Medicare Open Enrollment runs from October 15 through December 7, 2026. Whatever you pick takes effect January 1, 2027.
You may not need to change anything. Keeping your plan is a fine choice for plenty of people. But Texas has more Medicare Advantage plans than almost anyone can sort through, and most of them are not yours to pick. Ten minutes with the right numbers tells you which ones are.
Texas has 421 plans, and your county has a fraction of them
Texas has 421 Medicare Advantage plans for 2027. A shopper in Harris County can choose from 49 of them.
The statewide count is the number you will see in the news. It is not the number you can buy from.
Plans are sold county by county. And 193 of the 421 are Special Needs Plans. Those plans have eligibility rules, such as also having Medicaid, having certain chronic conditions, or living in a nursing home. That leaves 228 plans open to anyone, spread across Texas's 254 counties.
Medicare Advantage plans by Texas county, 2027
| County | All plans | Open to anyone |
|---|---|---|
| Harris (Houston) | 99 | 49 |
| Bexar (San Antonio) | 98 | 48 |
| El Paso | 89 | 42 |
| Dallas | 84 | 42 |
| Tarrant (Fort Worth) | 83 | 40 |
| Hidalgo (McAllen) | 71 | 35 |
| Travis (Austin) | 56 | 28 |
Scroll the table sideways to see every column.
Counted from the CMS CY2027 Landscape file. The difference between the two columns is Special Needs Plans, which have eligibility requirements.
Look at the right-hand column. In Harris County, about half the plans are Special Needs Plans. The same is true in Dallas County and in Travis, where 28 of 56 are open to anyone.
So the real job in a Medicare review is not sorting 421 plans. It is taking the few dozen sold in your county and keeping the ones that cover the doctors you see and the drugs you take. That often leaves only a handful worth comparing.
The premium is not the number to watch for 2027
The average Texas Medicare Advantage premium went from $3.94 to $4.27 a month. The Part D out-of-pocket cap went from $2,100 to $2,400.
CMS projects the national average Medicare Advantage premium will fall from $14.37 to $12.00 a month. Texas moved the other way, but from a much lower starting point: CMS puts the Texas average at $3.94 in 2026 and $4.27 in 2027.
A 33 cent change in a statewide average says almost nothing about your own plan. Two other numbers say more. CMS sets them for the whole Part D program, and they decide what you pay before your drug coverage pays in full.
Medicare's standard Part D benefit, set by CMS
| What it is | 2026 | 2027 |
|---|---|---|
| Highest deductible Medicare allows | $615 | $700 |
| Out-of-pocket cap, after which you pay $0 for covered drugs | $2,100 | $2,400 |
Scroll the table sideways to see every column.
Set by CMS for the defined standard benefit. Many plans charge a lower deductible or none at all, and the cap includes whatever deductible you pay. Your Annual Notice of Change lists your own plan's figures.
The cap is the one to look at. Once your drug costs for the year reach it, you pay nothing more for covered drugs. Moving it to $2,400 means anyone who hits that ceiling pays $300 more in 2027 than in 2026, before a single premium is counted.
If your drug costs are modest, this will not touch you. If you take a specialty drug and hit the cap early every year, it is the most important number in this article.
Drug plans in Texas: about half of enrollees can pay less
A federal program that held drug plan premiums down ends after 2026. In Texas, 54.51% of people in a standalone drug plan can find a lower premium than they pay now.
CMS ran a temporary program called the Part D Premium Stabilization Demonstration. It ends after 2026. Nationally, CMS projects the average standalone drug plan premium will move from $35.09 to about $36 a month. That sounds like nothing, but an average hides what happens to single plans.
Standalone Part D drug plans in Texas, 2027
| Texas | |
|---|---|
| Standalone drug plans available | 10 |
| Share of enrollees who can get a lower premium than in 2026 | 54.51% |
| Share of enrollees who get Extra Help | 23.31% |
Scroll the table sideways to see every column.
From the CMS 2027 state fact sheet for Texas. The same 10 plans are offered in every Texas county.
Read the middle row from the other side. If you are in a standalone drug plan, there is close to an even chance that nothing on the list beats your current premium. So for many Texans the savings will come from how a plan treats your drugs, not from the monthly bill.
Check where each of your drugs sits on the plan's list, and whether your pharmacy is preferred. Then compare premiums.
Open Enrollment is not the window for a Medicare Supplement in Texas
October 15 to December 7 covers Medicare Advantage and Part D. Medigap runs on its own rules, and Texas gives you no yearly do-over.
Mixing these up can be costly.
What you can do between October 15 and December 7: join, switch, or drop a Medicare Advantage plan. You can also join, switch, or drop a Part D drug plan. That is the list.
What this window does not do: give you a right to buy a Medicare Supplement, also called Medigap. The Texas Department of Insurance says it plainly: “The Medicare open enrollment period doesn’t apply to Medicare supplement plans.”
Your one-time Medigap open enrollment period is six months long. It starts when you enroll in Part B at 65 or older. You also have a right to buy in a short list of cases. Two examples: your Medicare Advantage plan leaves your area, or you leave a Medicare Advantage plan within 12 months of joining one for the first time. That right has a deadline, usually 63 days after the old coverage ends. Outside those cases, an insurer in Texas can ask health questions and turn you down.
What to do between now and December 7
Four things, in this order, and the first one is already in your mailbox.
Read what changed before you decide to stay.
- Read your Annual Notice of Change. Medicare requires your plan to get it to you by September 30. It lists what changes for 2027: premium, copays, deductible, and the drug list. Of everything your plan mails you, this is the one to read.
- Check whether your drugs are still covered the same way. Drug lists can change each year. A drug can move to a higher tier and cost you more, even if your premium went down.
- Check whether your doctors are still in network. Medicare Advantage networks are local and they change. People tend to find this one out in January, when it is harder to fix.
- Compare total cost among the plans sold in your county. Premium plus deductible plus what your prescriptions cost. A $0 premium plan is not free if it puts your daily drug on a higher tier.