Medicare 2026

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# Lewisville Medicare help: how to tell a SHIP counselor from a licensed…

Medicare 2027Lewisville, TX

If you live in Lewisville and you have Medicare questions, you have two very different kinds of help available — and knowing the difference can save you a lot of second-guessing. One is a free counselor who does not sell anything. The other is a licensed agent who can actually enroll you in a plan. Both have a place. Here is how to tell them apart and when to call which.

What "unbiased" actually means

Unbiased help means the person talking to you is not paid based on what you choose. That is the core of the State Health Insurance Assistance Program, known nationally as SHIP. In Texas it operates under the name HICAP — the Health Information, Counseling and Advocacy Program — through the Texas Department of Aging and Disability Services and the Texas Health and Human Services Commission.

HICAP counselors are trained volunteers and staff. They walk you through your options, explain what a plan does, and help you use Medicare's Plan Finder tool. They will not tell you which plan to buy. That is by design.

How to reach SHIP/HICAP near Lewisville

You can reach a HICAP counselor in a few ways:

• Call the Texas HICAP benefits counseling line at 1-800-252-9240.
• Contact the North Central Texas Area Agency on Aging, which serves Denton County and surrounding counties, at 1-800-272-3921.
• Visit shiphelp.org to find a local counselor by ZIP code.

Appointments are often free of charge and can be done by phone, video, or in person at senior centers and community sites around Denton County. During the Annual Enrollment Period (October 15 – December 7), demand goes up, so it helps to book early.

When a licensed agent makes sense

Licensed agents and agencies do something SHIP cannot: they actually enroll you. If you already know what kind of plan you want — say, a Medicare Advantage plan or a Medigap policy — a licensed agent can compare offerings from the carriers they represent and sign you up.

A few things to know:

• Agents are paid a commission by the insurance company when you enroll.
• Some are "captive" (they work for one carrier). Others are "independent" and represent several.
• No agent represents every plan on the market. That is worth remembering when you're comparing.
• Agents must follow CMS marketing rules — for example, they cannot show up uninvited or pressure you.

Neither option is better than the other. They are different tools. Many people use both: SHIP to learn, then an agent to enroll.

Questions to ask before you commit

Whether you sit down with a counselor or an agent, bring a list. Useful questions include:

• Are my current doctors and hospitals in the plan's network?
• Are my prescriptions on the plan's formulary, and in which tier?
• Does the plan work with the pharmacy I already use?
• If I travel out of state, how am I covered?
• What happens if I want to switch back to Original Medicare later?

Denton County had 77 Medicare Advantage plans available for 2026 from 12 carriers, so narrowing the field by asking the right questions matters more than looking at every option. The 2027 lineup is in each plan's ANOC and on Medicare.gov's Plan Finder.

Program facts worth knowing for 2027

A few Medicare rules changed recently that are worth understanding before any meeting:

• Part D now has an out-of-pocket cap of $2,100 for 2026.
• The Part D maximum deductible is $615.
• The old coverage gap (the "donut hole") is gone as of 2025 — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments if you choose.
• IRMAA surcharges on Part B and Part D premiums begin above $109,000 in income for a single filer in 2026.
• Annual Enrollment Period: October 15 – December 7. Medicare Advantage Open Enrollment: January 1 – March 31.

Watch for red flags

Real help — from either kind of source — will never:

• Call or knock unannounced to sell you a plan.
• Ask for your Medicare number in an unsolicited call or text.
• Promise a specific dollar amount you will "save."
• Claim to represent Medicare or the government.

If any of that happens, hang up and report it to 1-800-MEDICARE or the Senior Medicare Patrol.