The Best Medigap Plans in Texas for 2025

Table of Contents

Getting your Medicare coverage right often comes down to one thing: timing. There’s a crucial, one-time, six-month window where you can enroll in any Medigap policy you want—guaranteed. No health questions, no hoops to jump through. This is your Medigap Open Enrollment Period, and missing it can make finding affordable gap coverage much more difficult later on. It’s your single best chance to get the coverage you need at the best price. This guide will walk you through these important deadlines so you can confidently choose one of the best Medigap plans in Texas.

Key Takeaways

Prioritize Your Open Enrollment Window: Your 6-month Medigap Open Enrollment Period is a one-time opportunity to buy any plan without facing medical questions. Missing this window means insurers can use your health history to charge you more or deny coverage, so timing your application is critical.
Compare Prices, Not Benefits: All Medigap plans of the same letter (like Plan G) offer identical, government-standardized benefits. This allows you to choose the coverage level you need first, then shop around to find the most competitive monthly premium from a reputable insurance company.
Remember to Cover Prescriptions Separately: Medigap plans are designed to fill the gaps in Original Medicare Parts A and B, but they do not include prescription drug coverage. You will need to enroll in a separate Medicare Part D plan to help pay for your medications.

What is a Medigap Plan?

If you’ve ever felt surprised by a medical bill, you know how stressful unpredictable health care costs can be. That’s where Medicare Supplement Insurance, often called Medigap, comes in. Think of it as a safety net for your Original Medicare coverage. A Medigap plan is extra insurance you can buy from a private company to help pay for some of the out-of-pocket costs that Original Medicare (Part A and Part B) doesn’t cover. These plans are designed to make your health care expenses more predictable by covering expenses like deductibles, copayments, and coinsurance.

Understanding Original Medicare: Parts A and B

To see why Medigap is so valuable, it helps to first understand what it’s designed to supplement: Original Medicare. This is the federal health insurance program that forms the foundation of your coverage, and it’s broken into two main parts. Part A is your hospital insurance, which helps pay for your room and board if you’re admitted to a hospital or need short-term care in a skilled nursing facility after a hospital stay. Then you have Part B, which is your medical insurance. This part covers a wide range of outpatient services, like your regular doctor’s visits, necessary lab work, medical equipment, and important preventive care screenings.

While Original Medicare covers many essential health services, it was never designed to cover everything, leaving behind some significant gaps in coverage. You are still responsible for paying for things like deductibles, copayments, and coinsurance, which can lead to unpredictable medical bills. For example, under Part B, you typically still pay 20% of the cost for most doctor services and outpatient care after your deductible is met. This is precisely where Medigap plans step in. They are specifically designed to help cover these additional costs, creating a financial safety net and making your health care expenses much more predictable.

How Medigap Works With Original Medicare

It’s important to understand that a Medigap plan works with your Original Medicare, not as a replacement for it. You must be enrolled in both Medicare Part A and Part B to buy a Medigap policy. When you receive medical care, Medicare first pays its share of the approved amount, and then your Medigap plan steps in to pay its portion. This partnership helps reduce what you owe out of pocket. One key point to remember is that Medigap policies do not work with Medicare Advantage plans. You can have one or the other, but not both at the same time.

Closing the Gaps in Your Medicare Coverage

The term “Medigap” is quite literal—these plans are designed to fill the financial “gaps” in Original Medicare. While Medicare Part A and Part B provide great foundational coverage, they leave you responsible for certain costs. Medigap plans help pay for these remaining expenses, which can include your Part A hospital deductible or the 20% coinsurance for Part B services. For Texans who became eligible for Medicare after January 1, 2020, the most popular Medigap plans are Plan G and Plan N. These plans offer comprehensive coverage that helps many people feel more financially secure about their health care.

Which Medigap Plans Can You Get in Texas?

If you live in Texas, you have access to all ten standardized Medicare Supplement plans, also known as Medigap. This is great news because it gives you a wide range of options to find coverage that fits your specific needs and budget. The plans are labeled A, B, C, D, F, G, K, L, M, and N. While having so many choices is a plus, it can also feel a bit overwhelming.

The key thing to remember is that these plans are designed to fill the “gaps” in Original Medicare, like deductibles, coinsurance, and copayments. Each lettered plan offers a different combination of benefits. Think of it like choosing a trim level for a car—some have more features than others. While all ten plans are available, most people find that a few specific plans offer the best value and coverage. We’ll walk through which plans are the most popular in Texas and why, so you can feel more confident as you start to compare your options.

Breaking Down Every Medigap Plan in Texas

One of the best features of Medigap is standardization. This means that a Plan G from one insurance company provides the exact same medical benefits as a Plan G from any other company. The only differences will be the monthly premium you pay and the company’s customer service reputation. This rule makes it much easier to compare plans apples-to-apples. You don’t have to worry about hidden clauses or different coverage levels between carriers for the same lettered plan. Your main job is to first decide which plan letter (like G or N) has the benefits you need, and then find the most competitively priced policy from a reliable company.

What Are the Most Popular Medigap Plans in Texas?

