Texas Health Insurance

Residents in the Lone Star state of Texas will find there is a multitude of health insurance plans to choose from and wide choice of insurance companies. With a lot of health plan options, you can find a policy that fits your health and budget needs.

To learn about Texas health insurance rules, regulations, and laws read the information below. You can also view some of the biggest health insurance companies in the state and read about the state’s public health insurance programs.

Search health insurance by state here if you don’t live in Texas.

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Resources on this page

Health Insurance Information and Regulations in Texas

Public Health Insurance Programs for Texas Residents

Texas Health Insurance High Risk Pools

Texas Health Insurance Companies

Contact Info for the Texas Department of Insurance and Health

Texas Health Insurance Stats

Total Texas Residents: 25,339,900
Median Annual Household Income: $49,195
Texas Health Care Expenditures (in millions): $146,735
Households with at least 1 Full Time Worker: 12,037,700
Texas Health Insurance Coverage based on Total Population:

• Employer: 45%
• Individual: 4%
• Medicaid: 16%
• Medicare: 10%
• Uninsured: 24%

Avg. Annual Employee Premium in TX employer-sponsored plan (after employer contrib.) $999
Avg. Monthly Texas Individual Premiums: NA
Total Texas HMO Enrollment: 3,293,520

Want more information about cities in Texas? View information on:

• Houston health plans
• Dallas health plans
• Austin health plans
• San Antonio health plans

Health Insurance Information and Regulations in Texas

There are different Texas health insurance laws and regulations that protect and guarantee certain health coverage.

Under Texas health insurance law, insurance companies in the state may not require an exclusion period for a pre-existing health condition for any HMO health plan. Other kinds of plans may require an exclusion period or an elimination rider.

Texas health insurance companies are allowed to consider pregnancy a pre-existing condition.

State law also requires Texas health insurance companies to offer at least one plan that covers certain medical services, including:

• Screening for breast, colorectal, prostate, cervical, and HPV cancer
• Coverage for certain diabetes treatment
• Continuity of care for pregnant women
• Newborn hearing screening
• Children's vaccinations

Individual Texas health insurance policies are guaranteed renewable in the state, which means insurers cannot cancel a policyholders plan because they become sick.

Texas health insurance law also allows grandparents to keep dependent grandchildren on their health plans until they turn 25 years old.

And like all American citizens and legal residents, Texas residents are protected by the federal health insurance laws, HIPAA and COBRA. Group Texas health insurance is also guaranteed to be issued for groups of 2 to 50 people.

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Texas Public Health Insurance Programs

• Medicaid
  This federal-and state-funded program provides health insurance coverage for some low-income residents of Texas. For more information on the Texas Medicaid program, visit their website at http://www.hhsc.state.tx.us/medicaid/index.html


• TexCare CHIP
  Texas' Children's Health Insurance Program, TexCare CHIP, provides health insurance for children who do not qualify for Medicaid coverage but are unable to afford a private plan. To learn more about this children's Texas health insurance program, visit their website.


• Texas Health Insurance Risk Pool
  Texas residents with pre-existing health conditions that cannot find a health plan may qualify for coverage in the Texas Health Insurance Risk Pool. For more info, visit http://www.txhealthpool.org/


• Texas Breast and Cervical Cancer Control Program
  This program offers some women who have been diagnosed with breast or cervical cancer full health insurance benefits through Medicaid. To learn more about this women's Texas health insurance program, visit http://www.dshs.state.tx.us/bcccs/.


• Texas Medicare
  Seniors who are eligible for Texas health insurance can find coverage through Medicare Advantage, Supplement or Original Medicare. Around 47,000 Texas residents may also benefit from Medicare Rx and community attendant services for dual eligible residents.


• HealthyTexas Program
  A new program called HealthyTexas is a statewide program for small business owners and employees. The program helps low income, small business workers who need Texas health insurance. Visit http://www.healthytexasonline.com for more information about this health insurance program.

Texas residents may also be able to get financial assistance in buying a health plan through the Federal Health Coverage Tax Credit. To see if you qualify for the health insurance tax credit, visit the Internal Revenue Service (IRS) online.

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Texas Health Insurance High Risk Pools

The Patient Protection and Affordable Care Act established national high risk pools to provide people with pre-existing conditions health insurance.

The Pre-Existing Condition Insurance Plan (PCIP) in Texas will be administered by the federal government and is not a public problem. Texas enrollees will have to pay monthly premiums and out-of-pocket costs like normal Texas health insurance plans.

PCIP enrollees will pay around the same amount that Texas residents without pre-existing conditions pay on the private health insurance market. Texas enrollees will have to pay a $2,500 deductible for covered benefits before the health insurance benefits kick in. There is also a $25 copayment for doctor visits and a copayment for prescription drugs.

Texas residents are eligible for enrollment in the Texas PCIP if they are a United States citizen, have been without insurance for six months and been denied health insurance coverage because of a medical condition.

For more information on the Texas health insurance high risk pools visit http://www.healthcare.gov/index.html.

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The following list of companies offer Texas health insurance plans:

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Texas Department of Insurance and Health

Find the contact Information for the Texas health insurance and health departments at:

Go to Top of the Texas Health Insurance Page