Individual Coverage

While most Texans are covered through their employer, millions of Texas’ entrepreneurs, small business owners, and others look for health insurance coverage on their own. That’s where the Affordable Care Act’s “individual market” kicks in, and in Texas, it’s stronger than ever.

Featured Resources

Keeping Health Care Affordable: Renewing Enhanced Tax Credits One-Pager

Uninsured Cliff Set for Texas

TAHP Food for Thought: Individual Market Tax Credits October 2025

Additional Resources

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Policy Papers

TAHP Presentations

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Testimonies

Comment Letters

Legislative Briefs

News

Presentation: Why Texas Stands to Lose Without Enhanced Tax Credits

Uninsured Cliff Set for Texas

Texas Is Hit Hardest with Loss of Tax Credits

Keeping Health Care Affordable: Renewing Enhanced Tax Credits One-Pager

Marketplace Health Coverage in Texas: What’s Changing in 2026

Individual Market Coverage 101

Millions of Texans Could Lose Coverage Without Congressional Action

Texas Organizations Support Raising Awareness of Coverage Options: SB 963/HB 3747

2024.09.05 State-Based Health Exchange Testimony for House Insurance

Texas Leads the Way: Top 5 Things You Should Know About the Individual Market

Last Call for ACA Enrollment: Record-Breaking 3.3 Million Texans Already Signed Up

Texas Leads the Way in Health Insurance Competition

Open-Enrollment at Healthcare.gov Set for 10 Year Anniversary

ACA sign-ups continue to surge in Texas

Prioritize Addressing Abuse in the Texas Commercial Market

Finding Health Coverage When You Lose Your Job: COBRA Is Not Your Only Option

Individual Health Coverage is More Affordable than Ever in Texas

Individual Market One-Pager

Testimony On HB 700: State-Based Exchange

Learn More About Health Coverage

Keeping Health Care Affordable: Renewing Enhanced Tax Credits One-Pager

Texas Organizations Support Raising Awareness of Coverage Options: SB 963/HB 3747

Individual Health Coverage is More Affordable than Ever in Texas

Individual Market One-Pager

Learn More About Health Coverage

Presentation: Why Texas Stands to Lose Without Enhanced Tax Credits

Marketplace Health Coverage in Texas: What’s Changing in 2026

Individual Market Coverage 101

2024.09.05 State-Based Health Exchange Testimony for House Insurance

Testimony On HB 700: State-Based Exchange

Uninsured Cliff Set for Texas

Texas Is Hit Hardest with Loss of Tax Credits

Millions of Texans Could Lose Coverage Without Congressional Action

Texas Leads the Way: Top 5 Things You Should Know About the Individual Market

Last Call for ACA Enrollment: Record-Breaking 3.3 Million Texans Already Signed Up

Texas Leads the Way in Health Insurance Competition

Open-Enrollment at Healthcare.gov Set for 10 Year Anniversary

ACA sign-ups continue to surge in Texas

Prioritize Addressing Abuse in the Texas Commercial Market

Finding Health Coverage When You Lose Your Job: COBRA Is Not Your Only Option

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1. How can I enroll in a health insurance plan during open enrollment?
Open enrollment for health insurance typically occurs annually from November 1 to December 15. During this period, you can enroll in or make changes to your health insurance plan through the Health Insurance Marketplace at HealthCare.gov. If you miss this window, you may qualify for a Special Enrollment Period due to certain life events, such as marriage, birth of a child, or loss of other coverage.

2. What are the health insurance options available in Texas?
Texans have several health insurance options, including:
  • Employer-Sponsored Insurance: Coverage provided by your employer.
  • Individual Plans: Purchased directly from insurance companies or through the Health Insurance Marketplace.
  • Government Programs: Such as Medicaid, the Children's Health Insurance Program (CHIP), and Medicare.
  • Short-Term Plans: Temporary coverage for specific periods.

3. Who is eligible for Medicaid and CHIP in Texas?
Medicaid: Available to low-income individuals, families, pregnant women, the elderly, and people with disabilities. Eligibility is based on income and household size.
CHIP: Provides health coverage for children in families that earn too much to qualify for Medicaid but cannot afford private insurance.
For detailed eligibility criteria, visit the Texas Health and Human Services website.

4. What is the Health Insurance Marketplace, and how does it work in Texas?
The Health Insurance Marketplace is a platform where individuals can compare and purchase health insurance plans. In Texas, the federal government operates the Marketplace through HealthCare.gov. You can compare plans, check for subsidies, and enroll during the open enrollment period.

5. Are there financial assistance options to help pay for health insurance?
Yes, depending on your income and household size, you may qualify for subsidies to lower your premiums and out-of-pocket costs. These include:
  • Premium Tax Credits: Reduce the amount you pay for insurance premiums.
  • Cost-Sharing Reductions: Lower your out-of-pocket costs for deductibles, copayments, and coinsurance.
Eligibility for these subsidies is determined through the Health Insurance Marketplace.

6. What should I consider when choosing a health insurance plan?
Consider these factors:
  • Premiums
  • Deductibles
  • Network of doctors and hospitals
  • Coverage of required medications and services
  • Out-of-Pocket Maximum
For more guidance, refer to the Texas Department of Insurance's Health Plan Shopping Guide.

7. What is a Special Enrollment Period, and how can I qualify?
A Special Enrollment Period (SEP) allows you to enroll in health insurance outside the annual open enrollment period if you experience certain life events:
  • Loss of Health Coverage
  • Household Changes (e.g. marriage, divorce, birth)
  • Residence Changes
To apply, visit HealthCare.gov.

8. How can I find out if my doctor is covered under a specific health plan?
Most insurance companies provide online directories of in-network providers. You can also contact the insurer directly or ask your doctor’s office to verify coverage.

9. Where can I get assistance with understanding and enrolling in health insurance?
Several resources are available: