Texas Medicare Supplement (2026): Who Can Buy Medigap and When

Texas Medicare Supplement (Medigap) open enrollment gives you six months, from the first month you're 65 or older and in Part B, to buy any plan offered in Texas despite health problems.1,2 Since 2025, Texas law gives Texans under 65 who have Medicare because of amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD) that same six-month Medigap window, starting with their first month of Medicare Part B.2 Texans under 65 who have Medicare because of a disability get a narrower right: a six-month open enrollment for Medigap Plan A only, then a second open enrollment period in the first six months after they turn 65.2

Texas Medicare Supplement at a Glance

In This Guide

• Your Texas Medigap Open Enrollment Window at 65
• Texas Medigap Under 65 With ALS or ESRD
• Texas Medigap Under 65 With a Disability
• Federal Baseline vs. the Texas Rule
• After Your Window: Texas Guaranteed Issue Rights
• Which Medicare Supplement Plans Are Sold in Texas
• Texas Medicare Supplement Buyer Protections
• Medigap and Medicare Advantage in Texas
• Where to Get Free Help in Texas
• Frequently Asked Questions
• Learn More

Your Texas Medigap Open Enrollment Window at 65

Under federal law, the Medigap Open Enrollment Period is six months long and starts the first month you have Medicare Part B and are 65 or older.1 Section 1882 of the Social Security Act bars a Medigap insurer from denying or conditioning a policy, or discriminating in its price, because of health status, claims experience, receipt of health care, or medical condition, for an application submitted before or during that six-month period.1

The Texas Department of Insurance (TDI) describes the Texas version of the window in its Medicare Supplement guide. TDI's guide states:2

• Any plan offered in Texas: "The Medicare supplement open enrollment period is a six-month period during which you may buy any Medicare supplement plan offered in Texas. During this period, companies must sell you a policy, even if you have health problems."
• Parts A and B first: you must have both Medicare Parts A and B to buy a Texas Medicare Supplement policy.
• More than one use: you can use your Texas Medigap open enrollment rights more than once during the six-month period.2

The federal Medigap Open Enrollment Period is a one-time window and doesn't repeat every year the way the fall Medicare Open Enrollment Period does. Outside the Medigap window, Medicare.gov says you may pay more for a policy, have fewer policy options, and be denied a policy if you don't meet the insurer's medical underwriting requirements.1 Brevy's guide to the Medigap Open Enrollment Period covers the federal timing in more depth.

Texas Medigap Under 65 With ALS or ESRD

Texas's biggest departure from the federal Medigap floor is H.B. 2516, the Chris Larkin ALS Act, passed by the 89th Texas Legislature in 2025. H.B. 2516 added Texas Insurance Code §1652.059, effective June 20, 2025.2

Under Texas Insurance Code §1652.059, a company that offers Medigap coverage in Texas to people 65 or older must offer the same coverage to Texans younger than 65 who are eligible for and enrolled in Medicare because of end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). Under Texas Insurance Code §1652.059, except as TDI rules provide otherwise, any benefit, protection, policy, or procedure that applies to Texas Medigap coverage for a buyer 65 or older must also apply to Medigap coverage for under-65 Texans on Medicare because of ALS or ESRD.2

What Texans under 65 with ALS or ESRD pay

Texas Insurance Code §1652.059 caps what a Medigap company can charge an under-65 Texan with ALS or ESRD:

• Plans A, B and D: offered at the same premium rate the company charges a 65-year-old for the same plan.
• Every other plan: a premium rate no higher than 200% of the rate charged to a 65-year-old for the same plan.2

TDI's guide says the same thing in plain terms: an under-65 buyer with ESRD or ALS "will be charged the same rate as someone who is age 65 for plans A, B, and D," and "can be charged up to twice the rate" for other plans.2

The ALS and ESRD enrollment window

Under Texas Insurance Code §1652.060, a Texan under 65 on Medicare because of ALS or ESRD may enroll in Medigap any time during the six months beginning the first day of the first month of Medicare Part B enrollment. During that window, a Texas Medigap company may not:2

1. Deny or condition the issuance or effectiveness of a Medigap plan it offers in Texas.
2. Subject the applicant to medical underwriting, or charge more, because of health status, claims experience, receipt of health care, or medical condition.
3. Impose a waiting period.
4. Limit or exclude benefits based on a preexisting condition.2

H.B. 2516 applies only to a Medigap plan delivered, issued for delivery, or renewed on or after September 1, 2025.2

A hypothetical 58-year-old in El Paso who is newly on Medicare because of ALS shows how the Texas rule works. Starting with his first month of Part B, he has six months in which a Texas Medigap company must sell him any plan it offers to 65-year-olds, with no health questions, no waiting period, and Plans A, B and D at the age-65 rate.2

