Texas residents can apply for health insurance through the federal marketplace at HealthCare.gov, through Medicaid or CHIP for those who qualify, or by purchasing a plan directly from an insurance company. The path that makes the most sense depends on your income, your household size, and whether you have access to employer-sponsored coverage. Here’s how each option works and what you need to get started.
Choose Your Coverage Path
Texas uses the federal health insurance marketplace rather than running its own state exchange. That means HealthCare.gov is the main portal for comparing and buying individual or family plans, and it’s where you go to find out if you qualify for premium tax credits that lower your monthly cost. If your income is low enough, you may qualify for Medicaid or the Children’s Health Insurance Program (CHIP) instead, both of which are administered by the Texas Health and Human Services Commission.
If you have a job that offers health benefits, that’s typically your simplest option. Employer plans enroll on their own schedule, usually when you’re first hired or during the company’s annual enrollment window. Everything below applies to people who need to find coverage on their own.
When You Can Apply
The federal marketplace has a yearly open enrollment period, generally running from November 1 through mid-January. The most recent open enrollment window closed on January 15, 2026. Outside of that window, you can only enroll through a Special Enrollment Period triggered by a qualifying life event.
Qualifying life events fall into four categories:
- Loss of coverage: Losing a job-based plan, aging off a parent’s plan at 26, or losing eligibility for Medicaid, Medicare, or CHIP.
- Household changes: Getting married or divorced, having a baby, or adopting a child.
- Moving: Relocating to a new ZIP code or county, including students moving for school and seasonal workers moving for employment.
- Other events: Becoming a U.S. citizen, leaving incarceration, gaining membership in a federally recognized tribe, or experiencing income changes that affect your eligibility.
After a qualifying event, you typically have 60 days to select a plan. Medicaid and CHIP, on the other hand, accept applications year-round with no enrollment window.
What You Need Before You Apply
Gather a few key pieces of information for everyone in your household who needs coverage. Having everything ready before you start will keep the application from stalling halfway through.
- Social Security numbers (or document numbers for legal immigrants)
- Dates of birth for each household member
- Employer and income information: Pay stubs, W-2 forms, or your most recent tax return. The application uses your projected annual household income to determine whether you qualify for financial help, so estimate carefully.
- Current health insurance policy numbers, if anyone in the household already has coverage
- Immigration documentation, if applicable
HealthCare.gov offers a printable checklist you can download before starting your application to make sure nothing is missing.
Applying Through HealthCare.gov
Start at HealthCare.gov and create an account. The application asks about your household size, income, and whether you have access to other coverage. Based on your answers, the system will tell you if you qualify for premium tax credits (subsidies that reduce your monthly premium) or if your income qualifies you for Medicaid or CHIP instead. If you’re directed to Medicaid, the application will route you to the state program.
Once you’re approved for marketplace coverage, you’ll see a list of available plans in your area sorted by metal tier: Bronze, Silver, Gold, and Platinum. Bronze plans have the lowest premiums but highest out-of-pocket costs when you use care. Platinum plans flip that equation. Silver plans are worth a close look if your income qualifies you for cost-sharing reductions, which lower your deductibles and copays on Silver-tier plans specifically.
After selecting a plan, you’ll need to pay your first month’s premium before coverage begins. Plans chosen during open enrollment typically start on the first of the following month, though exact start dates depend on when you enroll.
Applying for Medicaid or CHIP
Texas has not expanded Medicaid under the Affordable Care Act, so eligibility is more limited than in many other states. Medicaid in Texas primarily covers children, pregnant women, parents and caretakers with very low incomes, and people with disabilities. Single adults without dependents generally do not qualify regardless of income.
CHIP covers children in families with income too high for Medicaid but too low to comfortably afford private insurance. Income thresholds vary by household size and are based on percentages of the federal poverty level. For a family of four, CHIP eligibility extends to roughly 200% of the federal poverty level. Pregnant women qualify at a higher income threshold.
You can apply for Medicaid or CHIP in several ways:
- Online: Through YourTexasBenefits.com, the state’s benefits portal
- By phone: Call 2-1-1, Texas’s health and human services helpline
- In person: Visit a local Texas Health and Human Services office
- Through HealthCare.gov: If your marketplace application shows you may qualify, it will refer your information to the state
There is no monthly premium for Medicaid. CHIP charges low premiums and copays that vary by income level. Both programs accept applications at any time of year.
Getting Free Help With Your Application
You don’t have to navigate the process alone. Texas has a network of certified navigators and application counselors trained to walk you through your options at no cost. These helpers can explain plan differences, assist with paperwork, and troubleshoot application issues.
To find someone near you, use the “Find Local Help” tool on HealthCare.gov. Enter your ZIP code, and it will show certified navigators, community health centers, and other organizations in your area that offer enrollment assistance. Many county public health departments also run their own navigation programs with staff certified through both the state and federal systems. You can get help in person, over the phone, or sometimes by video appointment depending on the organization.
Licensed insurance brokers can also help you compare and enroll in marketplace plans. Brokers are paid by the insurance company, not by you, so their assistance is free to the consumer. Just confirm that any broker you work with is certified to sell marketplace plans if you want to access premium tax credits.
Buying Directly From an Insurer
You can also purchase a health insurance plan directly from a company like Blue Cross Blue Shield of Texas, Ambetter, Molina, or other carriers operating in your area. Going direct gives you access to the same plans you’d see on the marketplace, and sometimes a few additional options not listed on HealthCare.gov.
The trade-off is important: if you buy off-marketplace, you cannot receive premium tax credits, even if your income would otherwise qualify. For most people whose household income falls between 100% and a few hundred percent of the federal poverty level, applying through HealthCare.gov will result in significantly lower monthly costs. Buying direct makes the most sense if your income is high enough that you wouldn’t qualify for subsidies anyway and you want a plan not available on the marketplace.
After You Enroll
Once you’ve picked a plan and paid your first premium, keep a few things in mind. Your insurer will mail you an insurance card, but you can often access your member ID online or through the insurer’s app right away. Verify that your preferred doctors and any medications you take are covered under the plan’s network and formulary before your first appointment.
Report any life changes to the marketplace throughout the year. A new baby, a raise, a job loss, or a move can all affect your subsidy amount or your eligibility. Failing to update your income could mean owing money at tax time if your credits were too large, or missing out on savings if your income dropped.