Texas Medicare Open Enrollment 2026: Free Help, No Sales Pitch
Your drug plan just mailed you its 2027 price list. Most people never open it. Then January rolls around, the pharmacy counter rings up a bigger number, and by that point it is usually too late to switch.
Texas Medicare open enrollment runs from October 15 through December 7, 2026. Any change you make takes effect January 1, 2027. You do not have to sort it out alone, either. Texas offers free counseling through a program called HICAP. And if your income is limited, Extra Help and the Medicare Savings Programs can take a real bite out of your costs.
Below, you will find the dates, the dollar limits, the phone numbers, and a game plan you can start today.
Quick Answer
Open enrollment runs October 15 to December 7, 2026, for coverage starting January 1, 2027. Free Texas Medicare counseling is available at 1-800-252-9240. Extra Help and Medicare Savings Programs are separate applications, and you can apply for both at any time of year.
| Need | Where to Go | Phone |
|---|---|---|
| Free one-on-one Medicare counseling | Texas HICAP | 1-800-252-9240 |
| Plan questions and enrollment help | 1-800-MEDICARE | 1-800-633-4227 |
| Extra Help with drug costs | Social Security | 1-800-772-1213 |
| Local help, ages 60+ (Collin and Denton) | North Central Texas Area Agency on Aging | 1-800-272-3921 |
Open Enrollment 2026 Dates: What They Mean for 2027 Coverage
This date often cause confusion. The enrollment period happening this fall is for your 2027 coverage, not 2026.
| Date | What Happens |
|---|---|
| September 30, 2026 | Deadline for plans to send your Annual Notice of Change |
| October 15, 2026 | Open enrollment begins |
| December 7, 2026 | Open enrollment ends |
| January 1, 2027 | New coverage begins |
| January 1 – March 31, 2027 | Medicare Advantage Open Enrollment Period (one change, Advantage enrollees only) |
What You Can Change During Open Enrollment
| Your Coverage Now | What You Can Do |
|---|---|
| Original Medicare, no drug plan | Join a Part D drug plan, or join a Medicare Advantage plan |
| Original Medicare + Part D | Switch Part D plans, drop Part D, or move to Medicare Advantage |
| Medicare Advantage | Switch to another Advantage plan, or return to Original Medicare and add a stand-alone Part D plan |
| Stand-alone Part D plan | Switch to a different Part D plan, or drop it |
Staying put is also a choice. If your plan still works for you, Medicare says you generally do not have to do anything. Just make sure "still works" is based on facts, not on habit.
What Changes in 2027: Part D and Advantage Costs
Prescription drug coverage gets a few rule changes on January 1. Advantage premiums, on average, are headed the other direction.
| Cost Measure | 2026 | 2027 |
|---|---|---|
| Maximum Part D deductible | $615 | $700 |
| Yearly out-of-pocket cap on covered drugs | $2,100 | $2,400 |
| National base Part D premium | $38.99 a month | $41.33 a month |
| Average Medicare Advantage premium (CMS projection) | $14.37 a month | $12.00 a month |
| Average stand-alone Part D premium (CMS projection) | Baseline | Up by less than $1 a month |
| Federal Part D premium stabilization program | Active (narrowed) | Ends |
Here is where people misread the 2027 rules. Those premium figures are national averages. Your own plan can land well above or below them. And the $2,400 cap is not a lid on everything you pay. Your monthly premium sits outside it, and so does any drug your plan does not cover.
The move for 2027: look up your own plan's numbers in your Annual Notice of Change, then compare them with at least one alternative on Medicare.gov.
Why a $0 Premium Plan Can Still Cost You
A $0 premium is a starting point, not a price tag. Check what the premium does not show.
| Cost That Hides Behind the Premium | Why It Matters |
|---|---|
| Copays and coinsurance | You still pay a share of doctor visits and hospital stays |
| Deductibles | Some plans make you pay first before coverage kicks in |
| Drug tiers | Your medication may sit in a higher-cost tier |
| Pharmacy network | Your pharmacy may not be a preferred one |
| Provider network | Your doctor or hospital may be out of network |
Free Medicare Help in Texas: HICAP and Your Other Options
You do not need to pay anyone just to understand your Medicare choices. Texas runs the Health Information, Counseling and Advocacy Program (HICAP). It is the Texas version of the national SHIP network, so if you searched for "SHIP" and came up empty, that is why.
