Original Medicare
You can add a separate Part D drug plan and, when appropriate, a Medigap supplement. These are different types of coverage.
MEDICARE · IN THE VALLEY AND ALL OF TEXAS
A clearer beginningwith Medicare
With so many letters, dates and choices, you deserve a straightforward explanation. Let’s take it one step at a time.
Erick VallarinoAn insurance agent here in the Valley
English and Spanish · Serving people in Texas
Your request arrived
Thank you. Erick will call you from Vallarino Insurance's main number, 956-564-2557.
Call ErickThe basics
First, what is Medicare?
Medicare is federal health insurance for people age sixty-five or older and some younger people who qualify through disability or certain conditions. It is different from Medicaid.
Turning sixty-five doesn’t mean every step happens automatically. Social Security benefits, employment and your current coverage all affect what comes next.
Understand your options first. Then decide at your own pace.
Official sources: Medicare.gov
Two pathsPart A + Part B
Part C
How your coverage fits together
Start with how you want to receive medical coverage. Then look at prescriptions and the costs you would pay yourself.
Medicare Advantage
A private Medicare-approved plan administers your Part A and B coverage. Most also include Part D. You must have A and B.
The letters, explained
What each part does
Choose a letter to understand its role. Medigap is a supplement, not another part of Medicare.
Hospital care
Helps cover inpatient hospital stays, skilled nursing facility care when requirements are met, hospice and some home health services. It does not pay for long-term care just because you need help bathing or dressing.
Visits and medical care
Helps cover doctor visits, outpatient care, medical equipment and certain preventive services. It has a monthly premium and may involve a deductible and coinsurance.
Another way to receive Medicare
Brings A and B coverage together through a private plan. Check its network, approvals and costs. Additional benefits depend on the plan and are not the same for everyone.
Prescription drug coverage
Helps cover prescription medicines. Check the plan’s drug list and pharmacies. It may be part of Advantage or a separate plan alongside Original Medicare.
Reference figures
What Medicare costs in 2026
These are Medicare costs, not an offer or a plan quote. They are not 2027 figures.
Part A premium
$0a month for most peopleUsually based on enough qualifying work history for you or your spouse. Otherwise, a premium may apply.
Standard Part B premium
$202.90a monthSome people pay more based on income.
Part B deductible
$283a yearAfterward, you generally pay twenty percent of the approved amount for Part B-covered services.
Part A hospital deductible
$1,736per benefit periodThis is not a yearly deductible. It can apply more than once in a year.
Official sources: CMS: 2026 Part A and B costs
Compare thoughtfully
Original and Advantage, side by side
No single choice fits everyone. Your doctors, prescriptions and budget matter.
Who administers it
OriginalThe federal program.
AdvantageA private Medicare-approved plan.
Doctors
OriginalProviders who accept Medicare nationwide.
AdvantageNetworks and plan rules vary. Check before choosing.
Specialists
OriginalUsually no referral needed.
AdvantageA referral or prior approval may be needed.
Prescriptions
OriginalYou can add a separate Part D plan.
AdvantageMost plans include Part D.
Yearly medical spending
OriginalA and B have no yearly cap of their own. Supplemental coverage can help.
AdvantageYearly limit for covered medical services; network rules matter.
Premiums
OriginalPart B plus any additional coverage you choose.
AdvantageYou still pay Part B and any plan premium.
Dental, vision and hearing
OriginalMost routine care is not covered.
AdvantageSome plans offer limited additional benefits. Check details.
Travel
OriginalCovered care with Medicare-accepting providers in the U.S.
AdvantageRules differ outside the service area. Confirm coverage before traveling.
Official sources: Medicare.gov
Questions worth asking
What is covered and what isn’t
Having Medicare doesn’t mean every service will be covered.
Coverage comes with rules
Medically necessary services and certain preventive care may be covered. The provider, setting and Medicare or plan requirements matter.
Not everything is included
Original Medicare generally does not cover long-term care, most routine dental care or hearing aids. Coverage outside the United States is very limited.
Official support
If you need help paying
These programs have their own requirements. The appropriate agency decides whether you qualify.
Extra Help
Can help people with limited income and resources pay Part D prescription costs. Read the official information and application options.
Learn about Extra Help →Medicare Savings Programs
Apply through HHSC in Texas. Depending on the program, assistance may cover premiums and other Medicare costs.
Contact Texas HHSC →Medicaid + Medicare
Some people have both. The state determines Medicaid eligibility and coverage; that is separate from choosing a Medicare plan.
Explore Texas resources →Step by step
How to get started
Checking your dates early can help you avoid interruptions in coverage and possible penalties.
Find your enrollment window
Your initial period usually lasts seven months: three before your sixty-fifth birthday month, that month and three after. If your birthday is on the first day of a month, these dates move one month earlier.
Review your current coverage
If you or your spouse is still working, check with the employer and Social Security before delaying Part B. COBRA or retiree coverage does not always offer the same protections.