You’ll hear a lot about three plans in particular: Plan F, Plan G, and Plan N. These are by far the most popular choices among Texans. For anyone new to Medicare, Plan G is often the top contender. It’s the most comprehensive option available, covering nearly all of your out-of-pocket costs under Original Medicare. The only thing it doesn’t cover is the annual Medicare Part B deductible. Plan N is another excellent choice if you’re looking for a lower monthly premium and don’t mind paying small copays for some doctor visits and emergency room trips. We have a detailed Texas Medigap guide that explores these popular plans more deeply.

Enrollment Statistics for Texas Medigap Plans

It’s helpful to see what plans other people are choosing, and the numbers in Texas tell a clear story. Nearly 950,000 Texans have enrolled in a Medigap plan, showing just how valuable this coverage is. When you look at the most popular options, Plan G is the top choice for 54% of new Medicare enrollees, largely because it offers such complete coverage. Plan F still accounts for a significant portion of the market at 35%, though it’s only available to those who were eligible for Medicare before 2020. Meanwhile, Plan N is selected by about 8% of residents, appealing to those who want lower monthly premiums. These trends highlight how important it is to understand your options during your Medigap Open Enrollment Period to secure the right coverage for your needs.

Who Can Still Enroll in Plan C and Plan F?

You might have heard that Plan F is the “cadillac” of all Medigap plans because it covers everything, including the Part B deductible. While that’s true, a federal law changed who can buy it. Plans C and F are now only available to individuals who were eligible for Medicare before January 1, 2020. If you became eligible for Medicare on or after that date, you won’t be able to purchase Plan C or F. For this reason, Plan G has become the new go-to plan for comprehensive coverage for new Medicare beneficiaries. It offers the same robust benefits as Plan F, with the single exception of the Part B deductible.

How Do Medigap Plans Differ?

While all Medigap plans are designed to fill the gaps in Original Medicare, they don’t all offer the same level of coverage. The primary difference between the standardized plans comes down to which out-of-pocket costs they cover and how much you’ll pay in monthly premiums. Some plans cover nearly everything, leaving you with very predictable medical bills. Others have lower monthly premiums but require you to share some of the costs, like paying small copayments for doctor visits.

Think of it as a trade-off: would you rather pay a higher premium each month for more comprehensive coverage, or a lower premium for a plan that requires you to pay for some services as you use them? Understanding these key differences will help you find a plan that fits both your healthcare needs and your budget. Let’s look at some of the most popular options side-by-side to see how they work.

Head-to-Head: Medigap Plan G vs. Plan N

Two of the most popular choices for new Medicare members are Plan G and Plan N. They both offer robust coverage but have a few important distinctions that can make one a better fit for you than the other.

Plan G is often considered the most comprehensive option available to anyone new to Medicare. It covers almost all of your out-of-pocket costs, including your Part A deductible and all coinsurance. The only thing it doesn’t cover is the annual Medicare Part B deductible. Once you meet that deductible yourself, Plan G picks up the rest of the Medicare-approved costs for the year. This makes it a great choice if you value predictability and want to minimize surprise medical bills.

Plan N is an excellent alternative if you’re looking for a lower monthly premium and don’t mind some cost-sharing. Like Plan G, you’ll still pay the annual Part B deductible. After that, Plan N requires you to pay a small copayment for some doctor visits (up to $20) and emergency room visits (up to $50). It also doesn’t cover Part B excess charges, which are extra fees that some doctors can charge. For many people, the monthly savings on Plan N are well worth these potential out-of-pocket costs.

Understanding Plan N Copayments

Let’s break down what those Plan N copayments actually look like. When you have Plan N, you agree to pay a small, fixed amount for certain medical services after you’ve met your Part B deductible. Specifically, you could have a copayment of up to $20 for some office visits and up to $50 if you visit the emergency room. It’s important to know that the ER copay is waived if your visit results in you being admitted to the hospital as an inpatient. For many people, these predictable, small costs are a fair trade for the lower monthly premium that Plan N typically offers compared to Plan G.

What Are Part B Excess Charges?

The other key difference with Plan N is that it doesn’t cover Part B excess charges. This might sound complicated, but the concept is straightforward. Federal law allows some doctors to charge up to 15% more than the Medicare-approved amount for a service. This extra fee is called an excess charge. The good news is that most doctors in the United States agree to accept the Medicare-approved amount as full payment, a practice known as accepting assignment. Because of this, excess charges are not very common. However, since they are permitted in Texas, it’s something to be aware of. You can always ask a new doctor’s office if they accept Medicare assignment to avoid any surprise bills.

Should You Consider a High-Deductible Plan?

For those who are generally healthy and want the lowest possible monthly premium, a high-deductible plan might be a good fit. Both Plan G and Plan F are available in high-deductible versions. With these plans, you pay a much lower premium, but you must first pay a significant annual deductible out-of-pocket before the plan begins to cover your costs.

For 2024, the deductible for the High-Deductible Plan G is $2,800. This means you are responsible for the first $2,800 of your Medicare-approved medical expenses for the year. After you’ve met that deductible, the plan functions just like a standard Plan G, covering 100% of your remaining costs. This option can be a smart financial choice if you’re comfortable covering the deductible in the event of an unexpected health issue.

