Medigap in Texas: How Medicare Supplement Insurance Works and When to Buy It

Original Medicare pays a big share of your health care costs, but not all of it. You still owe deductibles and coinsurance, and there's no yearly cap on what you can pay out of pocket. A Medigap policy, also called Medicare Supplement insurance, is one way Texans fill those gaps.

This is the season when a lot of people compare their options. Here's how Medigap works, why timing is everything, and the Texas rules worth knowing.

What Medigap does

Medigap policies are sold by private insurance companies. They help pay some of the costs Original Medicare doesn't, depending on the policy. In 2026, those costs include:

Original Medicare cost (2026)	Amount
Part A hospital deductible	$1,736 per benefit period
Part B deductible	$283 a year
Part B coinsurance	Generally 20% of the Medicare-approved amount

Medigap policies are standardized, and many of them pay all or part of the Part A deductible and Part B coinsurance. Some also help with costs like emergency care when you travel outside the U.S. CMS announces 2027 Medicare amounts each fall.

A few basics:

• Medigap only works with Original Medicare. You can have Medigap or a Medicare Advantage plan, but not both at once.
• It doesn't include drug coverage. People with Original Medicare and Medigap usually add a separate Part D plan.
• You pay a monthly premium to the insurer, on top of your Part B premium.
• It generally works with any provider in the U.S. that accepts Medicare, which is why some Texans who travel or see specialists in several cities prefer it.

Not sure which path fits you? Our guide to Medicare Advantage vs. Original Medicare in Texas compares them side by side.

Timing matters most

Your best chance to buy Medigap is your 6-month Medigap Open Enrollment Period. It starts the first month you're 65 or older and enrolled in Part B. The Texas Department of Insurance says that during this window, companies must sell you any Medigap plan they offer in Texas regardless of your health history.

After that window closes, you can still apply. But outside your open enrollment period or certain protected situations, there's no federal guarantee a company will sell you a policy, and it may cost more because of past or present health problems.

If you're still working and delaying Part B, your Medigap window waits until you sign up for Part B. See delaying Part B while still working.

The trial right

There's an important protection for people who try Medicare Advantage first. If you joined a Medicare Advantage plan for the first time and you return to Original Medicare within 12 months, you may have a federal right to buy a Medigap policy.

If you've had Medicare Advantage longer than that and have health conditions, find out whether you can get a Medigap policy before you drop your plan. Our Medicare Advantage Open Enrollment guide explains the Jan. 1 to March 31 window.

Texas rules for people under 65

Federal law doesn't guarantee people under 65 the right to buy a Medigap policy. Texas adds some protection:

• Disability: The Texas Department of Insurance says people under 65 with disability-based Medicare get a 6-month open enrollment period beginning when they enroll in Part B. That right applies to Medigap Plan A.
• ESRD or ALS: Under Texas House Bill 2516, which took effect Sept. 1, 2025, companies that sell Medigap to people 65 and older must offer the same coverage to people under 65 on Medicare because of ESRD or ALS.
• Turning 65: TDI notes that people who got Medicare because of a disability get another Medigap open enrollment period during the first six months after turning 65.

More detail is in our guide to Medicare under 65 with a disability in Texas.

Moving to Texas with a Medigap policy

Medicare says you can keep your current Medigap policy no matter where you live, as long as you still have Original Medicare. Your premium may change, so ask your insurer. If you want to switch to a different policy later, you may have to answer health questions. See moving to Texas on Medicare.

Free, unbiased help

Medigap policies in Texas are sold by private insurers licensed by the Texas Department of Insurance, which publishes a consumer guide to Medicare supplement insurance. For free one-on-one counseling, call the Texas Health Information, Counseling and Advocacy Program (HICAP) at 1-800-252-9240. You can also call 1-800-MEDICARE (1-800-633-4227) or read Medicare's free guide, Choosing a Medigap Policy, on Medicare.gov.