Confirm your Parts A and B
Some people are enrolled automatically; others apply through Social Security or, when applicable, the Railroad Retirement Board. Confirm when coverage begins.
Compare doctors and prescriptions
Review costs, networks and medicines before choosing how to receive coverage. If you’re considering Medigap, ask about your rights and enrollment window.
Keep your confirmation
Don’t cancel coverage just because you completed a form. Confirm acceptance and the start date, and keep your documents.
Official sources: Medicare.gov: enrollment timing
In everyday language
A small Medicare dictionary
Ten terms you’ll see in letters, documents and conversations.
Premium
What you pay each month for coverage, even if you don’t use it.
Deductible
What you pay for certain services before coverage begins sharing those costs.
Copayment
A fixed amount you pay for a covered service.
Coinsurance
Your percentage of a covered cost.
Network
Doctors, hospitals and other providers with agreements with a plan.
Drug formulary
A plan’s list of covered medicines and the rules that apply.
Referral
A professional’s direction for you to see another provider.
Prior authorization
Approval that may be required before receiving certain services or medicines.
Medigap
Private supplemental insurance that helps with some Original Medicare costs. It is not used to pay Advantage copayments.
Enrollment period
The time window when you can enroll or make a permitted change.
Myths and realityMyth
Myth
Myth
Myth
A letter isn’t the whole story
It’s worth pausing and asking before making a decision.
“Medicare pays for everything”
Reality: Premiums, deductibles and uncovered services can apply. Look at the whole cost, not just one benefit.
“I have to change my plan”
Reality: An advertisement or phone call does not require you to switch. First find out whether you need to do anything.
“My neighbor’s plan is perfect for me”
Reality: The same coverage can work differently depending on each person’s doctors and medicines.
“Asking for guidance enrolls me”
Reality: This form requests a call. It is not an enrollment and does not change your coverage.
Close to you
Medicare guidance for the Valley
I serve people across Texas, with a special focus on the Rio Grande Valley. We can talk in English or Spanish.
- Brownsville
- Harlingen
- McAllen
- Edinburg
- Mission
- Pharr
- Weslaco
You can also get independent guidance from Texas HICAP, the state’s Medicare counseling program, at 800-252-9240. For federal program information, visit Medicare.gov.
Official sources: Texas HICAP
A conversation, not pressure
How I help you
I’m Erick Vallarino, an insurance agent here in the Valley. My help costs you nothing.
I listen
We start with what you want to understand and the coverage you have now.
We check what matters
Doctors, prescriptions, dates and costs, not just the front page of a brochure.
I explain the differences
We compare the options I represent in plain language. You decide.
We clarify the next step
If you choose to continue, we review what’s needed. Requesting a call doesn’t obligate you to enroll.
For the person helping
Helping a parent or family member?
Start by organizing the questions. You don’t need to have every answer.
Choose “I’m helping a family member” in the form. Use that person’s age and, if requested, birth month and year; then enter your own name and cell phone number.
The person needing coverage keeps the decision. Sharing information or acting on their behalf may require their permission or valid representation.
Your information matters
Only what we need to return your call
This form does not ask for a Medicare number, Social Security number, address or medical information. Don’t put those details in the name field.
We use your information to handle your request under our privacy notice. Your answers are not saved in this browser when you close or reload the page. This page does not add advertising pixels.
Privacy notice →Before you decide
Questions I hear often
If your situation is different, we can talk it through. This guide is general information.
Do I have to retire to have Medicare?
No. You can have Medicare while working. Review how it coordinates with your workplace coverage before making changes.
Is enrollment automatic?
For some people, depending on the benefits they already receive. Don’t assume: confirm with Social Security or the Railroad Retirement Board.
Can I get Medicare before sixty-five?
In certain situations, yes: through disability, end-stage renal disease or ALS. Each path has its own requirements.
Is Medigap the same as Advantage?
No. Medigap helps with some Original Medicare costs. Advantage is another way to receive A and B; Medigap cannot be used to pay Advantage copayments.
When can I buy Medigap?
The federal Medigap open enrollment period lasts six months, starting the first month you are sixty-five or older and have Part B. Outside that period, medical underwriting and other rules may apply unless you have guaranteed-issue rights or other protections.
Can I keep my doctor?
Verify with the doctor and, where applicable, the plan. A practice saying it accepts Medicare does not confirm participation in a particular plan network.
Will all my medicines be covered?
Not necessarily. Check each medicine, dose, pharmacy and plan rule before choosing.
Can I change any time?
Not always. Enrollment windows and special periods depend on your coverage and circumstances. Receiving an advertisement does not give you a special enrollment period.
Do you charge for guidance?
My help costs you nothing. Premiums and the costs of coverage are separate.
What happens when I send this form?
You request a call from Erick. It does not enroll you, change your plan or authorize text messages.
Can I call without filling anything out?
Yes. Call 956-564-2557. Service is by appointment; if I can’t answer, you can leave a message.
Your next step
You don’t have to understand it all today
Let’s begin with your questions. No obligation to enroll.
Request guidance →956-564-2557By appointment