plans F, G, and N.
Nearly 42% of Texas Medigap beneficiaries have access to Medigap Plan F, the most comprehensive Medigap coverage.
About 45% of Texas beneficiaries have Medigap plan G, which is the highest-coverage option available to new Medicare beneficiaries, while Medigap plan N has 8% of Medigap beneficiaries. This plan has a lower premium with higher copays.
Cost Breakdown of Three Most Popular Medicare Supplement Insurance Plans in Texas
The three most popular supplement plans in Texas are Medigap Plan F, G, and N. The cost for these plans varies. Here’s a detailed cost breakdown for these popular Texas Medigap plans.
Medicare Supplement Plan F
In Texas, there are approximately 50 Medigap Plan F options offered by 39 different insurance providers. The availability and monthly premiums vary due to factors such as an individual’s age, sex, health status, and location.
Despite being one of the most popular Medigap plans across Texas, Medigap Plan F is not available to new applicants.
However, beneficiaries who were eligible for Medicare before January 1, 2020, can sign up for a plan. People who already have plan F can also keep the plan.
| Beneficiary | Harris County | Tarrant County | Reeves County |
| Average monthly premium for a 65-year-old female who doesn’t smoke | $208 | $185 | $174 |
| Average monthly premium for a 65-year-old female who smokes | $235 | $210 | $195 |
| Average monthly premium for a 65-year-old male who doesn’t smoke | $233 | $207 | $195 |
| Average monthly premium for a 65-year-old male who smokes | $264 | $235 | $219 |
Medicare Supplement Plan G
In Texas, approximately 50 Medigap Plan G options are offered by 40 different insurance providers, with premiums and availability depending on factors such as age, sex, location, and health status.
| Beneficiary | Harris County | Tarrant County | Reeves County |
| Average monthly premium for a 65-year-old female who doesn’t smoke | $170 | $151 | $142 |
| Average monthly premium for a 65-year-old female who smokes | $190 | $169 | $158 |
| Average monthly premium for a 65-year-old male who doesn’t smoke | $190 | $169 | $159 |
| Average monthly premium for a 65-year-old male who smokes | $213 | $190 | $177 |
Medicare Supplement Plan N
In Texas there are approximately 50 Medigap Plan N options offered by 38 different insurance providers with premiums and availability depending on factors such as age, sex, location, and health status.
| Beneficiary | Harris County | Tarrant County | Reeves County |
| Average monthly premium for a 65-year-old female who doesn’t smoke | $127 | $113 | $107 |
| Average monthly premium for a 65-year-old female who smokes | $144 | $128 | $121 |
| Average monthly premium for a 65-year-old male who doesn’t smoke | $143 | $127 | $120 |
| Average monthly premium for a 65-year-old male who smokes | $161 | $144 | $135 |
Cost Determination of Medicare Supplement Plans in Texas
The primary factors determining the cost of your plan are your location, age, provider, and the benefits it covers. Therefore, different counties in Texas, such as Harris, Tarrant, and Reeves, have different prices for popular plans such as Medigap Plan F, G, and N.
If Plan F costs less in Harris County, it may cost more in Reeves County. Similarly, some Medigap policies that may be more affordable for people aged 65 may become costly at age 85.
Generally, Medigap prices are determined in three ways.
- Community-rated: Everyone with the Medigap policy pays the same monthly premium, regardless of age.
- Issue age-rated: With this type of Medigap policy, the premium is based on your age when you first purchase the policy. The younger you are at the time of purchase, the lower your premium will be. The benefit of this rating system is that your premium won’t increase as you age. However, your premium may still go up due to inflation, healthcare cost increases, or changes in the insurance provider’s pricing.
- Attained age-rated: The premium is based on your current age and increases as you age. Therefore, plans that cost less at 65 may cost more at 85. While this type of policy may initially offer the lowest premium, it has the potential to become the most expensive over time. The premium can also increase due to inflation and other factors.
Besides this, the premiums may vary from provider to provider as these plans are offered by significantly different private health insurance companies. However, a Medicare Supplement Plan’s average monthly premium cost in Texas can range from $102 to $175.
Cost Comparison of the Top-Rated Medicare Supplement Plans in Texas
As all the same types of Medigap plans offer the same coverage across Texas, looking into the price difference can help you make a cost-efficient decision.
Your standardized benefits will be the same regardless of your chosen provider.
Let us look into the prices of the four popular Medigap companies providing plan G and N in Texas. The table below provides the estimated cost for a 65-year-old non-smoker female.
| Insurance Company | Plan G Monthly Premium | Plan N Monthly Premium |
| UnitedHealthcare | $129 | $96 |
| Mutual of Omaha | $123 | $93 |
| Aetna | $141 | $99 |
| Blue Cross Blue Shield | $130 | $106 |
Medicare Eligibility in Texas
What makes you eligible for Medicare in Texas? Medicare has the same eligibility criteria across all the States. You qualify for Medicare if:
- You are 65 years old or above
- You have a medical disability
- You have end-stage renal disease (ESRD)
- You have amyotrophic lateral sclerosis (ALS)
You can qualify for Medicare if you are approved by the Social Security Administration for either your age or disability.