HICAP is a partnership between the Texas Health and Human Services Commission, the Texas Legal Services Center, and local Area Agencies on Aging. Trained benefits counselors can help with:
- Original Medicare questions, rights, and appeals
- Medicare Advantage comparisons
- Part D drug plans and prescription assistance
- Medigap policy basics
- Applications for Medicare Savings Programs
Texas Medicare Help Line
1-800-252-9240
Free counseling from trained benefits counselors. Call early. Fall is the busy season.
| Option | Cost to You | Who Pays Them | Best For |
|---|---|---|---|
| Texas HICAP | Free | Government and program funding | Side-by-side comparisons and savings program applications |
| 1-800-MEDICARE | Free | Federal government | Quick questions, plan lookups, enrollment |
| Licensed agent or broker | No direct fee in most cases | Insurance companies, usually by commission | Enrolling once you know what you want. Ask which carriers they do not sell. |
💡 EasySmart Tip for Collin and Denton County Residents: If you are 60 or older, the North Central Texas Area Agency on Aging serves both counties and offers free Medicare benefits counseling. Call 1-800-272-3921 and ask for a Benefits Counselor. Prefer a face-to-face visit? Ask about the Area Agency on Aging that covers your county.
What to Bring to Your Counseling Appointment
A counselor can only work with what you hand over. Come prepared, and a 20-minute call becomes a real comparison.
- Your Medicare card
- Your Annual Notice of Change from your current plan
- A list of every prescription, with the dose and how often you take it
- The name of your regular pharmacy
- Your doctors and the hospital you use
- Recent bank statements and income records, if you want to check Extra Help or a savings program
Got a stack of pill bottles? Bring them. It is easier than trying to remember names from memory.
Read Your Annual Notice of Change First
Your plan must send this letter by September 30. It spells out next year's premiums, deductibles, benefits, and network changes. Start there. Then check your doctors and your prescriptions. Those three steps tell you fast whether your plan deserves a closer look.
Extra Help 2026: Income and Resource Limits
Extra Help (the official name is the Low-Income Subsidy) is a federal program for Part D drug costs. It can lower your premium and deductible. It also caps what you pay at the pharmacy. In 2026, most people who qualify pay no more than $5.10 for a generic and $12.65 for a brand-name drug.
| 2026 Extra Help Test | Single Person | Married Couple |
|---|---|---|
| Annual income limit | $23,940 | $32,460 |
| Monthly income (ballpark) | $1,995 | $2,705 |
| Resource limit (savings, investments) | $18,090 | $36,100 |
Social Security makes the call, using both income and resources. Exclusions and special situations can change the result. So being a little over a number does not always close the door.
Resources include cash, checking and savings, stocks, bonds, and retirement accounts. The home you live in, one vehicle, and your household belongings do not count. Plenty of folks assume owning a house disqualifies them. It does not.
📌 Good to Know: Some people never have to apply. If you get full Medicaid, Supplemental Security Income (SSI), or help from a Medicare Savings Program, you qualify for Extra Help automatically. Look for a purple notice from Medicare. If you get a gray "Loss of Deemed Status" notice instead, that means your automatic status is ending and you may need to apply.
How to Apply Without Getting Sent Back
You can apply on the Social Security Extra Help page, by phone at 1-800-772-1213, or at a local Social Security office. Applying does not enroll you in a drug plan. You still have to pick one. Your local SHIP counselor can also help you fill out the form for free.
Applications get delayed for avoidable reasons. Check this list before you submit:
- Every bank account is listed, including savings
- Retirement accounts, stocks, and bonds are included
- A spouse's income and savings are counted if you live together
- Pensions and rental income are in your monthly total
- Your mailing address is current, so the decision letter reaches you
Extra Help vs. Medicare Savings Programs: Which One Fits?
