Top 3 Medicare Mistakes Texans Make and How to Avoid Them

Navigating Medicare can be confusing, especially for Texans approaching their 65th birthday or considering retirement. With a mix of deadlines, enrollment periods, and plan options, it’s no surprise that many people make costly mistakes during the Medicare enrollment process.

Whether you live in Houston, Dallas, San Antonio, or a smaller Texas town, understanding your Medicare choices is crucial. In this article, we’ll uncover the top 3 Medicare mistakes Texans make—and, more importantly, how you can avoid them.

If you're planning for retirement or approaching the Medicare deadline in TX, read on for practical Medicare tips that can save you time, stress, and money.

Mistake #1: Missing the Medicare Enrollment Window

Why It Happens

Many Texans simply don’t realize there’s a specific window to enroll in Medicare. If you miss this Initial Enrollment Period (IEP), you could face lifetime penalties or go without coverage until the next open enrollment. This is especially true for individuals who aren't automatically enrolled, such as those who are still working past 65 or not yet collecting Social Security.

What You Need to Know

Your Initial Enrollment Period lasts 7 months: it begins 3 months before your 65th birthday month, includes your birthday month, and continues for 3 months afterward. Missing this window may result in delayed coverage and permanent penalties for Part B and Part D.

Here’s how it breaks down:

• Turning 65 in June? Your IEP is from March 1 – September 30.

• Enroll early (in the first 3 months) to avoid delays in your coverage start date.

If you continue to work and have employer coverage, you may qualify for a Special Enrollment Period (SEP) later, but that requires meeting certain conditions. Don’t assume—you need to verify your eligibility in advance.

How to Avoid It

• Mark your calendar 3 months before your 65th birthday.

• Schedule a Medicare review with a licensed agent to ensure you’re enrolling at the right time.

• If you’re still working, consult both your HR department and a Medicare advisor to see if delaying makes sense.

📌 Medicare Tips: Avoid penalties by enrolling during your Initial Enrollment Period, even if you think you won’t need coverage yet.

Mistake #2: Choosing the Wrong Plan Without Research

Why It Happens

Medicare is not one-size-fits-all. Between Original Medicare, Medicare Advantage (Part C), Medigap (Supplement Plans), and Part D drug coverage, Texans are faced with a lot of options. Many people make quick decisions based on:

• A friend’s recommendation

• An appealing TV ad

• A plan with the lowest monthly premium

While these factors can be helpful, they shouldn’t be your only considerations.

What You Need to Know

The right plan for your neighbor may not be the right plan for you. For instance:

• A Medicare Advantage plan may have low premiums but limited doctor networks.

• Original Medicare + Medigap might give you flexibility to see any doctor, but it comes with higher monthly costs.

• Part D drug plans vary widely—some cover your medications better than others.

In Texas, especially in urban areas like Austin or El Paso, Medicare Advantage plans may offer great value due to strong provider networks. In rural areas, access to those networks may be limited.

How to Avoid It

• Compare plans based on your specific medical needs, not just cost.

• Use Medicare.gov’s Plan Finder tool to enter your prescriptions and doctors.

• Ask a local licensed Medicare agent to walk you through available plans in your ZIP code.

📌 Medicare Tips: Never choose a plan based solely on cost—consider coverage, doctor access, and prescription benefits.

Mistake #3: Underestimating Out-of-Pocket Costs

Why It Happens

Many Texans assume Medicare covers everything. Unfortunately, it doesn’t. Original Medicare covers about 80% of approved medical costs, leaving you responsible for the remaining 20%, with no out-of-pocket maximum.

This becomes a serious issue if you have a hospital stay, need physical therapy, or require ongoing care for chronic conditions.

What You Need to Know

Here’s what Original Medicare doesn’t cover:

• Long-term care

• Most dental, vision, and hearing services

• Prescription drugs (unless you have Part D)

• International travel medical emergencies

Without a Medigap policy or a Medicare Advantage plan, you could be exposed to thousands in out-of-pocket expenses.

How to Avoid It

• Budget for more than just premiums. Consider deductibles, coinsurance, and drug costs.

• Explore Medicare Supplement Plans (Medigap) if you want to cap your out-of-pocket spending.

• Medicare Advantage plans often include additional benefits like dental and vision but may require referrals and network restrictions.

📌 Medicare Tips: Plan for gaps in coverage—look at Medigap or Advantage plans to reduce risk and surprise bills.

Bonus Mistake: Not Getting Help

Why It Happens

Many people try to figure out Medicare on their own. But without guidance, it’s easy to miss key details or make decisions that don’t match your healthcare needs or financial goals.

What You Need to Know

In Texas, there are free and paid resources to help you make informed choices, including:

• State Health Insurance Assistance Programs (SHIP)

• Local licensed Medicare agents

• Medicare.gov

The best help comes from someone who knows the Texas Medicare landscape and can explain how federal Medicare laws apply locally, especially when it comes to the Medicare deadline in TX or regional plan offerings.

How to Avoid It

• Contact a licensed Medicare insurance agent who works in your area.

• Schedule annual plan reviews, especially during the Medicare Annual Enrollment Period (Oct 15 – Dec 7).

• Use free resources, but always verify with an expert.

📌 Medicare Tips: You don’t have to do this alone. Seek guidance from someone who specializes in Medicare in Texas.

In Conclusion

Texans have access to a wide range of Medicare options, but that also means more chances for missteps. Don’t let confusion or procrastination jeopardize your health or finances. By avoiding these three Medicare mistakes, you can:

✅ Enroll on time

✅ Choose a plan that truly fits your needs

✅ Protect yourself from high out-of-pocket costs

Whether you're in Fort Worth, Corpus Christi, or a rural area of Texas, making informed choices during Medicare enrollment is crucial to a secure retirement.

👥 Need Help Navigating Medicare in Texas?

At Arnett Evans and Company LLC, we specialize in helping Texans age 55+ find the right Medicare coverage—whether you’re turning 65, retiring, or want to change plans.

📅 Schedule your free Medicare review today👉 Visit aecinsure.com to get started or use our new quoting tool and get a quote in as little as 15 minutes.