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Texas Medicare Plans

Medicare Supplement (Medigap) Policies
Texas requires insurers to offer at least one Medicare Supplement policy to adults under sixty-five afflicted with disability.

Mini-COBRA Policies
Texas requires small employers to provide thirty-six months of continuation coverage.

Medicare Savings Programs (Premium Support)

Texas has three Medicare Savings Programs:

  • Qualified Medicare Beneficiaries (QMBs): For individuals with a monthly income under $993 and for couples with a monthly income under $1331, the state pays all premiums for Part B and all Co-Pays and Deductibles for Parts A & B
  • Specified Low-Income Medicare Beneficiaries (SLMBs): For individuals with income under $1187 or couples with income under $1593, the state pays premiums for Part B.
  • Qualified Individuals (QIs):  For individuals with income under $1333 or for couples with an income under $1790, the state pays premiums for Part B.

To qualify for any one of these programs, participants must have assets below $6,600 or be part of a couple with assets below $9,910.

State Health Insurance Assistance Program
The Health Information Counseling and Advocacy Program (HICAP) is the SHIP in Texas for Medicare beneficiaries. HICAP has approximately 450 local staff and volunteer counselors working throughout the state in 28 Area Agencies on Aging (AAA). The Texas Department of Insurance (TDI) provides training, publications, and resource materials, as well as technical insurance expertise. The Texas Legal Services Center (TLSC) provides specialized legal back-up to local counselors, training on public benefit programs, document preparation, and a statewide toll-free legal assistance hotline for persons eligible for Medicare at (866) 979-4343. The Texas Department of Aging and Disability Services coordinates the network and the statewide partnership.

High-Risk Pool
Texas does have a high-risk insurance pool, open to residents on the basis of HCTC, medical and HIPAA eligibility.

State Pharmaceutical Assistance Program
Texas offers pharmaceutical assistance to those with end-stage renal disease.

Low-Income Subsidy (“extra-help”) for Prescription Drugs:
This program is a subsidy for Part D recipients with resources under $13,070 (or $26,120 for a couple) to receive money towards a Medicare prescription drug plan. The benchmark of support is different depending on which region of the country you live in.  In Texas in 2012, the low-income subsidy was $29.99 per month.

If you live in Texas, consult with one of our insurance specialists to get personal assistance that is specific to your area. One of our experienced specialists can compare plans in your area and help you find the Medicare insurance benefits that are right for your needs.