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8 Things You Need to Know About Health Insurance in Texas

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8 Things You Need to Know About Health Insurance in Texas

The CheckUp Team at

Updated: November 7, 2018    Published: November 1, 2018

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If you don’t know about Texas open enrollment, let’s start there. Open enrollment is the short nationwide time period during which you can join health insurance for next year.

For Texas residents, the open enrollment window is November 1st – December 15th. And if you miss this time frame like the Dallas Cowboys have been missing touchdowns lately, then you’ll have to have a special reason to get health insurance – or you won’t be able to sign up until next year. Here are eight key things to remember about Obamacare Texas open enrollment.

Eight Things You Should Know About Obamacare in Texas

Online Health Insurance Exchanges. This is where as a Texas resident you will go to enroll in the plan of your choice. Plans and coverage haven’t changed too much since last year. While there are eight companies few offer coverage in every county. The eight major carriers offering insurance in Texas are:

  • Ambetter
  • Sendero
  • SHA/Firstcare
  • Oscar
  • Community Health Choice
  • Christus
  • Molina
  • Blue Cross Blue Shield

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Shop around. Even if you like your plan, Texas health plans and doctor networks have changed. It’s always good to look at your options to see if there is one with less expensive rates. Health insurance comes in handy, so be cautious about cutting your coverage even if the government is no longer requiring it.

Now’s the time to make changes. Not only can you enroll in a new plan during this period, you can also choose a new plan from your current company. Plans may change and if they do, it is required they send you notice that they are doing so. It’s up to you, however, to make sure your physicians and medications are still covered in 2019.

Texas open enrollment is for health insurance only. If your employer offers health insurance, you will probably want to buy health insurance through them. Individual insurance plans typically cost more than employer group plans.  Open enrollment is not for insurance products you can buy year-round like auto, life insurance or long-term care insurance.

All ACA plans must include ten essential benefits. Those include outpatient care including chronic disease management, emergency care, hospitalization, pregnancy, and newborn care. Plus, medical services such as mental health and substance abuse. And prescription drug coverage, rehabilitation services, and devices, lab tests. They must also include preventive and wellness services, and dental and vision care for children.

Short-term plans are a better choice than before. In 2019 there will be another healthcare option for more Texans. Short-term plans are a low-cost solution for health insurance. These plans previously lasted for a maximum of 90 days, but in Texas they can last for 364 days.

These plans provide much lower monthly premiums, but much higher deductibles. So, if you need to see a doctor, you’ll likely end up paying more out-of-pocket. Additionally, these plans do not count as Affordable Care Act plans, meaning that they may not cover pre-existing health conditions or accept all Texans.

Texans can get federal credits. You may be eligible for a premium tax credit based on your income and the size of your family. Your household income must fall between 100 and 400 percent of the federal poverty level to qualify. In 2019 the income bracket for a family of four in Texas would be $25,100 to $100,400 to qualify for these credits.

Different plan options. You can generally choose between four levels of health insurance plans. Major medical plans for individuals and families are divided primarily into four categories, between bronze and platinum. Platinum plans are rare and expensive, but easier to find in Texas than in other states because the state is so large.

Silver plans are the most common plan type. If you meet the conditions for the tax credit as described above, and your income is below a certain level, you may also get assistance with paying your healthcare out-of-pocket costs, like deductibles and copayments. Your family income must be between 100 percent and 250 percent of the federal poverty level to qualify.

How to Enroll in Obamacare in Texas

Now that you understand how to join a plan, here’s how you can get your health insurance coverage. Enter your zip code below to see local health insurance choices. Remember, the health insurance Texas deadline is December 15th.

Get a Free Health Insurance Quote

  • Get an instant quote for health insurance plans
  • Compare prices from over 300 carriers
  • Find a plan that fits your budget
Please enter a valid US Zip Code

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