3.2 Texas Medicare Supplement Regulations
Key Takeaways
- Texas follows federal Medicare Supplement (Medigap) standardization requirements
- Texas provides a 6-month open enrollment period starting at age 65 and enrolled in Part B
- Guaranteed issue rights apply in specific situations like losing employer coverage
- Texas requires a 30-day free look period for Medicare Supplement policies
- Texas prohibits agents from selling unnecessary or duplicate Medicare coverage
Last updated: January 2026
Texas regulates Medicare Supplement (Medigap) insurance to protect senior consumers while following federal standardization requirements.
Standardized Plans
Texas follows the federal standardized Medigap plans (Plans A through N):
Available Plans in Texas
| Plan | Coverage Level |
|---|---|
| Plan A | Basic benefits only |
| Plan B | Basic + Part A deductible |
| Plan C | Comprehensive (pre-2020 enrollees only) |
| Plan D | Similar to C without Part B excess |
| Plan F | Most comprehensive (pre-2020 only) |
| Plan G | Like F without Part B deductible |
| Plan K | 50% cost sharing with OOP max |
| Plan L | 75% cost sharing with OOP max |
| Plan M | 50% Part A deductible |
| Plan N | Cost sharing with copays |
Note: Plans C and F are only available to those eligible for Medicare before January 1, 2020.
Open Enrollment Period
Texas provides a 6-month open enrollment period:
When It Begins
- First day of the month you are 65 or older AND
- Enrolled in Medicare Part B
Protections During Open Enrollment
- Guaranteed issue - Must be accepted regardless of health
- No preexisting condition exclusions
- No health questions asked
- Any plan available - Can choose any Medigap plan
Guaranteed Issue Rights
Beyond open enrollment, Texas provides guaranteed issue in specific situations:
Triggering Events
| Event | Guaranteed Issue Right |
|---|---|
| Losing employer coverage | 63 days to enroll |
| Leaving Medicare Advantage | Can return to Medigap |
| Medicare Advantage plan leaves area | Can purchase Medigap |
| Medigap insurer becomes insolvent | Can switch plans |
Trial Right (Medicare Advantage)
If you try Medicare Advantage for the first time:
- Have 12 months to decide
- Can return to previous Medigap plan
- Or buy Medigap Plan A, B, C, F, K, or L
- Guaranteed issue, no health underwriting
Free Look Period
Texas requires a 30-day free look period for Medigap policies:
- Can return policy for full refund
- No penalty for exercising free look
- Period begins when policy delivered
- Allows time to compare coverage
Prohibited Practices
Texas prohibits specific practices in Medicare Supplement sales:
Prohibited Actions
| Practice | Status |
|---|---|
| Selling duplicate coverage | Prohibited |
| High-pressure sales tactics | Prohibited |
| Misrepresenting coverage | Prohibited |
| Cold call sales | Prohibited |
| Selling to Medicaid beneficiaries | Generally prohibited |
Agent Requirements
- Must determine existing coverage before selling
- Must explain relationship to Medicare
- Cannot misrepresent affiliation with government
- Must provide Outline of Coverage
Test Your Knowledge
How long is the open enrollment period for Medicare Supplement in Texas?
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Test Your Knowledge
What is the free look period for Medicare Supplement policies in Texas?
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