The 2025 High-Deductible Amount

As you plan for the year ahead, it’s helpful to know the updated figures for high-deductible plans. For 2025, the deductible for High-Deductible Plans F and G is set at $2,870. This means you will be responsible for paying for your Medicare-approved health care costs out-of-pocket until you meet this amount. Once you’ve paid the $2,870 deductible, your plan will then cover 100% of your remaining costs for the rest of the year, just like a standard Plan G would. This trade-off—a higher deductible for a much lower monthly premium—can be a financially savvy choice for individuals who are in good health and want to keep their fixed costs low.

See What Each Medigap Plan Covers

The most important thing to remember when comparing Medigap plans is that they are standardized by the federal government. This means that a Plan G from one insurance company offers the exact same basic benefits as a Plan G from any other company. The same is true for Plan N and all other lettered plans. This standardization makes your job much easier because you don’t have to worry about differences in coverage from one carrier to the next.

All Medigap plans are designed to help pay for the costs that Original Medicare (Part A and Part B) leaves behind. These “gaps” include expenses like deductibles, coinsurance, and copayments. When you’re shopping for a plan, you’re not comparing benefits—you’re comparing the monthly premium and the reputation of the insurance company offering the plan.

Coverage for Foreign Travel Emergencies

If you have plans to travel outside the United States, it’s important to know how your health care will work. Original Medicare offers very limited coverage once you leave the country, which can be a major concern for travelers. This is another one of those critical “gaps” where a Medigap plan can provide significant value. Most of the popular plans, including Plan G and Plan N, include a benefit for foreign travel emergency care. After you pay a small annual deductible, these plans will cover 80% of your medically necessary emergency care costs during the first 60 days of your trip. This benefit can offer tremendous peace of mind, ensuring that an unexpected medical issue abroad doesn’t turn into a financial crisis.

When Should You Enroll in a Texas Medigap Plan?

When it comes to Medigap, timing is everything. Choosing the right moment to enroll is just as important as choosing the right plan, and honestly, it’s one of the areas that trips people up the most. Your age and specific life events, like retiring from a job, create specific windows of opportunity to sign up. Missing these windows can make it much harder—and more expensive—to get the coverage you want later on. The key is to understand your personal enrollment periods before they begin so you can act at the right time.

This knowledge gives you the power to get the best plan at the best price, without any hassle. Think of these periods as a protected time when the rules are in your favor, and insurance companies have to offer you a policy regardless of your health history. It might seem complicated at first, with different names for different enrollment windows, but it all boils down to a few key timelines. Once you know when your personal windows open and close, the whole process becomes much clearer and far less stressful. Let’s walk through the most important enrollment periods you need to know about so you can feel confident in your decision and avoid any costly mistakes.

Don’t Miss Your Medigap Open Enrollment Window

Your Medigap Open Enrollment Period is the absolute best time to buy a policy. This is a six-month window that starts on the first day of the month you are both 65 or older and enrolled in Medicare Part B. During this one-time period, you have the right to buy any Medigap plan sold in Texas. An insurance company cannot use medical underwriting to make decisions. This means they can’t refuse to sell you a policy, charge you more, or make you wait for coverage to begin, even if you have pre-existing health conditions. It’s a golden opportunity to get the coverage you want, guaranteed.

What Are Guaranteed Issue Rights?

If you miss your Open Enrollment Period, you might get another chance to enroll in a Medigap plan through what are called “guaranteed issue rights.” These rights apply in specific situations, such as if you lose your employer health coverage after turning 65 or if you have a Medicare Advantage plan that is leaving your service area. When you have guaranteed issue rights, insurance companies must sell you a Medigap policy without considering your health history. However, your plan choices may be more limited than during your Open Enrollment Period. These rights are designed to protect you from losing coverage due to circumstances outside of your control.

The 63-Day Window for Guaranteed Issue

Think of this 63-day window as a critical safety net if you find yourself without coverage outside of your initial enrollment period. Certain situations, which are often out of your control, give you a second chance to get a Medigap plan. For example, if you kept working past 65 and are now losing your employer health plan, or if your Medicare Advantage plan is ending its service in your area, you trigger this special window. During these 63 days, an insurance company is required to sell you certain Medigap policies without asking any health questions. This means they cannot deny you coverage or charge you a higher premium because of pre-existing conditions. While your choice of plans may be more limited than during your Open Enrollment, understanding your guaranteed issue rights is essential for ensuring you can secure the coverage you need.

What Happens if You Miss Your Enrollment Window?

If you apply for a Medigap plan outside of your Open Enrollment Period and don’t have guaranteed issue rights, the rules change. Insurance companies can require you to go through medical underwriting. This means they will review your medical history and can ask you detailed health questions. Based on their review, they have the right to deny you coverage altogether or charge you a significantly higher monthly premium for the same plan. This is why planning ahead and enrolling during your initial six-month window is so critical. It’s the simplest and most effective way to secure your Texas Medigap plan without worrying about your health history affecting your eligibility or your rates.

Special Enrollment Rights for Those Under 65

Medicare isn’t just for those 65 and older. If you qualify for Medicare due to a disability, you also get a critical window to enroll in a Medigap plan. Your six-month Medigap Open Enrollment Period begins on the first day of the month you are enrolled in Medicare Part B. This is your best opportunity to purchase any Medigap policy sold in Texas without facing medical underwriting. That means an insurance company cannot deny you coverage or charge you a higher premium because of pre-existing health conditions. It’s a vital protection that ensures you can get the comprehensive coverage you need.

