Are Texas Teachers eligible for Medicare? 2026 Guide

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Dear Connie,

I’ll be retiring from teaching in a year. I know that I would be eligible for Medicare because of my age, but I’m not sure if I can get Medicare. Are Texas teachers eligible for Medicare? How do I get healthcare after I retire?

Confused,
Susan from San Antonio, Texas 

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Dear Susan,

Congratulations on your soon-to-be retirement! Thank you for being so dedicated to education.

You want to plan your future after helping students for so many years. We want to help you enjoy your retirement without worrying about your health coverage.

As a teacher, your eligibility for Medicare depends on your work history.

Are Texas Teachers Eligible for Medicare?

Yes, retired Texas teachers can get Medicare around age 65. However, you must meet specific work requirements.

You are eligible for Medicare if you meet one of these conditions:

• You worked for at least 10 years outside of education and paid Medicare taxes
• Your spouse worked and paid Medicare taxes for at least 10 years

Many Texas teachers do not qualify for Medicare because they contributed to the Teacher Retirement System (TRS) rather than to Medicare. The Teacher Retirement System is a separate retirement program for public school employees. If you only worked as a teacher in Texas and never paid Medicare taxes, you may not qualify for Medicare Part A without a premium.

What If I Don’t Qualify for Medicare?

If you do not qualify for Medicare, you can get health insurance through TRS-Care. TRS-Care offers a standard plan for non-Medicare retirees. This plan provides health coverage after you retire from teaching.

If you are unsure of your Medicare eligibility, you can contact the Social Security Administration. They can tell you if you or your spouse paid enough Medicare taxes to qualify.

Medicare Options for Qualifying Texas Teachers

If you qualify for Medicare, you have two main options:

1. Original Medicare (Part A and Part B), the federal program that covers hospital stays and doctor visits
2. Individual Medicare plans (like Medicare Advantage or Medicare Supplement)
3. Medicare plans through the Teacher Retirement System of Texas

TRS-Care Medicare Plans

TRS offers Medicare-eligible retirees two plans:

• TRS-Care Medicare Advantage medical plan – This covers your doctor visits, hospital stays, and medical services
• TRS-Care Medicare Rx prescription drug plan – This covers your medications

For 2026, the TRS-Care Medicare Advantage plans are offered through UnitedHealthcare. The insurance company may change based on competitive bidding in future years.

Important Rules About TRS-Care and Medicare

The Centers for Medicare and Medicaid Services (CMS) has strict rules about mixing TRS-Care and individual Medicare plans:

• You cannot join an individual Medicare Part D plan if you are enrolled in a group retirement benefits program like TRS-Care
• You cannot join a group Medicare prescription drug plan if you have an individual Medicare Advantage plan

If you enroll in the TRS-Care Medicare Advantage plan and then drop the TRS-Care Medicare Rx to get an individual Part D plan, you will lose all your TRS-Care coverage. This is important to understand before making changes.

Medicare Costs for Texas Teachers

If you delay your Social Security benefits but still qualify for Medicare, you can get Medicare Part A and Medicare Part B. However, Medicare will bill you directly.

For 2026, you may pay a minimum premium each month for Part A if you have fewer than 40 quarters of Medicare-covered work. You must also pay the Medicare Part B monthly premium.

These costs apply whether you choose TRS-Care plans or individual Medicare plans.

Agent tip:

We recommend comparing the costs between a TRS-Care plan and individual Medicare options. This comparison could help you save money on hospital stays, doctor visits, and prescription medications.

Comparing Your Healthcare Options

When picking health insurance for retirement, consider your current and future needs. Compare the costs of TRS-Care and Medicare. This may help reduce your expenses for hospital stays, copays, and prescriptions.

With TRS-Care Medicare Advantage, you can see any doctor or specialist who accepts Medicare and bills UnitedHealthcare. If your doctors are not in the UnitedHealthcare network, you may need to pay out-of-pocket.

Remember that if you leave TRS-Care, you may not be able to re-enroll later. Make sure you understand all your options before making a decision.

Benefits of Medicare Advantage Plans

Individual Medicare Advantage plans often include extra benefits beyond Original Medicare. These may include:

• Dental coverage
• Vision care and eyeglasses
• Hearing aids and exams
• Fitness programs
• Over-the-counter medication allowances

Bottom Line

Texas teachers are eligible for Medicare at age 65 if they or their spouse worked and paid Medicare taxes for at least 10 years. If you qualify, you can choose between TRS-Care Medicare plans or individual Medicare plans. Compare your options carefully to find the coverage that best fits your retirement needs.

Texas teachers’ Medicare eligibility can be confusing, but you do not have to figure it out alone. At Connie Health, we help you find the right plan for your needs. We want you to spend your retirement years relaxing and enjoying life.

Need Help Deciding The Right Medicare Coverage For You?

• No-cost, unbiased service
• Compare all major plans and carriers
• Local, licensed insurance agents with 25+ years of combined experience

Call Now Compare Plans

Frequently Asked Questions

Can Texas teachers buy Medicare Part A if they didn’t pay Medicare taxes?

Yes. If you did not pay Medicare taxes, you can still enroll in Medicare Part A at age 65. You will pay a monthly premium. The amount depends on how many quarters of Medicare-covered work you or your spouse completed.

Can I have both TRS-Care and an individual Medicare Advantage plan?

No. You must choose either TRS-Care Medicare plans or individual Medicare plans. You cannot mix a TRS-Care Medicare Advantage plan with an individual Part D plan, or you will lose your TRS-Care coverage completely.

What happens to my spouse’s coverage when I switch to Medicare?

When you move to Medicare, your spouse may stay on TRS-Care if they are not Medicare-eligible. Their coverage and monthly cost may change. TRS-Care rules vary, so it’s important to review spouse coverage options before you enroll.

Does Medicare cover the same benefits as TRS-Care?

Medicare covers hospital stays, doctor visits, and medical services. However, Original Medicare does not include coverage for dental, vision, or hearing. Many Medicare Advantage plans add these extra benefits. Compare what each plan covers before choosing.

Do Texas teachers have to enroll in Medicare Part B to keep TRS-Care?

Yes. If you qualify for Medicare and want to stay enrolled in TRS-Care Medicare plans, you must enroll in Medicare Part B. If you do not enroll in Part B, you may lose your TRS-Care Medicare coverage.