These are two different programs with two different sets of rules. Extra Help covers Part D drug costs. Medicare Savings Programs (MSPs) cover Medicare premiums and, for one tier, cost sharing. You may qualify for both.
| Program | Main Help | Monthly Income (Single) | Monthly Income (Couple) | Savings Limit (Single / Couple) |
|---|---|---|---|---|
| Extra Help | Part D drug costs | About $1,995 | About $2,705 | $18,090 / $36,100 |
| QMB | Medicare premiums and cost sharing | Up to $1,330 | Up to $1,804 | $9,950 / $14,910 |
| SLMB | Part B premium | $1,330.01 to $1,596 | $1,804.01 to $2,164 | $9,950 / $14,910 |
| QI-1 | Part B premium | $1,596 to $1,796 | $2,164 to $2,435 | $9,950 / $14,910 |
The Texas figures come from the state's Medicaid handbook and took effect March 1, 2026. They do not include a $20 income disregard, which can work in your favor. The federal Medicare site shows slightly different numbers because it builds that disregard in. Both are right. If you are close to a line, go by the Texas rules and ask a counselor to run it.
The Part B premium these programs can cover is $202.90 a month in 2026.
Three Quick Self-Checks
| Example (Single, Texas) | Monthly Income | Countable Savings | Likely Result |
|---|---|---|---|
| Retiree A | $1,900 | $15,500 | Under the Extra Help limits ($22,800 a year, savings under $18,090). Above the MSP ceiling, so probably Extra Help only. |
| Retiree B | $1,500 | $6,000 | Lands in the SLMB range, so the state may pay the Part B premium. Extra Help would follow automatically. |
| Retiree C | $2,100 | $8,000 | Over the Extra Help income line on paper ($25,200 a year). Still worth a call, since exclusions can change the math. |
Look at Retiree A again. Most people expect the savings programs to be the easy ones to qualify for. For many Texans, it runs the other way. Extra Help has the higher income ceiling.
If Your Income Runs a Little High
Do not cross anything off your list yet. Programs count income differently, and what lands in your bank account is not always what gets counted. Texas also has three MSP tiers, not one. Someone above the QMB line may still fall in the SLMB or QI-1 range. The help is smaller, but covering a Part B premium is meaningful on a fixed income.
Depending on how your state handles it, an Extra Help application can also start a screening for a Medicare Savings Program. HICAP counselors can help you apply for both.
Already Have Extra Help? Check Your Notices
If you still qualify, you generally keep the help. But your drug plan can change, and Medicare may move you into a different plan in some situations. Read any notice that arrives. If it says your plan is changing, review the new plan before December 7.
Switching Rules When You Have Extra Help or Medicaid
| You Have | You Can | You Cannot |
|---|---|---|
| Extra Help or Medicaid | Join, switch, or drop a drug plan once per calendar month, or leave an Advantage plan for Original Medicare with a stand-alone drug plan | Use this option to switch from one Medicare Advantage plan to another |
💡 EasySmart Tip for Texas Residents: You do not need to wait for October to apply for Extra Help. Applications are open all year. Apply now anyway, since a decision can take a few weeks and you will want to know your status before you pick a plan.
How to Compare Plans Without Getting Overwhelmed
You do not need to read every plan in Texas. Start with what affects your daily life.
| Check | What to Look For |
|---|---|
| 1. Doctors and hospitals | Are your primary care doctor, specialists, and hospital in the plan's network? |
| 2. Prescriptions | Is every medication on the plan's drug list, and at what tier? |
| 3. Pharmacy | Is your pharmacy preferred? Costs can differ from one pharmacy to the next. |
| 4. Total cost | Premium, deductible, copays, coinsurance, and the yearly maximum you could pay |
| 5. Extra benefits | Dental, vision, hearing, or fitness perks you will actually use |
Extras look great in an ad. But they should break a tie, not make the call. Doctors, drugs, and total cost come first.
For a free side-by-side, use the Medicare Plan Finder. You can also call 1-800-MEDICARE or book a HICAP session.
Open Enrollment Plan, Step by Step
| When | Your Move |
|---|---|
| Now – October 14 | Find your Annual Notice of Change. Write down your premium, deductible, and any drug that changed tiers. |
| This week | Call HICAP (1-800-252-9240) to book an appointment. Start your Extra Help application if you think you may qualify. |
| October 15 onward | Compare plans on Medicare.gov using your full medication list. |
| Mid-November (a good personal target) | Make your decision. Phone lines get busier as the deadline gets closer. |
| December 7 | Last day to submit a change for 2027. |
| January 1 – March 31, 2027 | Advantage enrollees get one change if the new plan is not working out. |
When Should You Call for Help?
