Obamacare In Texas: Complete Guide

What Is Obamacare?

Obamacare in Texas is a 2010 federal law that extended health insurance coverage to almost every Texan, including people who struggled to find insurance previously. Obamacare is available to most people, even if you can’t get insurance through your job, have a pre-existing condition, or face certain other situations. The law encourages everyone to sign up for a health care plan, but it also places rules and restrictions on insurance companies.

Many people call this program Obamacare, but its legal name is the Affordable Care Act or ACA. If you’re looking for Texas Marketplace insurance, that’s another term for the ACA. No matter what you call this program, it can help you find coverage for yourself and your family. Learn more about Obamacare in Texas and explore your healthcare options.

Obamacare In Texas: Complete Guide 1

Who is eligible for Marketplace insurance?

Texas Marketplace insurance is available through an online federal portal. This secure website allows you to explore different health care plans, then enroll in one that meets your needs. Many people are eligible for Obamacare in Texas

You can use the Marketplace if you meet these requirements:

  • You live in Texas
  • You’re a United States citizen, national, or are otherwise legally in the state
  • You’re not in prison
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Types and levels of health insurance

When you choose Marketplace insurance, Texas residents can choose from several different types of coverage. Obamacare in Texas provides a range of plans. Each plan can have up to four different levels of coverage. Explore the following healthcare options.

Types of plans

  • HMO or Health Maintenance Organization plans have a set list of doctors you can visit. You’re typically required to use one of your plan doctors, except during emergencies. Patients also need a referral to see a specialist.
  • PPO or Preferred Provider Organizations also use a network of providers. You can see doctors outside the network but will usually pay more for their services. You typically don’t need a referral when you have a PPO.
  • POS or Point of Service plans charge lower costs when you visit doctors within your network. You will need a referral for a specialist visit.

Plan levels

Obamacare in Texas allows health care plans to have up to four different levels. These are described with the names of precious metals, depending on the level of coverage. The more coverage you want, the higher your monthly costs are likely to be.

  • Platinum plans cover around 90% of costs
  • Gold plans cover around 80% of costs
  • Silver plans cover around 70% of costs
  • Bronze plans cover around 60% of costs

You’re responsible for the bills that your insurance doesn’t cover. The Texas Marketplace insurance offerings might sound complicated, but you don’t need to navigate the ACA system alone. Coverage2Care can help you make sense of your options.

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Will I pay a penalty if I don’t sign up?

Obamacare in Texas requires that everyone have healthcare coverage. If you didn’t sign up for an insurance plan, you would have faced a tax penalty under the original version of this law. This requirement has been repealed, but you are still required to have health coverage.

How to sign up for Obamacare in Texas

Texas uses the federal Marketplace instead of setting up a Texas insurance Marketplace site. This website is free to use and allows you to explore healthcare options for your family. Most people sign up for Obamacare in Texas using Healthcare.gov. However, there are other ways to sign up as well. 

You can sign up for health coverage through the following methods:

  • Online at Healthcare.gov
  • Over the phone at 1-800-318-2596 (TTY: 1-855-889-4325)
  • By mail
  • In-person with a Healthcare.gov representative
  • With an insurance broker such as Coverage2Care
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When do I sign up for Marketplace insurance?

Obamacare in Texas has an annual open enrollment period when anyone can apply for healthcare coverage. You normally apply for coverage at the end of the previous year. For example, the open enrollment period typically runs from November 1 to December 15. If you sign up for Texas Marketplace insurance during this time, your plan would take effect in January.

The Obamacare enrollment period was temporarily extended due to the COVID-19 pandemic but is expected to return to the usual schedule for 2022 coverage.

Like many healthcare plans, you can sign up for Marketplace Insurance in Texas during certain life events. You can enroll at any time if these situations apply to you:

  • You had a baby or adopted a child
  • You got married
  • You lost other insurance coverage
  • You moved

You can also enroll at any time if you qualify for certain subsidies or assistance programs.

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Obamacare plans for small businesses in Texas

The ACA makes it easier for small businesses to offer health insurance to their employees. If your company employs between 1 and 50 full-time employees, you can use the Small Business Health Options Program, or SHOP, to find coverage for your staff. SHOP plans allow you to work directly with insurance companies. You can also use a service such as Coverage2Care to navigate your options. These plans qualify your company for the Small Business Health Care Tax Credit, which allows you to pay lower premium costs. 

Company health insurance is a valuable tool to attract and retain the best job candidates. Explore your SHOP choices to see how you can support your staff and keep growing as a company.

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Ready to compare affordable healthcare options?

Texas Marketplace insurance doesn’t need to be complicated. Contact Coverage2Care today to learn about your choices. Whether you’re looking for individual coverage, need a plan for your family, or want to provide health insurance for employees, we can help you navigate Obamacare in Texas. Licensed Coverage2Care agents are ready to connect you with a plan that best fits your needs, goals, and budget.

We work with top carriers such as United Healthcare, Aetna, Humana, and many others. We can help you compare rates in minutes, plus uncover the benefits that are most important to you.

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