The Texas health insurance marketplace is HealthCare.gov a website where you shop for and buy health insurance. Texas doesn’t run its own marketplace. Instead, the federal government operates it.
You use the marketplace to:
- Compare health plans side-by-side
- See if you qualify for discounts (called subsidies)
- Enroll in coverage that starts on a specific date
- Get help from licensed agents
It’s like an online store for health insurance, but with financial help for people who qualify.
How Does the Health Insurance Marketplace Work?
The Simple Process
Step 1: Go to HealthCare.gov and create an account
Step 2: Answer questions about your household and income
Step 3: See what plans you qualify for and how much they cost
Step 4: Pick a plan and pay your first month’s premium
Step 5: Get your insurance card in the mail
The whole process takes 30-60 minutes. The website tells you right away if you qualify for discounts.
What Plans Are Available?
The 4 Types of Marketplace Plans
Plans are grouped by “metal levels.” Higher metals = more coverage but higher monthly costs.
| Plan Type | What Insurance Pays | Your Monthly Cost | Best For |
| Bronze | 60% of costs | Lowest | Healthy people who rarely see doctors |
| Silver | 70% of costs | Medium | Most people (extra discounts available) |
| Gold | 80% of costs | Higher | People who see doctors regularly |
| Platinum | 90% of costs | Highest | Frequent medical care or prescriptions |
All plans cover:
- Doctor visits and hospital stays
- Prescription drugs and lab tests
- Emergency care and preventive care (free)
- Maternity and mental health services
- Pediatric dental and vision
Who Can Use the Texas Marketplace?
You Qualify If You:
- Live in Texas
- Are a U.S. citizen or legal resident?
- Don’t have affordable insurance from a job (affordable = costs less than 8.39% of your income)
- Aren’t in jail
Anyone can buy marketplace insurance. Subsidies are extra help based on income.
Do I Qualify for Lower Prices?
Income Limits for Subsidies in 2026
You may get discounts if your household earns between $15,060 and $60,240 per year (for one person).
2026 income ranges for premium tax credits:
- 1 person: $15,060–$60,240/year
- 2 people: $20,440–$81,760/year
- 3 people: $25,820–$103,280/year
- 4 people: $31,200–$124,800/year
Extra Discounts on Silver Plans
If you earn between $15,060 and $37,650 (for one person), Silver plans come with cost-sharing reductions. These lower your deductible, copays, and out-of-pocket maximum.
Tip: If you qualify for cost-sharing reductions, always pick a Silver plan to get the extra savings.
How Much Does Marketplace Insurance Cost in Texas?
Average Prices for 2026
Without subsidies: Average Silver plan costs $495/month
With subsidies: Average cost after discounts is $65/month
Many Texans pay $0–$50/month after subsidies.
What Affects Your Price?
Age: Older adults pay 3x more than younger people
Location: Houston and Dallas have lower prices than rural areas
Tobacco use: Smokers pay up to 50% more
Income: Lower income = bigger discounts
Plan type: Bronze is cheapest, Platinum is most expensive
Example Costs
A 35-year-old in Houston earning $35,000/year:
- Silver plan before subsidy: $425/month
- Tax credit: $355/month
- Final cost: $70/month
When Can I Enroll?
Open Enrollment for 2026
November 1, 2025 – January 15, 2026
Important deadlines:
- Enroll by December 15, 2025 → Coverage starts January 1, 2026
- Enroll December 16 – January 15 → Coverage starts February 1, 2026
Special Enrollment (Anytime)
You can enroll outside open enrollment if you:
- Lost your job or job-based insurance
- Got married or divorced
- Had or adopted a baby
- Moved to Texas from another state
- Became a citizen or legal resident
You have 60 days from the life event to enroll.
Texas Marketplace vs. Other States
What’s Different About Texas?
Texas uses HealthCare.gov
- No state-run website
- Federal customer service only
Texas hasn’t expanded Medicaid
- If you earn less than $15,060/year, you may fall in a “coverage gap”
- You won’t qualify for marketplace subsidies or Medicaid
- Exception: Pregnant women, children, and disabled individuals may qualify
Highest enrollment nationwide
- Over 2.9 million Texans enrolled in 2025
Highest uninsured rate
- About 16.6% of Texans have no insurance
How to Choose the Right Plan?
4 Questions to Ask
1. Can I afford the monthly premium?
This is what you pay every month, even if you don’t use insurance.
2. How much is the deductible?
Bronze plans have deductibles around $7,000. Silver plans average $3,500.
3. Are my doctors in-network?
Check the plan’s provider directory. Out-of-network care costs much more.
4. Are my prescriptions covered?
Look up your medications in the plan’s drug formulary.
Getting Help from Smart Insurance
Smart Insurance is a Texas-based insurance provider with licensed agents who help you:
- Understand your marketplace options
- Calculate your subsidy amount
- Compare plans based on your needs
- Enroll in coverage (we handle the paperwork)
Our enrollment help is always free. We also offer Auto Insurance, Home Insurance, Life Insurance, Renters Insurance, Commercial Auto Insurance, Flood Insurance, and SR22 coverage for your other insurance needs.
Call us or visit our website to speak with a Texas insurance specialist.
Frequently Asked Questions
What is the Texas health insurance marketplace?
The Texas health insurance marketplace is HealthCare.gov, where you shop for and buy health insurance plans. It’s run by the federal government and offers subsidies to lower your costs based on income.
When is open enrollment for 2026 in Texas?
Open enrollment runs November 1, 2025, through January 15, 2026. Enroll by December 15, 2025, for coverage starting January 1, 2026.
How much does marketplace insurance cost in Texas?
The average Silver plan costs $495/month before subsidies. After subsidies, most Texans pay $0–$100/month. Your exact cost depends on age, location, income, and plan type.
Can I get help signing up for marketplace insurance?
Yes. Smart Insurance offers free enrollment help from licensed Texas agents.
What if I earn too little for marketplace subsidies in Texas?
If you earn less than $15,060/year, you may fall into the coverage gap. Texas hasn’t expanded Medicaid, so many adults don’t qualify for help. Check if you’re eligible for traditional Medicaid categories.
