Paul Sanchez
Medicare is the federal health insurance program for people aged 65 and over in the US. If you are under 65, you may still be eligible for Medicare if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease). There are several ways to enrol in Medicare, depending on your situation. If you are a Texas resident, you can call the free helpline at 800-252-9240 to get help with the complexities of Medicare. The Texas Health Information, Counselling and Advocacy Program can help eligible people enrol and provide counselling about their options.
| Characteristics | Values |
|---|---|
| Medicare helpline in Texas | 800-252-9240 |
| Medicare website | www.medicare.gov |
| Medicare definition | Federal health insurance program for people aged 65 and over |
| Medicare Part A | Hospital Insurance |
| Medicare Part B | Medical Insurance |
| Medicare Part C | Medicare Advantage Plans (private insurance option) |
| Medicare Part D | Prescription medications |
| Initial Enrollment Period | Begins 3 months before the month you turn 65 and ends 3 months after; a total of 7 months |
| Cancelling Medicare Part A or Part B | Submit CMS Form 1763 to your local Social Security office |
| Signing up for Medicare Part A and/or Part B | Contact the Social Security Administration; apply online at www.socialsecurity.gov |
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What You'll Learn
Eligibility criteria for Medicare in Texas
Medicare is a federal health insurance program designed to reduce healthcare costs for eligible beneficiaries in Texas and across the United States. Texans have both public (Original Medicare) and private Medicare plan options. Original Medicare includes Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).
Eligibility for Medicare in Texas is primarily determined by age and health status. Individuals aged 65 or older generally qualify for Medicare, and those under 65 with certain disabilities or medical conditions may also be eligible. These conditions include End-Stage Renal Disease (ESRD) and Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's Disease.
For individuals under 65, eligibility for Medicare in Texas may be linked to their Social Security disability benefits. If an individual receives Social Security disability benefits, they will automatically receive Medicare Parts A and B after 24 months. Additionally, if they have Lou Gehrig's Disease (ALS), they will receive Medicare Parts A and B immediately upon enrolling in Social Security disability benefits.
Medicare Savings Programs are also available to help with the costs of Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments. These programs are income-based, and eligibility is determined by each state. Texans can contact their state or a local Medicare agent to understand their eligibility for these savings programs and other Medicaid options.
To summarize, eligibility criteria for Medicare in Texas include age, health status, and income. Texans aged 65 or older, or those under 65 with specific disabilities or medical conditions, may qualify for Medicare. Additionally, income-based savings programs and Medicaid options are available to help with the costs of Medicare coverage.
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How to apply for Medicare Part A
Medicare is the federal health insurance program for people aged 65 and over. If you are under 65, you may still be eligible if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease).
Medicare Part A covers hospital stays and most inpatient services. It also covers skilled nursing, home nursing, and hospice care.
If you are 65 or older, you can apply for Medicare Part A online. You can also apply for Part A only, or Part A and Part B together.
To apply online, you will need to create a secure my Social Security account. This is the fastest and easiest way to apply for Medicare and get any financial help you may need. You can also apply for Medicare at any Social Security office or by calling the Social Security Administration at 1-800-772-1213.
If you are already receiving Social Security retirement benefits between the ages of 62 and 65, you will be automatically enrolled in Medicare Part A when you turn 65. If you apply for Social Security three months before you turn 65 or later, you can sign up for Medicare at the same time.
If you are under 65 and have been receiving disability benefits for 24 months, you will be automatically enrolled in Medicare Part A beginning in the 25th month.
If you live in Texas, you can also call the Texas Health Information, Counseling, and Advocacy Program helpline at 800-252-9240 for help with enrolling in Medicare and finding information about your options.
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How to apply for Medicare Part B
Medicare is the federal health insurance program for people aged 65 and over. If you are under 65, you may still be eligible for Medicare if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease).
Medicare Part A covers hospitalization, home or skilled nursing, and hospice. Medicare Part B is medical insurance that helps cover services and supplies not covered by Part A. It helps pay for doctor's office visits and services, lab tests, and most outpatient care.
