If you buy your own health insurance in Texas, your window to sign up for next year opens November 1. Texas does not run its own exchange, so open enrollment in Texas happens on HealthCare.gov, the federal Health Insurance Marketplace. This guide walks you through it step by step for coverage starting January 1: the dates, what to gather before you apply, how the tax credit works, and why Texas Medicaid and CHIP have a separate front door. It works the same whether you live in Houston, Dallas, Fort Worth, San Antonio, Austin, El Paso, or the Rio Grande Valley.
This article is educational. Instant Health Help is a licensed health insurance agency, and our agent, Lobsang Rivas, holds an active non-resident health insurance license in Texas. We are not HealthCare.gov, CMS, Texas Health and Human Services, or an insurance company. We do not quote prices or name plans here, and results depend on your income, ZIP code, and household. Check the official dates on HealthCare.gov.
The short answer
- Texas uses HealthCare.gov. CMS lists Texas as a federally facilitated Marketplace state, so there is no separate Texas exchange website for individual plans.
- Open enrollment runs November 1 to January 15. Pick a plan by December 15 for coverage that starts January 1.
- Gather your paperwork first. Social Security numbers, addresses, tax filing details, and a best estimate of next year’s household income make the application go faster.
- The premium tax credit can lower your monthly premium. It is based on your household and the income you expect next year, and it is settled up when you file your federal taxes.
- Texas Medicaid and CHIP are run by the state. You can apply directly at Your Texas Benefits, and HealthCare.gov will send your information to the state if it looks like someone in your household qualifies.
Texas open enrollment dates for coverage starting January 1
| What | When |
|---|---|
| Open enrollment starts | November 1 |
| Last day to pick a plan for coverage starting January 1 | December 15 |
| Coverage starts for plans picked by December 15 | January 1 |
| Open enrollment ends | January 15 |
| Coverage starts for plans picked December 16 to January 15 | February 1 |
In both cases your coverage starts only after you pay your first premium. After January 15, you can generally enroll or change plans only if you qualify for a Special Enrollment Period because of a life event, like moving, losing other coverage, getting married, or having a baby.
Does Texas have its own health insurance marketplace?
No. For next year’s plans, CMS lists Texas among the states that use the federally facilitated Marketplace. That means you apply, compare plans, and get any savings through HealthCare.gov, whether you apply on your own, by phone with the Marketplace Call Center, or with a licensed agent. For a Texas overview of how we help by phone and online, see our Texas ACA health insurance help page.
What to gather before you apply
HealthCare.gov publishes a checklist of what the application asks for. Having these ready saves time:
- Basic information for you and everyone in your household, including names, dates of birth, and how each person is related to you, even people who are not applying
- A Social Security number for each person, including household members who are not applying for coverage
- Home and mailing addresses for everyone applying
- Immigration document information for any lawfully present immigrant who needs coverage
- How you file your federal taxes, such as jointly or separately if you are married, and who you claim as a dependent
- Income information for everyone in the household, like W-2s and pay stubs, net self-employment income, unemployment, Social Security, and retirement or pension income
- Your best estimate of household income for next year. It is fine to estimate. If it changes, you update it later
- Current coverage details, including policy numbers if anyone has coverage now
- Job coverage information for anyone who is offered a health plan at work, even if they are not enrolled in it
- An HRA notice from an employer, if anyone is offered help paying for coverage through an individual coverage HRA
You can download the full checklist from the HealthCare.gov get ready to apply page.
How to sign up on HealthCare.gov, step by step
- Log in or create your HealthCare.gov account. If you already have Marketplace coverage, log in to the account you used last time.
- Choose Texas and start your application for coverage starting January 1. List everyone in your tax household.
- Enter your income estimate for next year. Your savings are based on the income you expect for the year you want coverage, not last year.
- Submit and read your eligibility results. They show whether you qualify for a premium tax credit or extra savings, or whether someone may qualify for Texas Medicaid or CHIP.
- Compare plans at your ZIP code. Look past the monthly premium to the deductible, copays, out-of-pocket maximum, and whether your doctors and prescriptions are covered.
- Pick a plan by December 15 and pay your first premium so coverage can start January 1.
Already covered through HealthCare.gov this year? Starting November 1, you can log in, update your application with any changes you expect for next year, and compare plans before you renew.