Enrollment Period for Medicare in Texas
The best time to purchase a Medigap policy is during the Open Enrollment period. Medicare has two enrollment periods besides open enrollment. These are your initial enrolment period (IEP) and a general enrolment period (GEP).
- Open enrollment period (OEP): You can join, switch plans, or drop your coverage plans from October 15 to December 7 each year. Suppose you’re under 65 and have Medicare because of a disability or End‑Stage Renal Disease (ESRD). In that case, you might not be able to buy the Medigap policy you want, or any Medigap policy, until you turn 65.
- Initial enrollment period (IEP): The IEP is 7 months long, starting 3 months before your 65th birthday and ending 3 months after you turn 65. You can enroll during this period if you haven’t had Medicare before.
- General enrolment period (GEP): If you miss your IEP, you can access Medicare by applying for it during the general enrollment period (GEP) between January 1 and March 31 every year. During this period, you can also change your current Medicare plans. For example, if you have a Medicare Advantage plan and you want to switch to Original Medicare, you can do so during this period.
Benefits of Medicare Supplement Plans in Texas
Texas residents have a range of benefits to avail from a Medicare Supplement Plan. These plans help cover gaps in standard Medicare coverage.
The most important advantage of Medigap plans is that they provide coverage for costs that Original Medicare does not cover, such as copayments, coinsurance, and deductibles. This benefit provides financial relief to senior residents who are looking to lower additional costs associated with healthcare checkups.
Moreover, Texans have a variety of Medigap plans to choose from, each offering different levels of coverage. This variety of plans allows individuals to select a plan that best suits their healthcare needs and budget.
As these popular Medigap plans are standardized by the federal government, they offer the same benefits across the same plan. For example, all plan Gs in the State will offer the same standardized benefits to enrollees.
This standardization across the plans simplifies the selection process, as beneficiaries only need to look into the premiums, insurer ratings, and competitive rates.
Another benefit of Medigap policies is the freedom to choose healthcare providers. Unlike Medicare Advantage plans, Medigap plans do not restrict beneficiaries to a network of healthcare providers.
As long as a healthcare provider or a hospital accepts Medicare, the Medigap plan will cover its share of the approved amount. This is beneficial for those who travel frequently as it doesn’t restrict beneficiaries to a limited network of providers.
Some of the Medicare Supplement plans in Texas also offer coverage for services that Medicare does not insure, like medical care when traveling outside the United States. Therefore, having access to Medigap with Original Medicare proves more beneficial than having a standard Medicare plan.
Medicare Texas Resources
Several organizations across Texas provide free counseling and guidance to senior residents regarding Medicare plans. Here are some organizations to assist Texans.
| Organization | How you can get help | Website & Contact Info |
| Texas Health and Human Services | The Texas Health and Human Services offers various services to support the well-being, dignity, and choices of older Texans, along with resources for family caregivers. This includes information on state and federal benefits like Medicare and legal rights. | Website | (512) 424-6500 |
| Texas Health Information, Counseling and Advocacy Program | This service assists with Medicare enrollment, offers advice, and provides information on your options. Across the State, trained certified benefits counselors are available to help you identify and apply for suitable programs. | Website | (512) 424-6500 |
| Texas Area Agencies on Aging | Area Agencies on Aging (AAA) provide support for individuals aged 60 and above, along with their families and caregivers, by providing information and help in finding and using community services. These agencies also offer counseling on benefits and legal aid. | Website | (855) 937-2372 |
| Texas Consumer Assistance | This advocacy group serves as a central hub where residents can find information about different types of health insurance coverage and address any related issues or questions. | Website | (800) 252-3439 |
Choose the Right Medicare Supplement Plan With Silveredge in Texas
Texas, also known as the Lone Star State, is the most populous State in the South Central region of the United States, housing a considerable number of senior residents.
With high inflation and skyrocketing hospital bills, services such as Medicare are necessary in the region as they can cut down healthcare bills for senior residents.
Medicare supplement plans are standardized across the State of Texas. Therefore, you receive the same benefits. The only difference is the cost of these plans, as the premiums vary from provider to provider.
However, besides looking into the competitive rates, you must also check the available plans in your State, as Texas offers ten standardized Medicare supplement plans. The pricing for these plans also varies from provider to provider.
Leveraging the right resources can help you enroll in a cost-efficient Medicare Supplement plan. With the help of Silveredge, you can compare different plans in your region and look into the availability and premiums.
Silveredge’s licensed advisors have industry expertise that you can utilize to make the best decision for you or your loved ones. Contact Silveredge today to equip yourself with the necessary information regarding Medicare Supplement Plans in Texas!