It’s also important to know that protections are expanding. Starting September 1, 2025, individuals with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS) will have new rights that mirror those of people turning 65. This will provide a guaranteed opportunity to enroll in a Medigap plan without health questions. If you happen to miss your Open Enrollment Period, you may still have options through guaranteed issue rights. These rights apply in specific situations, like losing employer health coverage, and require insurance companies to sell you a policy, though your plan choices might be more limited.

How Are Medigap Premiums Calculated in Texas?

When you start shopping for a Medigap plan in Texas, you’ll quickly notice that the monthly premiums for the exact same plan can vary quite a bit from one insurance company to another. A Plan G from one carrier might have a different price tag than a Plan G from a competitor, even though the benefits are standardized by the government. This is because each company has its own way of calculating what you’ll pay.

Understanding how these premiums are set is key to finding a plan that not only fits your health needs but also your long-term budget. It’s not just about finding the cheapest plan today; it’s about understanding how that cost might change in the future. Several factors come into play, from the pricing method the insurer uses to your personal details like age and where you live. Let’s break down what goes into that monthly premium so you can make a more informed choice.

The Three Ways Insurers Price Your Plan

Insurance companies in Texas generally use one of three methods to price their Medigap policies. The method they choose directly impacts how your premium may change over the years.

Attained-Age Rated: Your premium is based on your current age and will increase as you get older. These plans often start with lower premiums but can become more expensive over time.
Issue-Age Rated: Your premium is based on your age when you first buy the policy. It won’t go up simply because you have a birthday, but it can still increase due to inflation and other factors.
Community-Rated: Everyone with the same policy pays the same monthly premium, regardless of their age.

Knowing which pricing method an insurer uses is crucial for planning your future healthcare expenses.

What Influences Your Medigap Premium?

Beyond the company’s pricing method, several personal factors will influence your final monthly premium. When you apply for a plan, insurers will look at your specific situation to determine your rate. Key factors include your location, as rates can differ by ZIP code, and your age at the time of enrollment.

Your gender and whether you use tobacco can also affect the cost. Most companies offer a lower rate for non-smokers. All these elements are combined to calculate the premium you’ll pay. This is why two people living in different Texas cities could see very different prices for the same Medigap plan. It highlights the importance of getting personalized quotes for your specific circumstances.

How Much Do Medigap Plans Cost in Texas?

To give you a real-world idea of how much prices can differ, let’s look at some sample monthly premiums. These examples are for a 65-year-old, non-smoking female living in Dallas.

For Medigap Plan G, you might see prices like:

AARP/UnitedHealthcare: $136
Mutual of Omaha: $152
State Farm: $160

For Medigap Plan N, the range could look like this:

AARP/UnitedHealthcare: $98
State Farm: $112
Mutual of Omaha: $115

As you can see, shopping around is essential. The best Medicare Supplement plans aren’t just about coverage; they’re also about finding a price that works for you.

How to Save Money on Your Texas Medigap Plan

While Medigap plans are designed to give you financial peace of mind, it’s also true that every dollar counts. Finding the right coverage is about balancing comprehensive benefits with a monthly premium that fits comfortably into your budget. The good news is that comparing the initial price tag isn’t the only way to manage costs. There are a few smart strategies you can use to potentially lower your monthly payments without sacrificing the quality of your coverage. By exploring available discounts and considering different types of plans, you can make sure you’re getting the most value from your policy.

Look for Premium Discounts

One of the simplest ways to reduce your monthly Medigap premium is by taking advantage of available discounts. The most common of these is the household discount. Many insurance companies offer a small reduction in your premium, often between 5% and 12%, if you live with a spouse or another adult. The specific rules vary from one company to the next. Some require both you and your household member to have a policy with them, while others may offer the discount simply for living with another adult over a certain age. It’s a detail that’s easy to overlook but can add up to significant savings over the year. When you’re getting quotes, it’s always worth asking if you might qualify for any premium discounts.

Consider a Medicare Select Plan

If you’re looking for another way to save, a Medicare Select plan might be an option worth exploring. These plans offer the exact same benefits as their standard Medigap counterparts but typically come with a lower monthly premium. The trade-off is that you must use hospitals within the plan’s specific network for non-emergency care to receive full coverage. However, and this is a key point, your coverage works at any hospital in an emergency. If you live near a network hospital and are comfortable using it for scheduled procedures, a Medicare SELECT policy can be a great way to get the robust coverage of a Medigap plan at a more affordable price.

How to Choose the Right Texas Medigap Plan for You

Picking the right Medigap plan feels like a big decision, but it doesn’t have to be overwhelming. By breaking it down and looking at your personal situation, you can find a plan that fits your needs and gives you peace of mind. It really comes down to three things: your health, your budget, and understanding some common misconceptions.

Start With Your Health Needs

First, take a moment to think about your health. Are you generally healthy, or do you have chronic conditions that require frequent doctor visits? Medigap plans are designed to help pay for the costs that Original Medicare doesn’t cover, like deductibles, coinsurance, and copayments. If you anticipate needing more medical care, a more comprehensive plan might save you money in the long run by covering these out-of-pocket expenses.

