Texas open enrollment runs from November 1 to January 15 on HealthCare.gov. To have coverage start January 1, pick a plan by December 15.
Two insurers are leaving, most proposed rates are rising, and the extra federal savings are gone. Here's what to check before you renew. A licensed agent can also help for free at 888-730-6031.
- Pick a plan by December 15 for January 1 coverage, or by January 15 for February 1.
- Cigna and Baylor Scott & White are leaving the Texas marketplace.
- Texas insurers proposed an average increase of about 13% before subsidies.
- Premium tax credits now stop above 400% of the poverty level, about $63,840 for one person.
- Update your income first, then compare plans instead of auto-renewing.
Texas Open Enrollment Dates and Deadlines
Because Texas uses HealthCare.gov, the Texas health insurance enrollment period follows the federal calendar. Your enrollment date decides when your coverage begins. For a full overview of how the yearly window works, see our guide to what open enrollment is.
| Date | What happens in Texas |
|---|---|
| November 1 | Open Enrollment begins. Renewal letters arrive by this date. |
| December 15 | Last day to enroll or switch for coverage that starts January 1. |
| January 1 | Coverage begins if you enrolled by December 15 and paid your first premium. |
| January 15 | Open Enrollment ends. Plans picked December 16 to January 15 start February 1. |
| After January 15 | You need a qualifying life event to enroll or switch. |
Source: HealthCare.gov dates and deadlines.
These dates could still move. A federal court struck down a rule that would have ended enrollment on December 15.
However, the government has appealed, according to healthinsurance.org's deadline tracker. For that reason, don't wait until January to act.
Also, Texas Medicaid and CHIP accept applications all year. You can apply for them at any time.
What's Changing in the Texas Marketplace
Fewer insurers and higher sticker prices are the two big changes this Texas open enrollment. Nearly 4.2 million Texans picked a plan in the last round of Texas marketplace enrollment. So, many households will feel them.
Insurers Leaving and Joining
Fifteen insurers plan to sell Texas marketplace plans, down from sixteen. Cigna and Baylor Scott & White are leaving. Meanwhile, Antidote Health Plan is entering the state.
If your insurer leaves, HealthCare.gov will match you with a plan from another company. That plan may not include your doctors. So, read our guide on what to do when your insurer leaves the marketplace and compare before December 15.
Proposed Rate Changes by Insurer
Most Texas insurers asked for higher rates. Nationally, insurers proposed a median increase of 15%, according to KFF. Here is how several Texas insurers compare.
| Insurer | Proposed average change (before subsidies) |
|---|---|
| Ambetter (Celtic Insurance) | +1.3% |
| Blue Cross Blue Shield of Texas | +8.9% |
| Oscar | +9.6% |
| Ambetter from Superior HealthPlan | +11.1% |
| Molina | +13% |
| UnitedHealthcare | +27.4% |
| Texas average | About +13.1% |
Source: Texas rate filings compiled by healthinsurance.org. Final approved rates may differ. Your net price depends on your subsidy and county.
Other Changes to Know
- HSA-eligible Bronze plans: every Bronze and Catastrophic marketplace plan now works with a health savings account.
- Immigration status rules: premium tax credits are now limited to certain statuses, such as lawful permanent residents.
- No extra pandemic-era savings: the enhanced tax credits have ended.
A licensed Vivna agent can compare Texas plans in your county at no cost. Call 888-730-6031 or request a free quote online.
How Subsidies Work in Texas Now
Subsidies still lower most Texans' premiums, but the rules are stricter. Last season, almost 92% of Texas enrollees received a tax credit. On average, it paid $667 a month toward their premium.
Now, the credit stops once income passes 400% of the federal poverty level. That limit is often called the ACA subsidy cliff. The table shows where it falls for common household sizes.
| Household size | 100% of poverty level | 400% of poverty level |
|---|---|---|
| 1 person | $15,960 | $63,840 |
| 2 people | $21,640 | $86,560 |
| 3 people | $27,320 | $109,280 |
| 4 people | $33,000 | $132,000 |
Based on the federal poverty guidelines used for the coming plan year, as reported in the healthinsurance.org subsidy guide.
Between 300% and 400% of the poverty level, you pay up to about 10.2% of income for the benchmark plan. Below that level, your expected share is smaller. Our guide to health insurance subsidies explains the full formula.
Texas has not expanded Medicaid. As a result, adults under 100% of the poverty level usually can't get marketplace savings. See our options for low-income coverage without Medicaid if that sounds like you.
Should You Let Your Plan Auto-Renew?
Usually, no. Auto-renewal keeps you covered, but it rarely finds the lowest price or the right network. Texas open enrollment is the right time to check.
