Texas Medicare Enrollment Guide (2026)

Last verified: March 2026. Costs and enrollment rules can change annually. Check Medicare.gov and the Texas HHS Medicare page for the latest details.

Key Takeaways

• Texas Medicare enrollment starts with a 7-month Initial Enrollment Period around your 65th birthday, and signing up in the first 3 months gives you the earliest coverage start date
• The standard Part B premium is $202.90/month in 2026, with a $283 annual deductible
• Missing your enrollment window can trigger permanent late-enrollment penalties: 10% per year for Part B and 1% per month for Part D
• Texas offers free Medicare counseling through HICAP at 1-800-252-9240
• Low-income Texans may qualify for Medicare Savings Programs that cover premiums, deductibles, and copayments

In This Guide

• When to Sign Up for Texas Medicare Enrollment
• How to Sign Up
• What Medicare Costs in 2026
• Late Enrollment Penalties
• Still Working Past 65?
• What Changed for 2026
• Help Paying for Medicare in Texas
• Free Medicare Help in Texas
• Mistakes to Avoid
• FAQ

If you're turning 65 in Texas and need to figure out Texas Medicare enrollment, here's the short version: you have a 7-month window to sign up, and the earlier you act within that window, the sooner your coverage starts. Most people don't realize they need to actively enroll unless they're already collecting Social Security. Miss the deadline, and you'll pay higher premiums for the rest of your time on Medicare.

This guide walks through every enrollment period, what Medicare costs in 2026, penalty rules, and where to get free help in Texas. You can chat with Brevy to check your options in a few minutes.

Important: The figures and rules described here are based on current data from the Centers for Medicare & Medicaid Services and the Texas Health and Human Services Commission, verified as of March 2026. Medicare costs change annually. Contact Medicare at 1-800-633-4227 or Texas HICAP at 1-800-252-9240 to verify current requirements for your situation.

When to Sign Up for Texas Medicare Enrollment

Your Initial Enrollment Period

Your Initial Enrollment Period (IEP) is a 7-month window centered on the month you turn 65. It starts 3 months before your birthday month, includes your birthday month, and ends 3 months after.

When you sign up during this window determines when your coverage begins:

Premium-free Part A starts the month you turn 65. If your birthday falls on the 1st of the month, it starts the month before.

The best move is to sign up in those first 3 months. That way, your coverage is in place the day you turn 65 with no gap.

General Enrollment Period

If you miss your IEP, the General Enrollment Period (GEP) runs January 1 through March 31 each year. Coverage starts the month after you enroll.

Late enrollment penalties will likely apply. More on those below.

Medicare Advantage and Part D Enrollment

Two additional periods matter if you're choosing a Medicare Advantage or Part D plan:

Fall Open Enrollment (October 15 through December 7): You can join, drop, or switch Medicare Advantage plans and Part D drug plans. Changes take effect January 1.

Medicare Advantage Open Enrollment (January 1 through March 31): If you're already in a Medicare Advantage plan, you can switch to a different MA plan or go back to Original Medicare and add a Part D plan. Coverage starts the first day of the month after the plan gets your request.

How to Sign Up

Automatic Enrollment

If you're already receiving Social Security or Railroad Retirement Board benefits at least 4 months before you turn 65, you'll be automatically enrolled in both Part A and Part B. You'll get a welcome package with your Medicare card about 3 months before your 65th birthday.

Automatic enrollment also applies if you've received SSDI for 24 months or have been diagnosed with ALS.

If you haven't started Social Security benefits yet, you won't be automatically enrolled. You'll need to sign up yourself.

Ways to Enroll

After you submit your application, expect your Medicare card within about 2 weeks.

Once you have Parts A and B, you can compare and enroll in Medicare Advantage or Part D plans at medicare.gov/plan-compare. Texas HICAP counselors can walk you through plan comparisons for free.

What Medicare Costs in 2026

Monthly Premiums

Deductibles and Cost-Sharing

A single hospital stay past day 60 could cost you $434 per day in coinsurance alone. That's why many people add a Medigap supplement or choose a Medicare Advantage plan with an out-of-pocket limit.

Higher-Income Surcharges (IRMAA)

If your modified adjusted gross income on your 2024 tax return exceeded $109,000 (individual) or $218,000 (joint), you'll pay higher Part B and Part D premiums:

Late Enrollment Penalties

Missing your enrollment windows has real financial consequences. These penalties are permanent.

Part B Penalty

For each full 12-month period you could've had Part B but didn't, Medicare adds 10% to your standard premium. This penalty lasts as long as you have Part B.

Example: If you delayed 2 years, you'd pay a 20% penalty. In 2026, that's $40.58 added to the $202.90 standard premium, for a total of $243.48 per month, every month, for life.

Part A Penalty

This only applies if you don't qualify for premium-free Part A (meaning you have fewer than 40 quarters of work history). The penalty is a 10% increase to your monthly Part A premium, lasting twice the number of years you delayed.

Part D Penalty

If you go 63 or more consecutive days without creditable drug coverage after your initial enrollment period, you'll owe 1% of the national base premium ($38.99 in 2026) for each uncovered month. Like the Part B penalty, this one is permanent.