For most people new to Medicare, the most popular choices are Plan G and Plan N. Plan G offers very broad coverage, second only to Plan F, which is no longer available if you became eligible for Medicare after January 1, 2020. Thinking honestly about your current and potential future health needs is the best first step in narrowing down your options.

How to Match a Plan to Your Budget

Next, let’s talk about your budget. The monthly premium is the amount you’ll pay to keep your plan active, and it’s important to find one that you’re comfortable with. What’s interesting is that prices for the exact same Medigap plan can vary quite a bit between different insurance companies. This is why it’s so important to compare your options.

For example, for a 65-year-old female nonsmoker in Dallas, a Plan G premium could range from about $105 to $152 per month. That difference adds up over a year. When you compare prices, you’re making sure you don’t overpay for the same coverage you could get for less elsewhere. Remember to balance the monthly premium against the potential out-of-pocket costs you might face with a less comprehensive plan.

Don’t Fall for These Common Medigap Myths

Finally, let’s clear up a few common myths that can cause confusion. First, not everyone with Medicare needs a Medigap plan. If you already have health coverage from a current or former employer, a Medicare Advantage plan, or Medicaid, you likely don’t need to purchase a Medigap policy. These plans work differently and can’t be combined with Medigap.

Another point of confusion is around Plan F. While you may hear people talk about it, if you became eligible for Medicare on or after January 1, 2020, you cannot buy it. For new enrollees, Plan G is now the most comprehensive option available and covers nearly everything Plan F did. Understanding these key facts can help you focus on the plans that are actually available to you and prevent you from spending time on options that aren’t a fit.

What Isn’t Covered by Medigap?

Medigap plans do an excellent job of covering the out-of-pocket costs that come with Original Medicare, like deductibles and coinsurance. It’s easy to assume that once you have a Medigap plan, you’re covered for everything. However, it’s just as important to understand what these plans don’t cover to avoid unexpected medical bills down the road.

Think of Medigap as a partner to Original Medicare (Part A and Part B). The rule of thumb is simple: if Medicare doesn’t cover a service in the first place, your Medigap plan won’t cover it either. These plans are designed to fill the “gaps” in Medicare’s coverage, not to add new benefits. The primary exceptions are some plans that offer foreign travel emergency care, which is a benefit Original Medicare doesn’t provide. But for most domestic healthcare services, the coverage follows Medicare’s lead.

This means that several major categories of healthcare fall outside of what Medigap can help with. Generally, Medigap plans are not designed to pay for services like prescription drugs, long-term care, or routine dental and vision appointments. Understanding these limitations is key to building a complete health coverage strategy that truly protects your health and your savings. Let’s walk through the major services that fall outside of Medigap coverage so you can plan accordingly.

Why You Still Need a Part D Plan

This is one of the most common points of confusion, so let’s clear it up: Medigap plans sold today do not cover prescription drugs. While some older plans sold before 2006 did offer this benefit, those are no longer available to new Medicare enrollees. To get help paying for your medications, you will need to enroll in a separate Medicare Part D plan. These standalone plans are offered by private insurance companies and are designed specifically to cover the costs of prescription medications. Think of it as the final piece of the puzzle alongside Original Medicare and your Medigap plan.

Does Medigap Cover Long-Term Care?

Another major area that Medigap does not cover is long-term care. This refers to custodial care services that help with daily activities like bathing, dressing, and eating, whether at home or in a facility like a nursing home. Original Medicare also doesn’t cover most long-term care, so a Medigap plan won’t have any costs to supplement. It’s important to plan for these potential expenses separately, as they can be significant. Medigap is there for your medical needs, but not for the day-to-day assistance that defines long-term care.

What About Vision and Dental Coverage?

If you need a routine eye exam, a new pair of glasses, or a dental cleaning, you’ll have to look beyond your Medigap plan. Just like Original Medicare, Medigap doesn’t cover routine dental, vision, or hearing care. This also includes items like dentures and hearing aids. While Medicare might cover a procedure if it’s deemed medically necessary (like cataract surgery), it won’t pay for the day-to-day upkeep. Many people choose to buy separate, standalone dental and vision plans to fill this gap and manage the costs of keeping their teeth and eyes healthy.

How to Compare Medigap Plans and Companies in Texas

Once you have an idea of which Medigap plan letter (like G or N) fits your needs, your next step is to choose an insurance company to buy it from. This is a key part of the process because while the plans are standardized by the government, the companies are not. A Plan G from one carrier offers the exact same medical benefits as a Plan G from another, but the price, rate stability, and customer service can be worlds apart. To make a smart choice, you’ll want to look at a few key factors: the monthly premium, the company’s reputation, and how the plan preserves your freedom to choose your healthcare providers.

Step 1: Compare Premiums Side-by-Side

The single biggest difference between insurance companies offering the same Medigap plan is the price. You might find that one company charges significantly more than another for the identical Plan G coverage. Because the benefits are set by law, you aren’t getting anything extra for that higher price. This is why it’s so important to shop around. You should compare prices from several different carriers before making a decision. Getting multiple quotes allows you to see the full range of what’s available and ensures you’re not overpaying for your coverage. Think of it like buying a car—you wouldn’t just accept the first offer you see.

