Medicare Supplement Plans in Texas
Original Medicare covers a lot, but not everything. After Medicare pays its share, you’re still responsible for deductibles, copays, and coinsurance that can add up fast. For many Texans turning 65 or newly enrolled in Medicare, that gap in coverage is the part nobody warned them about.
A Medicare Supplement plan, also called Medigap, is designed to fill exactly those gaps. At Wilkerson Insurance Agency, we help Texas residents compare plans from multiple carriers and find coverage that actually fits their healthcare needs and monthly budget.
What Is a Medicare Supplement Plan (Medigap)?
A Medicare Supplement plan is private insurance that works alongside your Original Medicare (Part A and Part B). When Medicare pays its portion of a covered service, your Medigap plan steps in to cover some or all of the remaining costs. This includes your hospital deductible, your 20% share of doctor visits, and skilled nursing facility costs.
Unlike Medicare Advantage, Medigap does not replace Medicare. It works with it. You keep your Original Medicare and your Medigap plan fills in the cost gaps.
In Texas, Medigap plans are regulated by the Texas Department of Insurance (TDI) and standardized by the federal government. That means a Plan G from one carrier has the same core benefits as a Plan G from another. Only the premium price and the service you receive will differ.
What Does Medicare Supplement Insurance Cover in Texas?
Depending on which plan you choose, Medicare Supplement coverage in Texas can include:
- Medicare Part A hospital coinsurance and extended hospital coverage (up to 365 extra days after Medicare benefits are used)
- Medicare Part B coinsurance, which is typically the 20% you owe after Medicare pays 80%
- Part A deductible, currently $1,676 per benefit period in 2025
- Skilled nursing facility coinsurance, covering days 21 through 100
- Hospice care coinsurance or copayment
- Blood (first 3 pints)
- Foreign travel emergency care, up to plan limits. This is especially helpful for Texas retirees who travel internationally
What Medigap does NOT cover:
Medigap plans do not cover routine dental, vision, or hearing care. They also do not include prescription drug coverage, long-term nursing home care, or private-duty nursing. For prescriptions, you would need a separate Medicare Part D plan.
Important: If you see a plan advertised as covering "everything," read the fine print. No single Medigap plan covers all possible healthcare costs.
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Medicare Supplement Plan Types Available in Texas
Texas follows the federal standardized plan structure. Plans are labeled by letter, and each letter represents a defined set of benefits regardless of which company sells it.
Plan | Best For | Key Benefit |
Plan A | Budget-conscious, healthy seniors | Covers Part B coinsurance only |
Plan B | Those wanting Part A deductible covered | Adds Part A deductible coverage |
Plan G | Most popular, broadest coverage | Covers everything except Part B deductible |
Plan N | Lower premium with some cost-sharing | Covers most costs; small copays for office/ER visits |
Plan K | Those comfortable with cost-sharing | Covers 50% of most costs; lower monthly premium |
Plan L | Middle-ground cost-sharing | Covers 75% of most costs |
High Deductible Plan G | Healthy seniors who rarely use care | Low premium; $2,800 deductible before benefits kick in |
Plan C / Plan F | Pre-2020 Medicare enrollees only | Covers Part B deductible. No longer available to new enrollees |
What's most popular among Texas residents?
Plan G and Plan N consistently draw the most interest from Texas Medicare enrollees. Plan G gives the most complete coverage with predictable costs. You only pay the Part B deductible and the plan covers the rest. Plan N trades slightly higher cost-sharing (small copays at office and ER visits) for a lower monthly premium. For healthy, active Texans who don’t visit doctors frequently, Plan N often makes the most financial sense.
How Much Do Medicare Supplement Plans Cost in Texas?
Texas Medigap premiums vary based on several factors, and no two people will see the exact same price.
Typical monthly premium ranges in Texas (2025 estimates):
- Plan G: approximately $90 – $200/month depending on age and carrier
- Plan N: approximately $70 – $160/month
- High Deductible Plan G: approximately $35 – $75/month
Three main factors shape your premium in Texas:
- Age at enrollment: enrolling at 65 during your Open Enrollment Period locks in the best rates
- Tobacco use: smokers pay higher premiums with most carriers
- Where you live: premiums in Dallas-Fort Worth, Houston, and rural Texas can differ noticeably by zip code
Texas carriers use different pricing structures. Some use attained-age pricing (premiums rise as you age), while others use issue-age pricing (locked closer to your enrollment age). An independent broker can help you identify which structure benefits you long-term. This is something you simply will not get when buying directly from a single carrier.
When Can You Enroll in a Medicare Supplement Plan in Texas?
Timing your Medigap enrollment correctly can save you thousands of dollars and protect you from being turned down for coverage.
Your Medigap Open Enrollment Period (OEP) is the single most important window to know. It begins on the first day of the month you turn 65 and are enrolled in Medicare Part B. This 6-month window gives you guaranteed acceptance. There are no medical questions, no underwriting, and no rejection based on your health history.
Under 65 in Texas? If you qualify for Medicare due to disability, you may have access to Medigap plans in Texas. Availability and pricing can differ in those cases. This is one area where working with a local broker who knows Texas TDI rules makes a real difference.
Don’t miss your window. Most people get one chance at guaranteed acceptance. Missing your OEP and having a health condition discovered during underwriting can make Medigap coverage significantly more expensive, or it may become unavailable altogether.
Medicare Supplement vs. Medicare Advantage in Texas
This is one of the most common questions Texans face when first enrolling in Medicare. It is a real choice, not just a marketing decision.
Medicare Supplement (Medigap)
- Use any doctor or hospital that accepts Medicare. No network restrictions apply
- Predictable out-of-pocket costs
- Coverage travels with you anywhere in the U.S. This is especially useful for Texas retirees who split time between Dallas, Houston, or travel across state lines
- Separate Part D plan needed for prescriptions
Medicare Advantage
- Often lower monthly premium
- May include dental, vision, hearing, and Rx in one plan
- Requires using a provider network (HMO or PPO)
- Prior authorizations often required for certain procedures
For many Texans, especially those with established doctors in Dallas, Plano, or Houston who they do not want to give up, Medigap offers the freedom that Medicare Advantage cannot. If you’re healthy, rarely travel, and want an all-in-one plan with a low premium, Advantage may suit you better.
There is no universal right answer. The right plan depends on your healthcare habits, your budget, and your doctors. We help you work through that comparison before you commit to anything.
Why Work With a Local Medicare Supplement Broker in Texas?
We are licensed in Texas and 18 additional states. Our team is led by LeRoy Wilkerson, a licensed independent agent with over 15 years of experience specifically in Texas health insurance and Medicare markets.
“LeRoy took the time to explain Medicare options in a way that was easy to understand. This allowed me to make the best decision for my needs.”. Reginald Wiley, Google Review
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Wilkerson Insurance Agency proudly serves Texas locations, helping find the best insurance plans. Our team is ready to provide personalized health insurance solutions that meet your unique needs, no matter where you are in Texas.
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Common Questions About Medicare Supplement Plans in Texas
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2727 LBJ Freeway, Suite 1062 Farmers Branch, TX 75234
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P.O. BOX 1711 Coppell, TX 75019