Texas Medigap Under 65 With a Disability

TDI's guide gives Texans under 65 who have Medicare because of a disability (other than ESRD or ALS) a narrower Medigap right: "People under age 65 who get Medicare because of disabilities have a six-month open enrollment period beginning the day they enroll in Medicare Part B. This open enrollment right only applies to Medicare supplement Plan A."2

A second window follows at 65. TDI states that people who have Medicare because of disabilities have another Texas Medigap open enrollment period during the first six months after turning 65.2 Medicare's federal guide, Choosing a Medigap Policy, likewise says a person who already has Medicare Part B will still get a Medigap Open Enrollment Period when they turn 65.2

The Texas disability rule sits above the federal floor. Medicare's federal guide says federal law generally doesn't require insurance companies to sell Medigap policies to people under 65, and that a person under 65 with Medicare because of a disability or ESRD might not be able to buy the Medigap policy they want, or any Medigap policy, until they turn 65. The same guide from the Centers for Medicare & Medicaid Services (CMS) lists Texas among the states that, at the time of printing, require insurance companies to offer at least one kind of Medigap policy to people with Medicare under 65.2

Federal Baseline vs. the Texas Rule

Texas Medigap law differs from the federal baseline mainly for people under 65. The table compares the two, using only what federal law, TDI and the Texas Insurance Code state.1,2

After Your Window: Texas Guaranteed Issue Rights

TDI's guide states that you may have the right to buy a Texas Medicare Supplement policy outside your Medigap open enrollment period if you lose certain types of health coverage, a right TDI calls guaranteed issue.2 Medicare's federal guide says that in a guaranteed issue situation an insurance company must sell you a Medigap policy, must cover all your pre-existing health conditions, and can't charge you more because of past or present health problems.2

TDI sets out these Texas guaranteed issue rules:

• The 63-day deadline: "The guaranteed issue right is good for 63 days from the date coverage ends or from the date of notice that coverage will end, whichever is later."
• No preexisting-condition restrictions: companies may not place any restrictions, such as preexisting condition waiting periods or exclusions, on these Texas policies.
• Proof of lost coverage: you must give the company proof that you lost coverage, usually a letter from the company notifying you that your coverage will end.
• Losing Medicaid: people who lose Medicaid because of a change in their financial situation also have a guaranteed issue right to buy a Texas Medicare Supplement policy.
• A Medicare Advantage plan ending: a Medicare Advantage plan that ends must give you written notice of your options and how long you have to buy a Medigap policy, and that notice is your proof to the Medigap company of your right to buy.2

Which plan letters a guaranteed issue buyer in Texas can choose depends on the buyer and the situation. For Texans under 65 on Medicare because of a disability (other than ESRD or ALS), TDI states that a guaranteed issue right lets them buy Plan A.2 Medicare's guide also notes that its federal tables describe the most common situations and that you may have additional rights under your state's laws, so confirm your plan options with TDI or Texas SHIP before you apply. Brevy's guide to Medigap guaranteed issue rights walks through the federal situations.2

A hypothetical example shows the Texas 63-day clock. Suppose a 62-year-old Texan on Medicare because of a disability is losing her retiree plan, and TDI or Texas SHIP confirms that the loss gives her a Texas guaranteed issue right. That Texas guaranteed issue right lasts 63 days from the later of the date her coverage ends or the date of the notice that it will end, and for a disability enrollee under 65 it means Plan A. Her family should keep the plan's termination letter, because TDI says a letter notifying you that coverage will end is usually the proof the Medigap company needs.2

Which Medicare Supplement Plans Are Sold in Texas

Medicare's 2026 guide charts the standardized Medigap plans as Plans A, B, C, D, F, G, K, L, M and N.3

• Plan A is always sold: TDI states that every company selling Medicare Supplement insurance in Texas must offer Plan A.2
• Plans C and F: Medicare's guide states that Plans C and F are no longer available to people new to Medicare on or after January 1, 2020. People new to Medicare on or after January 1, 2020, have the right to buy Medigap Plans D and G instead, which give the same benefits as Plans C and F but don't cover the Part B deductible.
• Who counts as new to Medicare: Medicare's guide says you're considered new to Medicare if you turned 65 on or after January 1, 2020, and got Medicare Part A on or after January 1, 2020. Someone eligible for Medicare before January 1, 2020, who hasn't yet enrolled may still be able to buy Plan C or Plan F.
• Plans E, H, I and J: no longer sold, though Medicare's guide says someone who already has one can generally keep it.3

For what each lettered plan covers, see Brevy's guide to how the lettered Medigap plans work. For how companies set Medigap prices, see Brevy's guide to Medigap premium pricing.

