Medicare Annual Enrollment in South Texas: dates and rules
Annual Enrollment runs October 15 to December 7, and anyone with Medicare can change plans. What to have ready if you live in Hidalgo, Cameron or Starr county.
- Annual Enrollment runs October 15 through December 7 every year, and the coverage you pick starts January 1.
- Anyone with Medicare can join, switch or drop a plan during this window, with no reason and no qualifying event needed.
- Bring a current list of your prescriptions, because how a plan treats your drugs usually costs more over a year than its monthly bill.
Medicare Annual Enrollment runs October 15 through December 7 every year. Anyone with Medicare can use it to join, switch or drop a plan, and the coverage you choose starts January 1.
When Annual Enrollment runs: October 15 to December 7
The window opens October 15 and closes December 7. Coverage you choose during that time starts January 1. It is the main chance most people get to change plans, and most plan changes in South Texas happen inside those eight weeks.
If you already have a Medicare Advantage plan, which is a private plan that delivers your Medicare coverage, there is a second window from January 1 to March 31. During that time you can switch to another Medicare Advantage plan or go back to Original Medicare, the government run version with Part A and Part B. You cannot use it to move from Original Medicare into a Medicare Advantage plan. See what that second window does and does not allow.
Who Annual Enrollment applies to
Anyone with Medicare can use Annual Enrollment to join, switch or drop a plan. You do not need a qualifying event, which is a life change like moving or losing coverage, and you do not need to give a reason.
Turning 65 is different. That is the Initial Enrollment Period, a seven month window that covers the three months before your birthday month, the month itself, and the three months after. If you are still working and covered by an employer plan, you may be able to delay Part B, the part of Medicare that pays for doctor visits, without a penalty.
One thing that catches people out is COBRA, the coverage that lets you keep an old employer plan for a while after leaving a job. It does not count as active employer coverage for that purpose. See how the seven month window works.
What to have ready
- Your Medicare card and the date your Part A and Part B started
- A current list of your prescriptions, including the dose of each one
- The doctors and clinics you want to keep
- Your Medicaid status, if you have Medicaid, since it affects which plans you qualify for
The prescription list matters more than people expect. Two plans that look similar can treat the same drug very differently. That difference usually costs more over a year than the premium, which is the monthly bill for the plan. You can check any plan's formulary, the list of drugs it covers, against your own list on the official plan finder. See how drug plans are structured.
Not sure whether to keep your plan, switch, or change paths this fall? Have a licensed agent review your plan. Enter your ZIP code and we call you back, usually the same business day.
If you have both Medicare and Medicaid
Texas Medicaid for adults 65 and over, and for people with disabilities, runs through a program called STAR+PLUS. If you have both Medicare and Medicaid, you may qualify for a Dual Eligible Special Needs Plan, which is a Medicare Advantage plan built for people who have both. You also generally get more chances to change plans during the year than someone with Medicare alone. See what a Dual Eligible Special Needs Plan covers.
Your exact Medicaid level matters here. Not every dual plan accepts every level, and your level decides how much of your cost sharing Medicaid picks up. Cost sharing means the copays and deductibles you would otherwise pay yourself. Confirm your level with Texas Health and Human Services before you enroll, not after. The current eligibility levels are at hhs.texas.gov.
Getting help in McAllen
We are an independent agency in McAllen, and we work with clients across Hidalgo, Cameron and Starr counties. We can go through your prescriptions and your doctors with you and tell you plainly what fits.
Before December 7, gather your Medicare card, your prescription list and your doctor list, then compare your current plan against the others. Call us at (956) 687 3334 and we will do it with you. Se habla español.
Annual Enrollment is the one window when anyone on Medicare can change plans for the coming year. Enter your ZIP code and a licensed agent from McAllen Insurance Group calls you back to walk through the plans available at your address, in English or Spanish.
Want this looked at properly?
We are an independent agency in McAllen serving Hidalgo, Cameron and Starr counties. There is no obligation to talk it through.
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Gerino Alejos
Licensed insurance agent · License 3128710 · NPN 18243381
Owner of McAllen Insurance Group, an independent agency on North 10th Street in McAllen. Works with clients across Hidalgo, Cameron and Starr counties on Medicare, Marketplace health, life and auto coverage. Se habla español.