To be eligible for Medicaid in Texas, you must be a resident of the state of Texas. A U.S. federal law. The U.S.
requires individual and small employer plans to cover 10 types of health care services, called essential health benefits. In addition, Texas requires that some plans include certain health benefits. Some plans may cover more services, such as dental and vision care for adults and weight-management programs. We make it easy to find the Texas Affordable Care Act coverage that fits your needs. If you already have health insurance, for example, through your work or your spouse's work, Medicare or some other health insurance, you probably won't have to change anything.
When the Affordable Care Act (ACA) comes into play is when you don't have health insurance, that's when you could end up paying a fine. The government created a health insurance marketplace to help you get coverage at an affordable price. However, you may be able to avoid the government market by taking out health insurance through an authorized insurance broker, such as eHealth, where you can have a wider selection of plans. You must have health insurance, but it doesn't have to be through the government. You can visit the website of the federal online health insurance marketplace or contact an authorized insurance broker, such as eHealth.
If you qualify for a subsidy, you can visit the federal marketplace or an authorized web broker, such as eHealth, can help you enroll in a plan that qualifies for a subsidy through a non-governmental site. Keep in mind that your coverage must include certain benefits to meet the ACA guidelines. Among these guidelines are the 10 essential health benefits listed below. There may be other health insurance that is also acceptable.
If you have questions, you can call the government's Marketplace call center (contact information below).However, if you don't have health insurance, you must get it or you could face a possible fine. Eligibility for Obamacare in Texas is quite broad. You have to live in the United States (the ACA is basically national) and be an American. You can't be in prison and get Obamacare; you'll have to wait until they put you in freedom.
The Texas Department of Criminal Justice has information on health coverage for prisoners. Texans who have Medicare cannot use the Marketplace to get a medical or dental plan. Learn about your Medicare health plan options. You can apply, but only people who are in certain situations will qualify. These are just a few of the situations that may qualify you for Obamacare if you are not an American.
For more information on how to apply if you are not a U.S. citizen, visit the official government website. If you have a health problem, according to the rules of the ACA, no insurance company can deny you coverage just because of that health problem health. However, if you smoke, you may have to pay a higher monthly premium.
The government health insurance market includes several types of plans, and each plan can have up to four levels. The health insurance market assigns metallic names to different levels of coverage, from the highest coverage rate (platinum) to the lowest coverage rate (bronze). The higher the coverage rate, the higher your monthly premium is likely to be tall. Catastrophic is a separate category, available only to people under 30 years of age or who have an exemption for economic hardship.
You may qualify for an exemption for financial hardship if your situation prevents you from obtaining health insurance; for example, if you are homeless (or have recently been), you may qualify. Catastrophic plans generally cover less than 60% of your health care costs on average, and premiums are often lower than those of standard health plans, but you may have to pay a substantial deductible before the plan pays for your care. Some Americans who need health insurance can use state health bags. For those states, such as Texas, that have not established such a system, you can apply for it through the federal health insurance market.
You can also get health insurance through an authorized insurance broker, such as eHealth. In the case of Texas (and other states that use the federal market), you can even apply for a government grant through the easy-to-use eHealth website, instead of using a government-run website. If your household income is less than a certain amount, you can get a subsidy in the form of a premium tax credit to help you pay for health insurance, if you meet the requirements. And if you qualify, you can decide if you want the government to help you pay your monthly premium (making it an advanced tax credit for premiums) or if you want the government to give you the tax credit when you file your federal tax return.
First of all, you should know your household's income level. It may be helpful for you to have your latest federal tax return available. Another type of aid that some people call a subsidy is something the government calls pocket savings. If you qualify for a tax credit like the one described above and your income is below a certain level, you may be able to get help paying for your out-of-pocket health care expenses, such as copayments and deductibles. If your household income is between 100% and 250% of the federal poverty line, you may qualify.
These savings are only available when you have a Silver plan (see description above). Do you want to know if you could qualify for a subsidy? Simply use the eHealth subsidy calculator to get an estimate. Learn more about Obamacare health insurance subsidies. December 15 is the deadline for the application.
The exact start dates for coverage will depend on the policies and procedures of the health insurance company you choose and other factors, such as whether your request had any errors. In certain situations, you may qualify for a special enrollment period, usually if there has been a major change in your life, such as one of the events listed below. There is a specific set of events that the government calls vital events that qualify. When one of these events occurs, you may qualify for a special enrollment period, where you can apply for health insurance outside of the open enrollment period through the federal marketplace or through independent brokers, such as eHealth. If you think you might qualify for a special enrollment period, feel free to complete this form and get a personalized quote.
Your costs will depend on the health insurance plan you select. Remember to consider not only the monthly premium, but also the maximum amounts for copayment, coinsurance, deductible and out-of-pocket. If you have a small business in Texas, such as an independent business you own, you could also be affected by the Affordable Care Act. Under the law, you don't have to provide health insurance if you have fewer than 50 full-time employees or their full-time equivalent. However, if you offer this coverage, you may qualify for a tax credit.
To compare plans right away and find a plan that fits your needs, use our no-obligation plan comparison tool. STAR+PLUS is health care coverage for eligible low-income people who are elderly or have a disability. This program also covers office visits, prescription drugs and eye exams, as well as long-term services and support. Learn more about Texas health insurance options for seniors today. An overview from the Kaiser Family Foundation of Texas' progress toward creating a state health insurance exchange.
Depending on your income and other circumstances, you may also be able to get help reducing your monthly insurance premium (the amount you pay to enroll in coverage) and, possibly, your out-of-pocket expenses. Patients receive unexpected medical bills if they receive care outside their health plan's network without realizing it. Between premium subsidies and cost-sharing reductions, an ACA plan may be the most affordable health insurance option for you. Eligibility for financial assistance (premium subsidies and cost-sharing reductions) depends on your income and how it compares to the cost of the second lowest-cost Silver plan in your area, depending on your age and location.
You should always carefully read the plan information and the benefits of any insurance plan you're considering. If you buy it from an insurance company or at the grocery store, you can buy a plan that also covers your family. Several studies and reports show lagging health outcomes and a high rate of uninsured people nationwide, due, at least in part, to the decision not to expand Medicaid in Texas. The board of the Texas Institute for Health Care Quality and Efficiency recommended the expansion of Medicaid as a solution to what they called an “unacceptable number” of people without health insurance in Texas.