Step 2: Research the Company’s Reputation

A low premium is appealing, but it’s not the only thing that matters. You also want an insurance company that is stable, reliable, and easy to work with. Before you sign up, take a moment to look into the company’s reputation. How long have they been in business? Do they have a history of large, unpredictable rate increases? You can check a company’s complaint history and verify that they are licensed to operate in Texas. The Texas Department of Insurance is a great resource for this. Working with an experienced agent can also give you valuable insight into which companies have a strong track record for customer satisfaction and fair pricing over the long term.

Largest Medigap Insurers in Texas

Texas is a big state, and the Medigap market here is just as large, with nearly 950,000 residents enrolled in a plan. Because so many people rely on this coverage, you’ll find a lot of familiar, big-name insurance companies offering plans. Some of the most popular choices you’ll come across include AARP/UnitedHealthcare, Blue Cross Blue Shield of Texas, Mutual of Omaha, and Aetna. When you start to research your options, you’ll see that certain companies stand out for their high ratings and specific strengths. For example, UnitedHealthcare is often recognized for its overall value, while Mutual of Omaha is known for offering helpful payment discounts, and State Farm receives high marks for customer satisfaction. Seeing these well-established names can give you confidence as you compare your choices.

Step 3: Confirm You Can Keep Your Doctors

One of the best features of Medigap is the freedom it gives you. With a Medigap plan, you can see any doctor or go to any hospital in the United States, as long as they accept Original Medicare. You don’t have to worry about staying within a specific network, and you never need a referral to see a specialist. Your Medigap plan simply works alongside your Original Medicare benefits. When you receive medical care, Medicare pays its share first, and then your Medigap plan pays its portion of the bill. This straightforward process gives you the flexibility to choose your own doctors and get care wherever you are, providing peace of mind.

Step 4: Look for Extra Perks and Benefits

While the core medical benefits of a Plan G are the same everywhere, some insurance companies add extra perks to make their policies more attractive. Since they can’t compete on the standardized coverage, they compete on price and these little bonuses. These extra benefits can include things like gym memberships or access to discount programs for dental, vision, or hearing services. Another common perk is a household discount, which can lower your monthly premium if you and your spouse both enroll with the same company. It’s always worth asking about these additions, as they can add significant value to your plan without increasing the cost. They might just be the tie-breaker between two otherwise identical options.

How to Apply for a Medigap Plan in Texas

Once you’ve compared your options and have a plan in mind, the application process is fairly straightforward. Getting your application ready doesn’t have to be a headache, especially when you know what to expect. The key is understanding what you’ll need, when you’ll need to provide it, and how your timing affects the entire process. Let’s walk through the three main steps so you can feel confident when you’re ready to apply.

What You’ll Need to Apply

Before you can apply for any Medigap plan in Texas, you first need to be enrolled in Original Medicare. This means you must have both Medicare Part A (hospital insurance) and Part B (medical insurance). Your red, white, and blue Medicare card is the main piece of paperwork you’ll need, as it contains your Medicare number and the dates your Part A and B coverage started. Think of it as your ticket to apply. If you’re under 65 and qualify for Medicare due to a disability, you may also be eligible to purchase a Medigap plan. The most important first step is ensuring your Original Medicare coverage is active.

Will You Have to Answer Health Questions?

The short answer is: it depends entirely on when you apply. If you apply during your 6-month Medigap Open Enrollment Period, insurance companies in Texas cannot use your health history against you. They are required to sell you any plan they offer at the standard price, regardless of any pre-existing conditions. This is a critical protection called “guaranteed issue rights.”

However, if you miss this window, the rules change. Insurance companies can then ask you detailed health questions and perform medical underwriting. Based on your answers, they could charge you a higher premium or even deny your application altogether. This is why timing your application is so important for your Texas Medigap options.

What to Expect After You Apply

Timing is everything when it comes to Medigap. Your best opportunity to enroll is during your one-time, 6-month Medigap Open Enrollment Period. This window automatically begins on the first day of the month you are both 65 or older and enrolled in Medicare Part B. Applying during this period guarantees your acceptance into any plan you choose.

If you miss this initial window, you may have other opportunities to apply, but they are not guaranteed. The next step is to mark your calendar with your personal enrollment dates. Once you know your window, you can focus on choosing the right plan and company without the pressure of a looming health screening.

Your Rights as a Medigap Policyholder in Texas

Once you’ve chosen and enrolled in a Medigap plan, it’s important to know that you have specific rights and protections under Texas law. These rules are in place to ensure you are treated fairly and to give you confidence in your coverage. Understanding these rights from the start can save you a lot of worry later on. They give you a safety net, ensuring you have time to review your decision and that your coverage will be there for you when you need it, as long as you continue to pay your premiums. These protections are a key part of what makes Medigap a reliable choice for so many people.

The 30-Day “Free Look” Period

One of the best consumer protections you have is the 30-day “free look” period. This gives you a full month from the day you receive your policy to review it and make sure it’s the right fit for you. During this time, you can read through all the details and even change your mind without any penalty. If you decide for any reason that you don’t want to keep the policy, you can return it to the insurance company within those 30 days and receive a complete refund of any premiums you’ve paid. This trial period offers valuable peace of mind, ensuring you don’t feel locked into a decision you’re not 100% comfortable with.