Reach out to a free counselor if any of these sound familiar:
- Your Medicare Advantage plan is changing for 2027
- Your doctor or hospital may be leaving your plan's network
- Your prescription costs went up
- Your pharmacy is no longer preferred
- You are thinking about leaving Medicare Advantage for Original Medicare
- You think you may qualify for Extra Help or a Medicare Savings Program
- You got a Medicare notice and it makes no sense
Do not wait for the last week. Give yourself time to check doctors, drugs, and costs before December 7.
Frequently Asked Questions
Q: When is Medicare open enrollment in Texas for 2026?
A: It runs from October 15 through December 7, 2026. Changes you make generally take effect January 1, 2027.
Q: Is Texas HICAP free?
A: Yes. HICAP counseling costs nothing, and the counselors do not sell insurance. You can call 1-800-252-9240 to ask for help.
Q: Is HICAP the same as SHIP?
A: Pretty much. SHIP is the national network of state counseling programs. Texas calls its version HICAP.
Q: What are the 2026 Extra Help income limits?
A: The annual income limit is $23,940 for one person and $32,460 for a married couple. Resource limits are $18,090 and $36,100. Special rules and exclusions can affect the result.
Q: Can I apply for Extra Help during open enrollment?
A: Yes. You can apply any time of year. Open enrollment only controls when most people can change plans. It does not limit when you can ask for the subsidy.
Q: What is the difference between Extra Help and a Medicare Savings Program?
A: Extra Help is for Part D drug costs. Medicare Savings Programs help with Medicare premiums, and the QMB tier also covers cost sharing. A person may qualify for both.
Q: Does my house count for Extra Help?
A: No. The home you live in and one vehicle are left out of the resource test. Cash, bank accounts, stocks, bonds, and retirement accounts do count.
Q: What happens if I miss December 7?
A: Most people have to wait until next year unless they qualify for a special enrollment period. Medicare Advantage enrollees get one change between January 1 and March 31. People with Extra Help or Medicaid can switch drug plans once a month.
The Bottom Line
Open enrollment is not a contest to find the lowest premium. It is a check that your coverage still fits your doctors, your drugs, and your budget.
Start with Medicare.gov or 1-800-MEDICARE. Want someone to sit down with you? Call Texas HICAP at 1-800-252-9240. And if money is tight, look past the plan itself. Extra Help and the Medicare Savings Programs are easy to miss when all you search for is a cheaper plan.
Key Takeaways
- Open enrollment: October 15 – December 7, 2026. New coverage starts January 1, 2027.
- Free Texas help is one call away: HICAP at 1-800-252-9240.
- 2027 brings a $700 Part D deductible and a $2,400 yearly cap. Check your own plan's numbers.
- 2026 Extra Help limits: $23,940 (single) and $32,460 (couple), with savings limits of $18,090 and $36,100.
- Texas MSP income ceilings are lower than Extra Help, but the Part B premium help can be worth it.
- Your home and one car do not count toward the Extra Help savings test.
Source: Texas Health and Human Services Official Website (.gov) and Social Security Administration Official Website (.gov)
Related Guides
Official Sources
- Texas HHS — Medicare Help and HICAP
- Texas Department of Insurance — Medicare Contacts
- Social Security — Extra Help with Medicare Prescription Drug Costs
- Texas HHS Handbook — QMB Income Limits
- Texas HHS Handbook — SLMB Income Limits
- Texas HHS Handbook — QI Income Limits
- Texas HHS Handbook — MSP Resource Limits
- Medicare.gov — Special Enrollment Periods
- CMS — 2027 Part D National Average Bid Amount Information
- CMS — 2027 Medicare Advantage and Part D State Fact Sheets
- North Central Texas Area Agency on Aging
Last checked: October 2026. Limits, plan costs, and enrollment rules can change. Confirm current figures with Social Security, Medicare, Texas HHS, or HICAP before you apply or switch plans.
Editorial Note
EasySmartHub is an independent informational resource. We are not affiliated with Medicare, the Social Security Administration, the Texas Health and Human Services Commission, or any government agency or insurance company. Eligibility limits, plan prices, and program rules can change, so always confirm current information with an official source. This article is for general information only and is not medical, legal, insurance, or financial advice.
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