Find Affordable Health Insurance In Texas

How To Get Health Care Insurance When You Are Not On An Employer’s Group Health Plan

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Major Medical Affordable Care Act Plans Texas

The Affordable Care Act (ACA) health insurance, sometimes known as Obamacare, extends medical coverage beyond doctor visits and surgical procedures. Most of the plans pay all or a portion of the price of your prescribed drugs, as well as other healthcare-related services such as rehab, nursing home care, physical therapy, and mental health care.

What It Is: Traditional health care coverage like you would have through an employer. Provides coverage for pre-existing conditions.

Cost: $400 – 700/month, per person. National average is $438.


When Is Federal Open Enrollment?

You can enroll in an ACA health plan during the Federal Open Enrollment period. Every year, from November 1 to January 15, this takes place.

When Is The Texas Open Enrollment Period?

Texas observes the annual federal open enrollment period, which lasts from November 1 to January 15.

Special Enrollment Periods

Outside of the federal Open Enrollment period, you can register for an ACA health plan within 60 days after a qualifying life event.

Types Of Qualifying Life Events:

  • Loss of health coverage. Losing existing health coverage, including job-based, individual, and student plans.
  • Changes in marital status (getting married/divorced)
  • Having a baby or adopting
  • Changes in residence. Moving to a different ZIP code or county

Texas Cities By Population

San Antonio
Fort Worth
El Paso
Corpus Christi
Grand Prairie

Temporary Medical Insurance In Texas

A temporary health insurance plan can offer you basic medical coverage. It’s a great solution for individuals looking to cover a gap between major medical health plans.

What It Is: These types of plans are for people in good health that do not need to treat pre-existing conditions.

Cost: Dependent on your age and state availability. Compared to ACA, these plans are very affordable.

Who Needs Temporary Health Insurance?

  • Individuals who missed the deadlines for the ACA exchanges and need to wait until the next enrollment period
  • Individuals who have a waiting period before enrollment in an employer’s health insurance or another program
  • People who are temporarily in between jobs or have been laid off
  • Self-employed individuals
  • People looking for a plan less expensive COBRA health insurance
  • Those needing temporary coverage:
    • College students or recent graduates
    • Young adults coming off their parent’s health benefit plan
    • Retirees waiting for Medicare eligibility
    • Coverage for dependents not covered under an employer plan

What Is COBRA Insurance?

According to the Federal COBRA Act, if a qualifying event causes an employee’s employer-provided health insurance to expire, the individual and any qualifying dependents may continue to be covered.

What It Is: A continuation of your most recent employer group health plan.

Cost: $400 – 700/month, per person. National average is $438.

COBRA coverage is offered for up to 18 months for employees and 36 months for families.

Within 45 days of losing the coverage, the employer who provides the work health insurance shall provide enrollment details for a COBRA plan.

Low-Income Health Insurance In Texas

The STAR managed care program provides coverage to the majority of Texas Medicaid recipients. STAR provides assistance to low-income children, pregnant women, and families. STAR members receive their services through the health plans they select.

If you are new to STAR, you will select a health plan among those offered in your service area. Learn more about selecting or changing your health plan.

Benefits from STAR

Members of the STAR program are eligible for Medicaid benefits such as:

  • Checkups with the doctor and dentist on a regular basis.
  • Vaccines and prescription medications
  • Hospital treatment and services
  • X-rays and laboratory testing
  • Eye and hearing care
  • Medical specialists and mental health care are available.
  • Special health needs and pre-existing conditions are treated.

Reporting Health Insurance Fraud In Texas

Ombudsmen for Texas Health and Human Services advocate for clients, while investigators look into reports of fraud and waste, and civil rights staff ensure clients receive services and benefits regardless of their race, color, national origin, sex, age, religion, or disability, and in some cases political beliefs and sexual orientation.

To report insurance fraud in Texas, contact the state Inspector General’s office. 


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