Health Insurance Options in Texas: From Employer Plans to Medicaid and the Marketplace

Texans have multiple pathways to health coverage, depending on income, employment, age, and family status.

1. Employer-Sponsored Insurance

Many employers offer group plans. Check eligibility, premiums, and network with your HR department.

2. Health Insurance Marketplace (HealthCare.gov)

• Open Enrollment: Typically Nov 1 – Jan 15 annually.
• Subsidies: Premium tax credits and cost-sharing reductions available for incomes 100%-400% of the federal poverty level (and temporarily higher under recent legislation).
• Plans categorized by metal tiers (Bronze, Silver, Gold, Platinum) balancing premium vs. out-of-pocket costs.

3. Medicaid (Texas Health and Human Services)

Covers low-income adults, children, pregnant women, seniors, and people with disabilities. Eligibility is stricter in Texas than in expansion states. Apply via YourTexasBenefits.com or a local HHS office.

4. CHIP (Children's Health Insurance Program)

Low-cost coverage for children in families earning too much for Medicaid but unable to afford private plans. Same application portal as Medicaid.

5. Medicare

Federal program for age 65+ and certain younger people with disabilities or end-stage renal disease. Enroll via Social Security Administration (SSA).

6. Private Individual Plans

Purchased directly from insurers or brokers outside the Marketplace. No subsidies, but may offer different networks or benefits.