Who Is Eligible For Medicare In Texas?

Who is eligible for Medicare in Texas? Texas Medicare is part of a federal program that provides medical, hospital, and prescription drug insurance. More than 4 million seniors and other qualifying people are Texas Medicare members. Most people qualify for Medicare starting when they turn 65. If you or a family member are approaching this milestone birthday, you might be wondering who is eligible for Medicare and how to join the program. Learn more about Medicare eligibility, your Medicare options, and how to apply for Texas Medicare.

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Medicare Eligibility In Texas

There are several different ways to see who is eligible for Medicare in Texas. Most people can enroll in Medicare when they turn 65. The Initial Enrollment Period starts a few months before your 65th birthday and lasts until three months after your birthday. 

In most cases, there’s a work history requirement to receive Medicare. If you or your spouse paid Medicare taxes for at least ten years, then you’re eligible for Texas Medicare starting at age 65.

Most Texans who receive Medicare qualify because of their age and work history. However, other groups of people can enroll in Medicare as well. People living with certain disabilities or End Stage Renal Disease (ESRD) can also receive Medicare, regardless of their age. If you have questions about who is eligible for Medicare in your family, Coverage2Care can help you navigate the enrollment process.

Medicare Options For Texans


Texas Medicare Part A — Hospital Coverage

Texas Medicare Part A covers hospital visits and other services such as stays in a long-term skilled nursing facility, home health care, and hospice services. This was the first form of Medicare offered by the government. You might also hear it called traditional or original Medicare.

If you’re wondering who is eligible for Medicare Part A, you’ll be happy to know that most Texas seniors qualify. You can enroll in Part A once you turn 65. Coverage is free if you or your spouse paid Medicare taxes through your job for ten years or longer. If you don’t have this work history, you can often purchase coverage for a small monthly fee.


Texas Medicare Part B — Doctors and Outpatient Services

Texas Medicare Part B is insurance that covers visits to your doctor’s office and many outpatient services. If you have family who is eligible for Medicare Part B, they can use this coverage for preventative care, necessary medical services, and durable medical equipment such as wheelchairs, canes, and diabetes supplies.

If you qualify for Medicare Part A, you also qualify for Part B. Most people can receive this coverage after turning 65, provided they or their spouse paid ten years of Medicare insurance. There is a monthly cost for Medicare Part B. If you don’t qualify for free Medicare Part A, you can still purchase Part B coverage at a higher rate.

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Texas Medicare Part C — Medicare Advantage

Medicare Part C is private insurance that offers all the same coverage as Medicare. These insurance policies cover hospital stays, visits to the doctor, outpatient services, and other benefits. Medicare Part C is also known as Medicare Advantage. Medicare Advantage programs are required to cover all the same treatments as standard Medicare through the government. You can often find additional coverage through an Advantage plan.

Medicare Advantage is available using the same standards as Medicare Part A and B. If you or your spouse paid at least ten years of Medicare taxes, you can enroll in Medicare Advantage once you turn 65. Plans may also be available even if you don’t have a qualifying work history.


Texas Medicare Part D — Prescription Drugs

Medicare Part D covers prescription drugs and medications. Prescriptions are an important part of your medical care, but Part A and B don’t cover medication. Texas Medicare Part D is valuable optional coverage that pays for your prescription drugs. 

Every Medicare Part D plan is provided by a private insurance company. If you purchase a Medicare Advantage plan, you can add Medicare Part D coverage. People who choose Part A and Part B through the government will still need to shop for a private Part D plan. Part D options can be confusing, but Coverage2Care is here to help you explore your choices.

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How To Apply For Medicare In Texas?

Medicare offers useful coverage for Texas seniors, but the system can seem complicated. Ultimately, most Texans are eligible for Medicare on their 65th birthday. If you’re already receiving Social Security benefits when you turn 65, you’ll automatically be enrolled in Medicare. If not, there are two standard times to apply.

Your first chance to sign up for Medicare is in your Initial Enrollment Period (IEP), which is a seven-month span around your 65th birthday. You can sign up during the three months before your birthday month, the month of your birthday, and three months after your birthday. If you have insurance through your private employer, you can delay enrolling for as long as you keep your coverage through work. Otherwise, you can face fees if you skip your IEP and sign up later in life.

People who delay signing up for Medicare because they have private insurance will have a second enrollment period once their work coverage ends. This Special Enrollment Period lasts for eight months after your private insurance ends.

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Learn More With Coverage2Care

The Medicare application process can be complicated, but enrolling in Medicare is worth the trouble. If you have a family member who is eligible for Medicare, or if you’re about to qualify yourself, you should explore all the options on the market. 

Luckily, you don’t need to tackle this process alone. Coverage2Care can help you find an affordable Medicare plan with great coverage.

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