Where and when to explore for Medicare in Texas

You can explore for Medicare through three main routes: online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. Texas has Social Security offices in most cities and towns — you can find the nearest one by entering your zip code at ssa.gov/locator.

You should explore three months before you turn 65, even if you do not plan to start benefits right away. This timing matters because Medicare coverage typically begins on the first day of the month you turn 65, but only if you have already applied. If you explore after that month, your coverage will start later, and you may owe a penalty on your premiums for the rest of your life.

If you are already receiving Social Security or Railroad Retirement Board benefits, you will be enrolled in Medicare automatically three months before you turn 65. You do not need to explore, but you should still review your coverage choices to make sure they fit your needs.

Key Takeaways

  • explore three months before you turn 65 through Medicare.gov, 1-800-MEDICARE, or your local Social Security office in Texas.
  • If you are already getting Social Security benefits, Medicare enrollment happens automatically — you do not need to explore.
  • You will need your Social Security number, birth certificate, proof of citizenship or legal residency, and information about any current health coverage.
  • Texas has no state-specific Medicare process process; all applications go through the federal Medicare program.
  • If you miss the three-month window, you can still explore, but your coverage will start later and you may face a permanent premium increase.

What documents you need before you start

Gather these documents before you begin your process, whether online or by phone. You will need your Social Security number, birth certificate, and proof of U.S. citizenship or legal residency. A passport, naturalization certificate, or permanent resident card all work for citizenship proof. A driver's license or state ID card works for residency proof.

You will also need information about any health insurance you currently have — the name of your plan, your policy number, and your group number if it is employer coverage. If you are still working and covered by your employer's health plan, bring that information too, because it affects when you should enroll in certain parts of Medicare.

If you are explore by phone or in person, have your income information ready. Medicare uses your income to calculate what you pay for premiums and out-of-pocket costs, so you may be asked about your modified adjusted gross income from your most recent tax return.

explore online at Medicare.gov

Go to Medicare.gov/sign-up and select "explore for Medicare." The online form takes about 15 to 20 minutes. You will answer questions about your personal information, citizenship, and current coverage. At the end, you can choose which parts of Medicare you want to enroll in — Part A (hospital insurance), Part B (medical insurance), or both.

After you submit your process online, you will receive a confirmation number. Medicare will mail you a decision letter within two to four weeks. If Medicare needs more information from you, they will contact you by mail or phone. Keep your confirmation number so you can check the status of your process anytime at Medicare.gov by signing into your account.

If you run into trouble with the online form, you can call 1-800-MEDICARE and ask for help completing it over the phone instead. The phone representatives can walk you through each question.

explore by phone or in person

Call 1-800-MEDICARE (1-800-633-4227) to explore over the phone. Representatives are available Monday through Friday, 8 a.m. to 8 p.m. Central Time. Have your documents ready when you call. The conversation usually takes 20 to 30 minutes. You will receive a confirmation number at the end, and Medicare will mail you a decision letter.

To explore in person, visit your local Social Security office in Texas. You can find the address and hours at ssa.gov/locator by entering your city or zip code. Bring all your documents with you. The office staff will help you fill out the process and answer questions about your coverage choices. This usually takes 30 to 45 minutes.

In-person appointments are not required, but you can schedule one ahead of time to avoid waiting. Call the office directly or use the online scheduler at the Social Security website.

Choosing your coverage: Part A, Part B, and Part D

Part A covers hospital stays, skilled nursing care, and hospice. Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working. Part B covers doctor visits, outpatient care, and medical equipment. Part B has a monthly premium that changes each year — in 2024, the standard premium is $164.90 per month, though it may be higher if your income is above a certain level.

Part D is prescription drug coverage. You choose a Part D plan from private insurance companies, and the premium and covered drugs vary by plan. You should enroll in Part D when you first turn 65, even if you do not take many medications, because waiting to enroll later can result in a permanent penalty on your premiums.

When you explore, you will be asked whether you want Part A, Part B, Part D, or all three. If you are still working and covered by your employer's health plan, you may be able to delay Part B without penalty, but you should still enroll in Part A. Talk to your employer's benefits office or call 1-800-MEDICARE to understand how your employer coverage affects your Medicare choices.

What happens after you explore

Medicare will mail you a decision letter within two to four weeks of your process. The letter will tell you which parts of Medicare you are enrolled in and when your coverage starts. You will also receive a Medicare card in the mail, usually within two weeks of approval. Do not wait for your card to start using your benefits — your coverage begins on the date listed in your decision letter.

If you enrolled in Part B or Part D, you will also receive information about your premium payments and how to choose a plan. For Part B, the premium is usually deducted from your Social Security check automatically. For Part D, you choose a plan and pay the premium directly to the insurance company.

If Medicare denies your process or you disagree with your enrollment date, you have the right to appeal. The decision letter will explain how to file an appeal and the important date for doing so. You can also call 1-800-MEDICARE to ask questions about your decision.

Special situations in Texas

If you are a federal employee or retired federal employee in Texas, you may have different enrollment rules. Contact the Office of Personnel Management at 1-888-767-6738 to learn how your federal benefits affect your Medicare enrollment.

If you are a railroad worker or retired railroad worker, contact the Railroad Retirement Board at 1-877-772-5772. Railroad employees have their own retirement system and different Medicare enrollment rules.

If you are Native American or Alaska Native, you may be able to enroll in Medicare without penalty even if you miss the normal enrollment window. Call 1-800-MEDICARE to discuss your situation.

If you are still working past age 65 and covered by your employer's health plan, you can delay enrolling in Part B without penalty as long as your employer has 20 or more employees. When you do enroll in Part B later, tell Medicare about your employer coverage so your enrollment is handled correctly.

Frequently Asked Questions

What if I miss the three-month window before I turn 65?

You can still explore after you turn 65, but your coverage will start on the first day of the month after you explore, not on your 65th birthday. You may also owe a permanent 10 percent increase on your Part B premium for each year you delayed enrollment. The only exception is if you were covered by an employer health plan with 20 or more employees — in that case, you can enroll without penalty when you leave that job.

Do I have to choose a Medicare Advantage plan or a Medigap plan when I explore?

No. When you explore for Medicare, you enroll in Original Medicare (Part A and Part B). After that, you can choose a Medicare Advantage plan or buy a Medigap supplemental plan separately. You have until December 7 each year to make these choices for the following year, so you do not have to decide right away.

Can I explore for Medicare before I turn 65?

You can explore starting three months before you turn 65. You cannot explore earlier than that. If you are disabled or have end-stage renal disease, different rules explore — call 1-800-MEDICARE to discuss your situation.

Will explore for Medicare affect my Social Security benefits?

No. explore for Medicare does not change your Social Security benefits or when you can start them. You can explore for Medicare at 65 and delay Social Security benefits until a later age if you choose.

Is there a cost to explore for Medicare?

No. There is no fee to explore for Medicare through any method — online, by phone, or in person. Be cautious of websites or people offering to help you explore for a fee. Medicare.gov and 1-800-MEDICARE are always free.