Other ways to apply: you can call the Marketplace Call Center at 1-800-318-2596 (TTY 1-855-889-4325), find trained local help by ZIP code, work with a licensed agent or broker, use an approved enrollment partner, or mail in a paper application. Paper applicants get eligibility results by mail within 2 weeks.
Tax credit basics in plain English
- What it does: the premium tax credit lowers your monthly Marketplace premium. It is based on your household information and the income you estimate on your application.
- Who it is for: HealthCare.gov says households with income between 100% and 400% of the federal poverty level qualify for the premium tax credit in all states.
- You choose how to use it: you can take all, some, or none of it in advance to lower your monthly payment.
- It gets settled at tax time: you file IRS Form 8962 with your federal return, using the Form 1095-A from the Marketplace. If you used more credit than you qualified for based on your final income, you pay back the difference. If you used less, you get the difference back as a refund or a lower tax bill.
- Only through the Marketplace: you can buy health insurance other ways, but the Marketplace is the only way to get the premium tax credit, and in Texas the Marketplace is HealthCare.gov.
- Extra savings come with Silver: if your income qualifies for extra savings, called cost-sharing reductions, you get them only on a Silver plan.
HealthCare.gov says next year’s income levels and savings amounts go up on November 1, so wait for your own eligibility results before you decide.
Texas Medicaid and CHIP: a separate application
Medicaid and the Children’s Health Insurance Program (CHIP) in Texas are run by Texas Health and Human Services (HHSC), not by HealthCare.gov plans. Two ways in:
- Apply directly with the state at YourTexasBenefits.com, the state’s benefits site. With an account you can check your application status, report changes, renew, and upload items the state asks for.
- Apply through HealthCare.gov. If it looks like anyone in your household qualifies for Medicaid or CHIP, HealthCare.gov securely sends your information to the state, and the state contacts you about enrollment.
You can apply for Medicaid and CHIP any time of year, not just during open enrollment. Texas HHSC says a child can get CHIP if the child is 18 or younger, lives in Texas, is a U.S. citizen or qualified non-citizen, and is in a family that meets the income guidelines. See CHIP on the Texas HHS site for the current guidelines. HHSC decides who qualifies.
One household can end up split: for example, children on Medicaid or CHIP and parents on a Marketplace plan. HealthCare.gov notes that in many cases, if you qualify for savings on a Marketplace plan, your children will qualify for either Medicaid or CHIP.
Protect your information
HealthCare.gov warns never to share your information with anyone offering cash, gifts, or other perks to sign you up. Your plan and any savings always come through HealthCare.gov, even when someone helps you apply. A licensed agent should be able to give you a name and license number you can look up.
Frequently asked questions
When is open enrollment in Texas?
For coverage starting January 1, HealthCare.gov lists open enrollment as November 1 through January 15. Pick a plan by December 15 for a January 1 start. Plans picked December 16 through January 15 start February 1.
Do Texans sign up on HealthCare.gov?
Yes. Texas uses the federal Marketplace, so individual and family Marketplace plans and the premium tax credit come through HealthCare.gov.
What documents do I need to apply?
Social Security numbers for your household, addresses, tax filing details, income information, a best estimate of next year’s income, and details about any current or job-based coverage. HealthCare.gov’s checklist lists everything.
Can I apply for Texas Medicaid or CHIP on HealthCare.gov?
You can start there. If someone looks eligible, HealthCare.gov sends the information to the state. You can also apply directly at YourTexasBenefits.com. Texas HHSC makes the decision.
How Instant Health Help can help
We help Texas residents by phone and online, in English or Spanish. We go over who needs coverage, your ZIP code, your income estimate, your doctors, and your prescriptions, then walk through the HealthCare.gov application with you and compare the plans available at your address. If someone in your household may fit Texas Medicaid or CHIP better, we will explain the difference and point you to the right application.
Want help signing up before December 15?
Have your income estimate and your list of doctors and prescriptions ready, and we will walk through open enrollment with you step by step.
Call (321) 315-0054 | agent@inshh.com
Helping Texas residents statewide by phone and online: Houston, Dallas, Fort Worth, San Antonio, Austin, El Paso, the Rio Grande Valley, and communities across the state.
You may qualify after tax credits. Eligibility varies.