If you do nothing by December 15, HealthCare.gov may re-enroll you automatically. You could land in your current plan or a similar plan from the same company. In addition, your savings will be based on old information unless you update your application.
During Texas open enrollment, run through this quick check before you accept a renewal:
- Update your income for the coming year on your application.
- Confirm your doctors with our find a doctor in my network tool.
- Check your prescriptions on each plan's drug list.
- Compare total yearly cost, including premium, deductible and out-of-pocket maximum.
Even after December 15, you can still switch until January 15. Learn more in our guide to renewing your health insurance.
How to Enroll in a Texas Marketplace Plan
You can enroll on HealthCare.gov yourself, or you can get free help from a licensed agent. Either way, these steps keep the process simple.
- Gather income details, household members, your current plan and your doctor list.
- Update your application with your expected income.
- Compare plans by total yearly cost, not just the monthly premium.
- Check each plan's network and drug list.
- Choose a plan by December 15 and pay your first premium.
Depending on your county, our agents can compare plans from insurers such as Ambetter, Oscar, Molina and UnitedHealthcare. Our Texas health insurance guide covers plan types and local options in more detail.
If You Miss the Enrollment Deadline in Texas
After Texas open enrollment closes on January 15, you need a qualifying life event to buy a marketplace plan. Common examples include moving, losing other coverage, getting married or having a baby.
For many events, you have 60 days to enroll. If you lose Medicaid or CHIP, the window is 90 days, according to HealthCare.gov. Our guide to buying health insurance after open enrollment walks through each option.
In Texas, Vivna also offers short-term health insurance from UnitedHealthcare to bridge a gap. However, it is not ACA coverage, may exclude pre-existing conditions and requires health questions.
Texas Open Enrollment FAQs
Can I change my plan after December 15?
Yes. Texas ACA open enrollment lets you switch plans until January 15. A plan you pick between December 16 and January 15 starts February 1.
After January 15, you'll need a qualifying life event to change plans. So, if a January 1 start matters to you, choose by December 15.
What happens if my insurer leaves the Texas marketplace?
HealthCare.gov will usually match you with a plan from a different insurance company. Your renewal letter names that new plan.
The new plan may use a different network, so check your doctors and drugs before December 15. You can still pick a different plan instead.
Can I get a subsidy if I earn more than 400% of the poverty level?
Not under current federal rules. You can still buy a marketplace plan at full price during the same enrollment window.
Other choices may include a Bronze plan with an HSA or, if you're healthy, a short-term plan. See our options without subsidies to compare them.
Does it cost anything to use a licensed agent?
No. Our help is free because insurers pay us. Your marketplace premium is the same whether you enroll alone or with an agent.
An agent can also compare plans across insurers in your county. You can find more answers in our Texas health insurance FAQ library.
Next Steps for Texas Open Enrollment
Texas open enrollment is your one yearly chance to fix a plan that no longer fits. First, update your income. Next, check your doctors and drugs, and then compare plans before December 15.
Ready for help? Call a licensed Vivna agent at 888-730-6031, Monday through Friday, 9 a.m. to 6 p.m. Eastern. You can also visit our open enrollment health insurance page for plan comparisons.
Sources
- HealthCare.gov: When can you get health insurance? (dates and deadlines)
- HealthCare.gov: Renew, change, update, or cancel your plan
- HealthCare.gov: Special Enrollment Periods
- healthinsurance.org: Texas health insurance marketplace
- healthinsurance.org: Will you receive an ACA premium subsidy?
- healthinsurance.org: Open enrollment deadlines
- KFF: How much and why ACA marketplace premiums are going up
Related Guides
- What is open enrollment?
- Open enrollment deadlines by state
- Your open enrollment checklist
- Florida open enrollment guide
- Why premiums are going up
About the author: Heather Sprague
Heather is the owner and agent of record at Vivna Insurance, a licensed independent agency in Deerfield Beach, Florida. She helps families and self-employed workers compare marketplace, short-term and supplemental plans.
Licensed health insurance agent, Vivna Insurance (Agency NPN 19168641). Call 888-730-6031.
Reviewed by Michael Sprague, licensed health insurance agent.
Vivna Insurance is a licensed independent agency, not a government website, and is not HealthCare.gov. Our help is free; we are paid by the insurance companies we work with. Plan availability, rates and savings vary by county and income.
Get Local Help in Texas
Plans, networks and county programs differ across Texas. Start with your city guide below.
See every city we cover on the Texas health insurance page, or read our Texas health insurance questions and answers.
Prefer to talk it through? Call 888-730-6031 Monday through Friday, 9 a.m. to 6 p.m. Eastern, for free help from a licensed agent.
