How to Sign Up for Medicare Parts A and B in Texas

Signing up for Medicare Parts A and B is a one-time task, but the timing matters. Get it wrong and your coverage can start late, or you can pick up a penalty that sticks with you. Here's how it works for Texans.

Step 1: Find out if you'll be enrolled automatically

You'll get Parts A and B automatically if you started Social Security or Railroad Retirement Board benefits at least four months before you turn 65. Your welcome package and red, white, and blue Medicare card arrive about three months before your coverage starts.

Part B has a monthly premium ($202.90 in 2026 for most people), so the package explains how to decline it if you have other coverage. Before you do, read our guide to delaying Part B while you're still working. Turning it down without qualifying coverage can mean a delay and a lifelong penalty.

If you haven't started Social Security yet, you need to sign up yourself.

Step 2: Know your Initial Enrollment Period

Your Initial Enrollment Period (IEP) lasts seven months:

• The 3 months before the month you turn 65
• The month you turn 65
• The 3 months after

Coverage always starts on the first of a month.

If you sign up for Part B...	Coverage starts
Before the month you turn 65	The first day of your birthday month
In your birthday month or the 3 months after	The first day of the following month

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

Step 3: Apply through Social Security

Social Security recommends signing up about three months before your 65th birthday. You can:

1. Apply online at ssa.gov/medicare/sign-up. You'll need a my Social Security account.
2. Call 1-800-772-1213 (TTY 1-800-325-0778), Monday through Friday, 8 a.m. to 7 p.m., to apply or make an appointment.
3. Visit a local Social Security office. Offices are spread across Texas, but in rural counties the nearest one may be a long drive, so the online and phone options can save you a trip. Call ahead for an appointment.

If you or your spouse worked for a railroad, contact the Railroad Retirement Board at 1-877-772-5772 instead.

Have ready the start and end dates of any current group health coverage, and of any group coverage you've had since turning 65.

Step 4: Decide how you'll fill the gaps

Parts A and B are the foundation, but they don't cover most prescriptions and have no yearly out-of-pocket cap. Most people choose one of two paths:

• Original Medicare plus a Medigap policy and a Part D drug plan
• A Medicare Advantage plan, which bundles hospital and medical coverage and usually drug coverage

If Medigap appeals to you, watch your six-month Medigap open enrollment period, which begins when you enroll in Part B at 65 or older. According to the Texas Department of Insurance, during that window companies must sell you any Medigap plan they offer in Texas regardless of your health history. Our guide to Medicare Advantage vs. Original Medicare in Texas walks through the trade-offs.

If you miss your window

If you don't sign up during your IEP and don't qualify for a Special Enrollment Period, you'll wait for the General Enrollment Period, January 1 through March 31. Coverage starts the month after you sign up. You may also owe a Part B late enrollment penalty: an extra 10% of the standard premium for each full 12-month period you could have had Part B but didn't, usually for as long as you have Part B.

Moving to Texas near 65?

If you're relocating to Texas, you sign up the same way. Social Security handles enrollment nationwide. Our guide to moving to Texas on Medicare covers what changes when you arrive.

Free help in Texas

The Texas Health Information, Counseling and Advocacy Program (HICAP) offers free, unbiased Medicare counseling at 1-800-252-9240. Counselors can help you map out your enrollment timeline. If you prefer Spanish, ask for a Spanish-speaking counselor, or call 1-800-MEDICARE and request an interpreter.