Understanding Medicare in Texas

How Medicare is structured

Medicare is generally organized into parts. Part A helps with inpatient hospital stays, skilled nursing facility care, and some home health and hospice services. Part B helps with outpatient services such as doctor visits, preventive care and durable medical equipment. Part C, known as Medicare Advantage, is an alternative way to receive Part A and Part B benefits (and often Part D) through private plans that contract with Medicare. Part D provides prescription drug coverage, either as a standalone plan alongside Original Medicare or bundled into a Medicare Advantage plan.

• Part A: hospital and inpatient-related coverage
• Part B: outpatient and medical services
• Part C: Medicare Advantage, an alternative to Original Medicare
• Part D: prescription drug coverage

Original Medicare, Advantage and Supplement compared

Original Medicare consists of Parts A and B and is administered directly by the federal government, generally allowing you to see any provider that accepts Medicare. Medicare Advantage plans are offered by private companies and often include additional benefits, but typically use provider networks and cost-sharing rules set by the plan. Medicare Supplement, sometimes called Medigap, is a separate type of policy that works alongside Original Medicare to help with certain out-of-pocket costs, but it cannot be combined with Medicare Advantage. Deciding among these paths depends on your health needs, provider preferences and how you want to manage potential costs, and none of these options can be guaranteed to be the cheapest or best fit without a personal comparison.

Texas access considerations

Texas is a large and geographically diverse state, and this can affect how people think about Medicare choices. In major metro areas like Houston, Dallas-Fort Worth, San Antonio and Austin, there tend to be more providers and specialists concentrated close together. In parts of West Texas, the Panhandle and the Rio Grande Valley, residents may need to travel farther to reach certain specialists, which is a practical factor worth weighing when comparing plan types and provider networks. Thinking through your typical travel distance to care can be a useful part of the plan-selection conversation.

When you can enroll

Most people have an Initial Enrollment Period around when they turn 65, generally spanning several months before and after their birthday month. Each fall, the Medicare Annual Enrollment Period (October 15 to December 7) allows most beneficiaries to make changes to their Advantage or Part D coverage for the following year. There is also a Medicare Advantage Open Enrollment Period (January 1 to March 31) for people already enrolled in an Advantage plan who want to make a one-time change. Certain life events, such as moving or losing other coverage, may qualify you for a Special Enrollment Period outside these windows.

Who this may help

• People approaching age 65 for the first time
• Current Medicare beneficiaries reviewing their overall coverage
• Family members helping a parent or relative understand Medicare
• Texans moving to or within the state who need to review Medicare options
• People with a qualifying life event outside standard enrollment windows

Potential benefits

• A general understanding of how Parts A, B, C and D fit together
• A framework for comparing Original Medicare with Medicare Advantage
• Awareness of Texas-specific access considerations
• Clarity on which enrollment period may apply to your situation

What to consider

• RGI Group does not offer every Medicare plan available in Texas
• Enrollment outside your window may not be possible without a qualifying event
• Plan features and provider networks vary and can change from year to year
• Official Medicare resources should be consulted for authoritative details

How enrollment works

• Identify which part of your Medicare timeline applies to you (new to Medicare, reviewing current coverage, or a life event)
• Review the difference between Original Medicare, Advantage and Supplement
• Note the enrollment period that fits your situation
• Discuss your general needs and questions with us by phone or virtual appointment
• Confirm any details independently through Medicare.gov or 1-800-MEDICARE

Frequently asked questions

• Is RGI Group part of the government Medicare program? No. RGI Group is an independent agency and is not affiliated with or endorsed by the U.S. government or the federal Medicare program.
• Does RGI Group offer every Medicare plan available in my area? No. We do not offer every plan or carrier available in every part of Texas. Medicare.gov, 1-800-MEDICARE and the Texas HICAP program can provide information on the full range of options in your area.
• What is the difference between Medicare Advantage and Medicare Supplement? Medicare Advantage is an alternative way to receive your Medicare benefits through a private plan, often with additional benefits and a provider network. Medicare Supplement works alongside Original Medicare to help with certain out-of-pocket costs and generally allows you to see any provider that accepts Medicare, but the two cannot be combined.
• When can I first enroll in Medicare? Most people have an Initial Enrollment Period around their 65th birthday. Missing this window may mean waiting for a later enrollment period, so it's worth understanding the timeline that applies to you.
• What is the Annual Enrollment Period? It runs from October 15 to December 7 each year and is when most people can review and change their Medicare Advantage or Part D coverage for the following year.
• Where can I get unbiased Medicare counseling in Texas? The Texas Health Information Counseling and Advocacy Program (HICAP, the Texas SHIP) offers free, unbiased counseling, alongside Medicare.gov and 1-800-MEDICARE.
• Does RGI Group have an office in my city? No. RGI Group has one office, in Austin, and serves Texas residents statewide by phone and virtual appointment. Paperwork can usually be completed electronically, so you do not need to travel to meet with us.
• Is there a cost to review my options with RGI Group? You do not pay RGI Group a separate fee to review coverage options. You are also free to enroll on your own through the official government resources linked on this page.
• Can we talk in Spanish? Yes. Appointments and follow-up can be handled in English or Spanish, whichever you prefer.
• Which plans and carriers are available to me? Availability depends on your county, eligibility, and the product you are looking at, and it can change from year to year. We can tell you what we are able to offer for your situation rather than promise a specific plan or price.
• What should I have ready for a first conversation? Your ZIP code, who needs coverage, the doctors or prescriptions that matter to you, and a general sense of your budget. Please do not send Social Security numbers, Medicare ID numbers, date of birth, income, diagnoses, or prescription details through this website.

Official resources

• Medicare.gov — https://www.medicare.gov (The official U.S. government site to compare plans, check enrollment periods and find local counseling.)
• Texas Department of Insurance — https://www.tdi.texas.gov (Texas's insurance regulator, with consumer guides on Medicare-related products sold in Texas.)
• 1-800-MEDICARE — https://www.medicare.gov/talk-to-someone (The federal Medicare help line for questions about eligibility, enrollment and coverage.)

Talk with a licensed Texas agent

Call or text (346) 888-8811. Office: 5900 Balcones Drive, Ste 100, Austin, TX 78731. Open 24 hours, 7 days a week. Licensed in Texas. Guidance available in English and Spanish.