Example: 14 months without creditable coverage adds about $5.50 per month to your Part D premium, forever.

The Part D penalty doesn't apply if you had creditable drug coverage elsewhere (like through an employer plan) or qualify for Extra Help.

Still Working Past 65?

If you're still employed and covered by your employer's health plan, you may not need to sign up for Part B right away. But the rules depend on your employer's size.

Employers with 20 or more employees: Your employer plan is primary, and Medicare is secondary. You can delay Part B enrollment without penalty and use the employer coverage Special Enrollment Period (SEP) when you retire. That SEP gives you 8 months from the date your employment or employer coverage ends, whichever comes first.

Employers with fewer than 20 employees: Medicare becomes primary. You should enroll in Part B at 65, even if your employer still provides insurance.

The COBRA trap: COBRA doesn't count as employer group health plan coverage for Medicare purposes. If you rely on COBRA after turning 65 without enrolling in Part B, you'll face lifetime late enrollment penalties. Your 8-month SEP clock starts when your active employment-based coverage ended, not when COBRA runs out.

HSA heads-up: If you contribute to a Health Savings Account, stop contributions at least 6 months before enrolling in Medicare Part A to avoid IRS tax penalties. Part A enrollment is retroactive up to 6 months, which catches many people off guard.

The employer-coverage rules are where most families get tripped up. A quick call to the HICAP helpline at 1-800-252-9240 before making decisions can save you from costly mistakes.

What Changed for 2026

Several Medicare costs shifted for 2026:

• Part D $2,100 out-of-pocket cap continues from 2025. Once you hit this limit, you owe nothing for covered drugs the rest of the year.
• Medicare Prescription Payment Plan lets you spread drug costs in monthly installments instead of paying large amounts at the pharmacy.
• Part B premium rose to $202.90/month, up from $185.00 in 2025.
• Part B deductible increased to $283, up from $257.
• Part A hospital deductible went up to $1,736, from $1,676.

The $2,100 Part D cap is the biggest change for most beneficiaries. Before this cap was introduced under the Inflation Reduction Act in 2025, some people paid thousands out of pocket for specialty medications each year.

Help Paying for Medicare in Texas

If you're on a limited income, Texas offers Medicare Savings Programs (MSPs) that can cover your premiums, deductibles, and cost-sharing:

QMB enrollment also eliminates any Part B late enrollment penalty you've accumulated.

Extra Help (also called the Low-Income Subsidy) is a separate program through Social Security that reduces Part D prescription drug costs.

Many eligible Texans don't apply because they don't know these programs exist. A quick eligibility screening through Texas HICAP can tell you whether you qualify.

Free Medicare Help in Texas

Texas's SHIP program is called HICAP (Health Information, Counseling, and Advocacy Program). It's a partnership between the Texas Health and Human Services Commission, the Texas Legal Services Center, and the Area Agencies on Aging.

HICAP counselors can help with:

• Medicare enrollment and eligibility questions
• Medigap policy comparisons
• Medicare Advantage and Part D plan comparisons
• Medicare Savings Program eligibility screening
• Appeals and complaints

Every service is free and unbiased. These are trained, certified counselors who don't sell insurance.

Mistakes to Avoid

These are the enrollment errors that cost Texas seniors the most:

Not signing up on time. If you're not collecting Social Security, you won't be automatically enrolled. Missing your IEP means waiting until the next General Enrollment Period and paying permanent penalties.

Counting on COBRA. COBRA doesn't count as employer coverage for Medicare purposes. Don't let it delay your Part B enrollment.

Skipping Part D. Even if you take no medications right now, going without creditable drug coverage for more than 63 days triggers a permanent penalty. It's cheaper to pay a modest monthly premium than to absorb a growing surcharge later.

Missing the Medigap window. If you want a Medigap supplement plan, your best shot is the 6-month Open Enrollment Period that starts when your Part B begins at age 65. After that window closes, insurers can turn you down based on health conditions.

Not reviewing plans each fall. Drug formularies, premiums, and provider networks change every year. Use the Fall Open Enrollment Period (October 15 through December 7) to compare your current plan against alternatives.

FAQ

Sources

1. Centers for Medicare & Medicaid Services, "2026 Medicare Parts A & B Premiums and Deductibles," cms.gov
2. Medicare.gov, "When Does Medicare Coverage Start," medicare.gov
3. Medicare.gov, "How Do I Sign Up for Medicare," medicare.gov
4. Medicare.gov, "Avoid Late Enrollment Penalties," medicare.gov
5. Medicare.gov, "Medicare Costs at a Glance" (Publication 11579), medicare.gov
6. Texas Health and Human Services Commission, "Medicare," hhs.texas.gov
7. SHIP National Technical Assistance Center, "What's New in Medicare for 2026," shiphelp.org
8. CMS, "Original Medicare (Part A and B) Eligibility and Enrollment," cms.gov

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Medicaid rules vary by state and change frequently. Always verify eligibility and benefits with your state Medicaid agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.