To sign up for Medicare Part B, you will need to contact the Social Security Administration. You can apply online, which is the easiest and fastest way to sign up and get any financial help you qualify for. You will need to create a secure my Social Security account to sign up for Medicare or apply for Social Security benefits online.
You can only sign up for Part B at certain times. The first time you can enroll in Part B is during the Initial Enrollment Period, which is a 7-month window that starts three months before your 65th birthday month and ends three months after your birthday month. If you miss this window, you can still sign up during a General Enrollment Period from January 1st through March 31st, but you may have to pay a late enrollment penalty. The monthly premium for Part B goes up 10% for each 12-month period that you could have had Medicare but didn't sign up for it.
If you are already covered by an employer group health plan, you can delay Part B until you retire. If you decline Part B during your Initial Enrollment Period because of active employment for a company with 20 or more employees, you should enroll during your Special Enrollment Period.
If you already have Medicare Part A and want to sign up for Part B, you can apply online or fill out form CMS-40B and send the completed form to your local Social Security office by fax or mail. If you are applying during a Special Enrollment Period, you will also need to fill out form CMS-L564.
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Medicare Part B penalty
Medicare is the federal health insurance program for people aged 65 and over. If you are under 65, you may still be eligible for Medicare if you have a disability, End-Stage Renal Disease (ESRD), ALS (Lou Gehrig's Disease), or permanent kidney failure.
Medicare Part B is medical insurance. If you miss your Initial Enrollment Period (IEP) for Medicare, you may have to pay a late enrollment penalty. The IEP for Medicare begins 3 months before you turn 65 and ends 3 months after the month you turn 65.
The Part B penalty is assessed for as long as the person has Part B. For each 12-month period that you delay enrollment in Medicare Part B, you will have to pay a 10% Part B premium penalty. For example, if you delayed enrollment for 2 years, you will have to pay a 20% late enrollment penalty (10% for each full year of the delay) plus the standard Part B monthly premium. This amount is rounded to the nearest $0.10 and includes the late enrollment penalty.
You may not have to pay the Part B penalty if you qualify for a Special Enrollment Period (SEP). For example, if you have insurance based on your current work, you may qualify for an SEP. Additionally, if you have employer insurance, you can delay enrollment without incurring a penalty.
Texas has a free helpline to guide residents through the complexities of Medicare. The Texas Health Information, Counseling and Advocacy Program can help eligible individuals enroll and provide counseling about their options.
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Medicare helpline in Texas
Medicare is the federal health insurance program for people aged 65 and over in the US. If you are under 65, you may still be eligible if you have a disability, End-Stage Renal Disease (ESRD), ALS (Lou Gehrig's Disease), or permanent kidney failure, or if you receive Disability benefits.
Texas has a free helpline to guide residents through the complexities of Medicare. The Texas Health Information, Counseling and Advocacy Program can help eligible individuals enroll, provide information, and offer counselling about their options. The helpline number is 800-252-9240.
If you have End-Stage Renal Disease (ESRD), you can call 800-772-1213 to apply for Medicare. If you are deaf or hard of hearing, you can call TTY +1 800-325-0778 to sign up for Medicare Parts A and B, or Part A only.
For specific billing questions and questions about your claims, medical records, or expenses, you can call 1-800-MEDICARE, or log into your secure Medicare account.
The Texas Department of Insurance also lists a contact number for Medicare beneficiaries: 800-252-3439.
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Frequently asked questions
You can apply for Medicare in Texas by contacting the Social Security Administration. You can apply online, which is the fastest and easiest way, or by mailing or faxing the completed CMS-L564 form to your local Social Security office.
Medicare Part A covers hospital insurance, home or skilled nursing, and hospice. Medicare Part B covers medical insurance. Medicare Part C is a private insurance option that covers hospital and medical costs, and Medicare Part D covers prescription medications.
The cost of Medicare depends on the coverage you choose. There are several Medicare Savings Programs available for those who meet certain income and asset limits.
The Initial Enrollment Period begins 3 months before you turn 65 and ends 3 months after the month you turn 65, for a total of 7 months. If you miss this period, you may have to pay a penalty.
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