Texas Medicare Supplement Buyer Protections

TDI's Medicare Supplement guide lists these Texas buyer protections:2

• 30-day free look: you can return a Texas Medicare Supplement policy within 30 days and get your money back with no questions asked. The 30-day free look period doesn't apply to Medicare Advantage.
• Guaranteed renewable: all Texas Medicare Supplement policies are guaranteed renewable, so a company may not cancel your policy or refuse to renew it unless you made intentional false statements on your application or didn't pay your premium.
• Premium increase timing: an insurance company may raise your Texas Medigap premium once a year, and companies may increase issue-age policy premiums once during your first year of coverage and then may not increase the premium for 12 months.
• One policy at a time: it's illegal to sell you more than one Medicare Supplement policy.2

Pausing Texas Medigap when you qualify for Medicaid

TDI states that if you become eligible for Medicaid, you may ask that your Texas Medicare Supplement benefits and premiums be suspended for up to two years, and you must notify your company within 90 days of becoming eligible. If you lose Medicaid eligibility within two years and want the Texas Medigap policy back, you must contact your company within 90 days of losing eligibility.2 Brevy's guide to suspending Medigap when you qualify for Medicaid explains the pause in more detail, and Texans with limited income can also check Texas Medicare Savings Programs.

The Texas durable medical equipment charge limit

TDI states that under Texas law, durable medical equipment (DME) suppliers aren't allowed to charge Medicare enrollees more than 115% of the Medicare approved price unless the supplier gives a written disclosure of the additional cost and the enrollee agrees in advance.2 Texas Insurance Code §1652.059, as added by S.B. 1330 effective September 1, 2025, provides that a Texas Medigap issuer is not required to reimburse an enrollee or nonparticipating supplier for the amount by which a charge for DME, orthotic devices or supplies, or prosthetic devices or supplies exceeds 115% of the Medicare-allowed amount.2

Sales practices that break Texas law

TDI's guide lists agent and company practices that break Texas law, including:2

• Twisting: knowingly making misleading statements to encourage you to drop a policy and buy a replacement from another company.
• Using high-pressure tactics, including force, fright, or threat.
• Cold lead advertising, which hides the fact that an agent or company may try to sell you insurance.
• Mailings made to look like mail from the government, or acting as a representative of Medicare or a government agency.
• Selling you a Medigap policy that duplicates Medicare benefits or coverage you already have.
• Suggesting that you falsify an answer on an application.2

TDI states that if you believe an agent or company has engaged in unfair and illegal practices, you can file a complaint with TDI.2

Federal law adds a protection for switching Medigap policies. Under Section 1882 of the Social Security Act, if a Medigap policy replaces another Medigap policy that has been in effect for six months or longer, the new policy may not impose a new preexisting-condition, waiting, elimination, or probationary period for similar benefits.4 Medicare.gov cautions that, under federal rights, you usually can't switch Medigap policies outside your open enrollment period unless you have a guaranteed issue right, and that switching outside it may mean paying more and answering medical questions.4

Medigap and Medicare Advantage in Texas

Medigap works with Original Medicare, not with Medicare Advantage. Medicare's booklet "Understanding Medicare Advantage Plans" states that you "can't use Medigap to pay your Medicare Advantage Plan copayments, coinsurance, deductibles, and premiums."5

The same Medicare booklet states that if you're in a Medicare Advantage plan, "it's illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare," and that you should report anyone who tries to your State Insurance Department, which in Texas is TDI.5 Brevy's guide to illegal Medigap sales to Medicare Advantage members covers the rule.

Dropping a Medigap policy to join Medicare Advantage carries a risk. Medicare's booklet says that in most cases, if you drop your Medigap policy to join a Medicare Advantage plan, you may not be able to get the same policy back. Federal law gives a trial right to a person who joins a Medicare Advantage plan for the first time and isn't happy with it: that person can buy a Medigap policy and a separate Medicare drug plan if they return to Original Medicare within 12 months of joining.5 Brevy's guide to switching between Medicare Advantage and Original Medicare walks through the trial right.

The fall Medicare Open Enrollment Period runs October 15 through December 7 each year, and a switch from Medicare Advantage to Original Medicare made then takes effect January 1.6 Leaving Medicare Advantage and buying a Texas Medigap policy are separate decisions, so check whether a Texas guaranteed issue right applies before you leave.2

Where to Get Free Help in Texas

• TDI Help Line, 800-252-3439: TDI states you can call its Help Line to learn a Medigap company's complaint history or verify company and agent licenses.2
• Texas SHIP, 800-252-9240: TDI states that the Texas State Health Insurance Assistance Program (SHIP) can help you compare plans and costs in your area.2
• 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048: Medicare.gov says you can talk or live chat with a real person 24 hours a day, 7 days a week, except some federal holidays.7

For the rest of your Medicare choices in the state, including Medicare Advantage and drug plans, see Brevy's guide to Medicare plans and coverage in Texas.

Learn More

Find personalized help comparing Medicare Supplement options in Texas at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.