If you have Medicare because of a disability
Federal law doesn't require Medigap companies to sell to people under 65, but Texas does, in part. Under 28 Texas Administrative Code §3.3324, a company must make Plan A available to people who qualify for Medicare before 65. TDI explains the details:
- You have a six-month open enrollment period that starts when you first enroll in Part B.
- During it, companies must sell you Plan A on a guaranteed-issue basis, even if you have health problems.
- Companies can charge higher rates to people under 65.
If you have ESRD or ALS
House Bill 2516, passed in 2025, expanded Medigap access for Texans under 65 with end-stage renal disease or amyotrophic lateral sclerosis. Since September 1, 2025:
- A company that sells Medigap to people 65 and older must offer you the same coverage.
- Plans A, B and D must be priced at the rate charged to someone who is 65. Other plans can cost up to twice that rate.
- You can enroll during the six months that start the first month you're enrolled in Part B, and companies can't use medical underwriting, waiting periods or preexisting-condition limits.
People already enrolled in Part B because of ESRD or ALS had a one-time window from December 1, 2025 to June 1, 2026. If you missed it, ask TDI whether any later window applies to you.
When you turn 65
Everyone who had Medicare before 65 gets a fresh six-month Medigap open enrollment period at 65. You can buy any plan offered in Texas at standard age-65 rates. TDI notes that many companies move under-65 policyholders to their age-65 rates at that point.
Other options before 65
Medicare Advantage plans can't turn you down because of health conditions, so they're another way to limit out-of-pocket costs before 65. Texas also has 173 special needs plans in 2027, which are limited to people with certain conditions or circumstances, such as having both Medicare and Medicaid. If your income is limited, see does Texas Medicaid pay Medicare premiums.
Get help
A licensed insurance agent with Benefits Life can check which Medigap and Medicare Advantage plans you can get under 65 from the companies they work with, at no cost to you, at (512) 265-6565, TTY 711. See Medigap in Texas.
Related questions
When can I buy Medigap in Texas?
Open enrollment and guaranteed-issue rights.
Can I change Medigap plans in Texas?
Switching after your window closes.
How do I sign up for Medicare in Texas?
Disability, ESRD and turning 65.
Sources
- Texas Department of Insurance — Medicare supplement insurance guide
- TDI Bulletin B-0027-21 — Medicare supplement for people under 65 with disabilities
- TDI Bulletin B-0010-25 — HB 2516, Medicare supplement for people under 65 with ESRD or ALS
- Texas Legislature — HB 2516 (89th Legislature), enrolled text
- 28 Texas Administrative Code §3.3324
Frequently asked questions
Which Medigap plans can I buy under 65 with a disability in Texas?
Companies must offer you Plan A on a guaranteed-issue basis during the six months after you first enroll in Part B. They may offer other plans, but they don't have to, and they may ask health questions for them. Companies are allowed to charge higher rates to people under 65.
What changed for ESRD and ALS in 2025?
House Bill 2516 added sections 1652.059 and 1652.060 to the Texas Insurance Code. Since September 1, 2025, a company that sells Medigap to people 65 and older must offer the same coverage to people under 65 who have Medicare because of ESRD or ALS. Plans A, B and D must be priced at the age-65 rate, and other plans can cost no more than twice that rate.
When can I enroll if I have ESRD or ALS?
Any time during the six months that start the first month you're enrolled in Part B. The law also gave people already on Part B a one-time window from December 1, 2025 to June 1, 2026, which has now closed. TDI says no medical underwriting, waiting period or preexisting-condition limit may be applied.
Do I get another chance at 65?
Yes. When you turn 65, you get a new six-month Medigap open enrollment period. You can then buy any Medigap plan sold in Texas at the same rates as anyone else turning 65, without health questions.
Medicare in your Texas county
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