Moving to Texas and Need Health Insurance
We get these calls daily and luckily, we have some good news.
The move and better yet, a loss of coverage, is a qualifying event to enroll anytime of the year.
Usually, the next question is "Does Texas have Obamacare".
This can loosely be translated as, can I get a subsidy towards my choice of plan in Texas?
The answer is "yes" and we'll go through that below.
First, our credentials as licensed Texas health agents:
This is what we'll cover:
- How to get health insurance if I'm moving to Texas
- Getting the most Texas obamacare subsidy
- How to compare the plans in Texas
- Understanding the doctor networks in Texas
- A mover's guide to the carriers in Texas
- How to quote and enroll in Texas health plans with subsidy
Let's get started with everything you need to lock in a health plan in Texas. Welcome!
Reach out with any questions of course:
Call 800-320-6269
Chat online here
Pick a time to talk here
How to get health insurance if I'm moving to Texas
Let's walk through the common questions that come up when moving to Texas.
First, logistics.
Loss of coverage (from prior State) allows us to enroll as early as the first of the next month. That's the earliest...we can't get mid month effective dates unfortunately.
Usually, the prior plan will cover through the end of month so we want to coordinate this.
If for some reason, your prior coverage is ending mid month, we can get short term coverage for 30 days here.
Let's give an example.
You're moving to Texas May 15th. Your coverage will go through end of May from prior plan (you'll likely only have emergency coverage in Texas for back half of the month).
We can enroll you for June 1st but we need to process the plan by end of May to get June 1st.
Otherwise, it will push us out to July 1st.
We want to enroll within 60 days of the qualifying event (loss of coverage or the move itself).
Quick note...if we didn't have coverage before and we're using the move as the qualifying event, we need to enroll by the 15th of the month to get the next 1st as an effective date.
If you enroll in the back half of the month, we'll get the 1st AFTER the next 1st.
So, in our example above using the move as the qualifying event, if we enroll after May 15th, we'll get July 1st as our effective date.
Again, we can fill in gaps with short term but ideally, we apply early!
Texas does have Obamacare or the ACA coverage and it uses the Federal exchange. We'll explain how to adjust the current account.
This means you can get subsidies (the big deal with Obamacare) and the richer silver plans if eligible.
More importantly, there's no waiting period for pre-existing conditions and you can't be declined.
These rules are all Federal now so you're probably well-versed in them by now from the other State.
Let's turn our attention to pricing and most importantly, the subsidy!
Getting the most Texas obamacare subsidy
We have a whole guide on how to get the most out of the subsidy but a few tips since so many people get it wrong (understandable...it's confusing).
- First, income is the estimate for this year's AGI on the 1040 tax form; next April's filing
- Household is everyone that files together on the 1040 tax form even if not enrolling
It still goes by the Federal income guidelines which will match most other States (outside of California).
Here's the income chart:
Texas is different at the lower end in that below 100%, you're eligible for medicaid ONLY if you meet other requirements.
This means you may end up with nothing (subsidy, richer silver plans, medicaid, etc). Reach out to us if you're in this situation and we can help.
The income portion is where we see many people make mistakes that can prevent them from getting the most subsidy available to them.
Let us help you at zero cost for our assistance! Don't go this alone especially if your situation is in flux (from the move).
What about the actual plans available in Texas after moving there?
How to compare the plans in Texas
Luckily, the plans should feel pretty familiar as the benchmark plans are all standardized now at the Federal level.
Here's the Texas benchmark plans:
This makes it easier to compare and we have big guides on how to compare the Texas metallic plans.
There are even major medical Texas options including HSAs.
The move allows us to change our plan level as a qualifying event so a quick refresher:
- Bronze - high deductible, no/few copays for RX and doctor visits; high max-out-of-pocket
- Silver - mid deductible, copays for office and RX; high max
- Gold - low/no deductible, richer copays; still high max
- Platinum - no deductible, richest copays; mid max
If you're eligible for the silver 87 or 94 based on income, look no further!
Those are basically platinum level plans for the same price as the normal silver.
Otherwise, reach out to us and we'll go through the options to see where the sweet spot is in terms of value. We do it all day long and there's no cost for our assistance.
We just need dates of birth, zip code, and best estimate for this year's income.
What about doctors?
Understanding the doctor networks in Texas
After subsidy, the doctor networks are usually the next question but this may be less of an issue if you've just moved to Texas.
You're starting from scratch!
That being said, let's look at the rough strokes of the Texas obamacare doctor networks.
One note...the networks are identical on or off exchange as are benefits and pricing. Just a head's up for recent movers.
Currently, we have the following options in most areas:
- HMO - lowest price, smaller networks and care decisions are more "managed"
- EPO - works like a PPO but with no benefit out of network other than true emergency
- POS - HMO core network with some flexibility outside; not quite a PPO
There are no PPO plans available any longer on the individual family market (Obamacare).
We can get PPOs through a small business plan if you might be eligible. This is usually only important if we want to see providers in other States which may be the case if you're moving.
Big review on how to get PPO plans in Texas still.
HMO's really dominate the Texas individual market. This makes sense as the cost of underlying coverage has exploded and HMOs do the best job of containing this cost.
Our quoting tool will provide a doctor finder if you happen to have a provider in mind but the better bet for a new mover is to look at the carrier first since that drives breadth and quality of network.
Let's go there.
A mover's guide to the carriers in Texas
Picking a good carrier is half the battle if you're new to the State.
Here's the current top list:
- BCBS of Texas - the dominant carrier with roughly ½ the market; strong network
- Oscar - EPO networks is usually the driver here for people who want more control
- Ambetter - EPO and same effect
- United Health - up and coming (just joined the exchange) with massive nationwide footprint and expertise
You can probably stop there and be just fine. For people newly moving to Texas, BCBS of Texas is usually the safest bet and their pricing is generally #1 or 2 in a given market.
Remember, we can always change carriers/plans at open enrollment end of the year (see Texas obamacare open enrollment).
If it all seems brand new and you're just getting your Texas legs underneath you, BCBS is hard to beat unless the pricing is really off (very rare).
Speaking of which.
How to quote and enroll Texas health plans with subsidy
We make this free, fast, and easy here:
Remember...
- Income is the estimate for this year's AGI on the 1040 tax form; next April's filing
- Enter everyone on that 1040 even if not enrolling
We can help with this if your income is in flux (very likely from the move) to make sure it doesn't mess up your subsidy!
If you're already on an Exchange plan from the other state, that's okay, the enrollment option through the quote tool above will update the account since it's ultimately all through the Federal Exchange.
We'll help you through the entire process and there's zero cost. More importantly, you'll have a Texas health agent to lean on now and going forward.
Welcome to Texas. Reach out with any questions.
Call 800-320-6269
Chat online here
Pick a time to talk here