Your Policy is Guaranteed Renewable

Another fundamental right you have as a Medigap policyholder in Texas is that your policy is guaranteed renewable. This means the insurance company cannot cancel your coverage for any reason as long as you pay your premiums on time. It doesn’t matter if your health changes or how many medical claims you file; your policy will remain in force. The only exception is if you made false or misleading statements on your application. While the company can’t drop you, they are permitted to raise your premium. This typically happens once a year and is a normal part of having a Medigap plan.

Smart Shopping Tips and Warnings

Choosing a Medigap plan is a significant decision, and it’s wise to approach it with a clear strategy. Because all plans of the same letter offer identical benefits, your focus should be on finding the right company at the right price. This involves a bit of research and knowing what to look out for. Unfortunately, there are sometimes confusing or high-pressure sales tactics in the insurance world. Being aware of these potential pitfalls can help you feel more in control of the process and ensure you make a choice that’s truly in your best interest, not someone else’s.

Practical Steps for Choosing a Company

The most important step you can take is to shop around. Prices for the exact same Medigap plan can vary significantly from one insurance company to another, so getting multiple quotes is essential to avoid overpaying. At the same time, consider your actual needs and be careful not to buy more coverage than you require. A more comprehensive plan comes with a higher premium, so it’s about finding the right balance for your health and budget. An independent agent can be a great resource here, as they can provide quotes from multiple carriers and offer an unbiased view of which companies have a history of stable rates and excellent customer service.

How to Avoid Unfair Sales Tactics

You should never feel rushed or pressured into making a decision about your health coverage. Be cautious of anyone who uses high-pressure tactics or creates a false sense of urgency. Another red flag is a practice known as “twisting,” where an agent makes misleading statements to convince you to switch from a policy you already have. According to the Texas Department of Insurance, these are unfair sales practices. Always take your time to review your options, ask plenty of questions, and trust your instincts. If something doesn’t feel right, it’s perfectly okay to walk away and seek advice from a source you trust.

Medigap vs. Medicare Advantage: Which is Right for You?

One of the biggest decisions you’ll make when you enroll in Medicare is choosing between a Medigap plan and a Medicare Advantage plan. Think of it as two different paths you can take to round out your health coverage. Both have their own set of rules, costs, and benefits, and the right choice really comes down to your personal health needs, budget, and how you prefer to get your medical care.

It’s important to know that these two types of plans are mutually exclusive. You can’t have both a Medigap policy and a Medicare Advantage plan at the same time. Medigap plans are designed to work alongside Original Medicare (Part A and Part B), while Medicare Advantage plans (also called Part C) are an alternative way to receive your Medicare benefits through a private insurance company. Understanding this core difference is the first step in figuring out which path is the best fit for you.

Coverage Differences You Need to Know

The main difference lies in how each plan works with your basic Medicare benefits. A Medigap plan is a supplement. It works with your Original Medicare coverage, not in place of it. When you visit a doctor or hospital, Medicare pays its approved amount first for a covered service. Then, your Medigap plan steps in to pay its share, which typically includes things like deductibles, copayments, and coinsurance. This partnership helps cover the out-of-pocket costs that Original Medicare leaves behind.

On the other hand, a Medicare Advantage plan replaces your Original Medicare. You’re still in the Medicare program, but a private insurance company manages your benefits. These plans must cover everything Original Medicare does, and they often include extra perks like prescription drug, dental, or vision coverage. The Texas Department of Insurance makes it clear that Medigap policies do not work with Medicare Advantage plans, so you have to choose one or the other.

Breaking Down the Costs

When you look at costs, the two options have very different structures. With a Medigap plan, you’ll pay a separate monthly premium in addition to your Part B premium. However, once you’ve paid that premium, your out-of-pocket costs for medical care are often very low or even zero, depending on which plan you choose. This makes your healthcare spending predictable. Because Medigap plans are standardized by the government, a Plan G from one company has the exact same basic benefits as a Plan G from another. This makes it much easier to compare plans based on price.

Medicare Advantage plans often have low or even $0 monthly premiums, which can be very appealing. However, you’ll typically pay for services as you use them in the form of copayments, coinsurance, and deductibles. These plans also have an annual out-of-pocket maximum, which is the most you’ll have to pay for covered services in a year. While the low premium is attractive, your total annual costs can be less predictable and may be higher if you need frequent medical care.

Comparing Doctor Networks and Flexibility

Your freedom to choose doctors and hospitals is another major point of contrast. If you have Original Medicare and a Medigap plan, you have a nationwide network. You can see any doctor or go to any hospital in the U.S. that accepts Original Medicare. You generally don’t need a referral to see a specialist, giving you incredible flexibility and control over your healthcare decisions. This is a huge advantage for people who travel often or want to see specific specialists without network restrictions.

Medicare Advantage plans usually operate with local provider networks, like an HMO or a PPO. This means you’ll need to use doctors, hospitals, and specialists that are in the plan’s network to get the lowest costs. Going out of network can be expensive or might not be covered at all, except in emergencies. You may also need a referral from your primary care physician to see a specialist. This trade-off in flexibility is often what allows these plans to offer lower premiums and extra benefits.

Alternatives and Financial Help for Medigap

While Medigap plans offer incredible peace of mind for many Texans, they aren’t the right or only choice for everyone. Your personal situation—including other health coverage you might have and your financial circumstances—plays a huge role in determining the best path forward. It’s important to know that you have options. For some, existing health insurance from an employer or another program makes a Medigap plan unnecessary. For others, the monthly premium might feel out of reach. The good news is that you’re not stuck. Understanding these alternatives is just as important as understanding the Medigap plans themselves. It ensures you make a choice that truly works for your life, without feeling pressured into a plan that isn’t a good match for your needs or your budget.

When You Might Not Need a Medigap Plan

Before you dive into comparing Medigap plans, it’s worth taking a moment to see if you even need one. A Medigap policy is designed to supplement Original Medicare, but if you already have other comprehensive health coverage, buying a Medigap plan could mean you’re paying for benefits you already have. According to the Texas Department of Insurance, you probably don’t need Medigap if you are covered by a group plan from an employer, have a Medicare Advantage plan, or are enrolled in Medicaid. For example, Medicare Advantage plans already include an annual out-of-pocket maximum, and Medicaid typically covers most of your Medicare cost-sharing. In these cases, adding a Medigap policy would be a duplicative and unnecessary expense.

What to Do if You Can’t Afford Medigap

If the monthly premium for a Medigap plan feels like a stretch for your budget, don’t worry—you have several options. First, you could consider a different, more affordable Medigap plan, like switching from a Plan G to a Plan N, which typically has a lower premium in exchange for small copayments. You might also qualify for Texas Medicaid, a program that helps individuals with limited income cover their health costs. Another path is to switch to a Medicare Advantage plan, which often has lower or even $0 monthly premiums. And remember, Medigap is entirely optional; you can always choose to stay with Original Medicare alone and pay the out-of-pocket costs as they come.

Where to Find Free, Unbiased Help in Texas

Figuring out Medicare can feel like learning a new language, and you shouldn’t have to do it alone. Whether you’re trying to decide between Medigap and Medicare Advantage, compare plan costs, or understand your enrollment rights, there are free, official resources available to help you. These programs are staffed by trained counselors who can provide personalized, unbiased information without trying to sell you a specific product. Their only goal is to help you understand your options so you can make a confident decision. Tapping into these resources can save you a lot of time and prevent costly mistakes. In addition to these state and federal programs, working with a licensed, independent insurance agent can also provide clarity, as they can walk you through the plans available in your area and help you compare costs from different companies.

State and Federal Resources

When you need reliable information, it’s always best to go straight to the source. For Texans, there are two key resources you can turn to for free, expert help. The first is Medicare itself. You can call their main helpline at 800-MEDICARE (800-633-4227) with questions about your eligibility, benefits, or to get official information on Medicare Advantage plans. The second is the Texas Health and Human Services’ State Health Insurance Assistance Program, or SHIP. You can reach them at 800-252-9240 for one-on-one counseling to help you compare plans and understand costs in your specific area. SHIP counselors are highly trained volunteers who provide objective guidance to help you find the best fit for your needs.

Frequently Asked Questions

I missed my Medigap Open Enrollment Period. Can I still get a plan? Yes, you can still apply for a Medigap plan at any time, but the process is different. Outside of your initial six-month window, insurance companies can require you to answer health questions. This means they can review your medical history and potentially charge you a higher premium or deny your application based on pre-existing conditions. That’s why your Open Enrollment Period is so valuable—it’s the one time you are guaranteed acceptance without any health screening.

If all Plan Gs have the same benefits, why are the prices so different? This is a great question because it gets to the heart of shopping for a plan. While the government standardizes the medical benefits for each lettered plan, it doesn’t regulate the price. Each insurance company sets its own monthly premiums based on its own business model, pricing structure, and risk assessment. This is why you could see the exact same Plan G coverage offered for a wide range of prices, and it’s the main reason why comparing quotes from different companies is such a critical step.

Can I switch to a different Medigap plan later on? You can apply to switch your Medigap plan at any time, but there’s a catch. Unless you have a special circumstance that gives you guaranteed issue rights, you will likely have to go through medical underwriting to switch. An insurance company can review your health history and may decide not to approve your application for a new plan. Because of this, it’s best to choose your initial plan carefully during your Open Enrollment Period when your acceptance is guaranteed.

Do I really need a separate Part D plan if I have Medigap? Yes, you absolutely do. Medigap plans sold to new Medicare members do not include coverage for prescription drugs. Medigap is designed to help pay for your hospital and medical costs under Part A and Part B, but it leaves a gap for medications. To get help with those costs, you will need to enroll in a standalone Medicare Part D prescription drug plan.

Is Medigap or Medicare Advantage a better choice? Neither one is universally “better”—the right choice depends entirely on your personal priorities. If you value predictable monthly costs and the freedom to see any doctor in the country who accepts Medicare without a referral, a Medigap plan is likely a great fit. If you prefer a lower monthly premium and are comfortable using a local network of doctors in exchange for bundled benefits like drug and dental coverage, a Medicare Advantage plan might be more suitable.