How to Get Health Insurance Quotes in Texas
Last updated · By Frank Caballero, licensed health insurance broker, NPN 21032307
Short answer
In Texas, self-employed people and families usually compare two kinds of quotes: private, medically underwritten plans priced on age, ZIP code and health, and Marketplace plans on HealthCare.gov, where household income sets any subsidy.
If approved, a private plan can start the first of any month; HealthCare.gov plans follow open enrollment unless you qualify for a special enrollment period.
Frank Caballero, a licensed broker (NPN 21032307), quotes both for Texas households from Houston to El Paso by phone or video, at no fee.
Texas at a glance
| Where ACA plans are sold | HealthCare.gov (the federal Marketplace) |
|---|---|
| Medicaid expansion | Not expanded |
| Open enrollment for 2027 coverage | Nov 1, 2026 – Jan 15, 2027 (Dec 15 for a Jan 1 start) |
| Private plan enrollment | Any month, if approved |
| 2027 subsidy line (400% of the poverty level) | $63,840 for one person; $132,000 for a family of four |
| 2027 Marketplace out-of-pocket maximum | $12,000 for one person; $24,000 for a family |
| 2027 average Marketplace rate change | 13.1% to 14.1% (final, 15 insurers filed) |
| Largest metro areas | Houston, Dallas–Fort Worth, San Antonio, Austin and El Paso |
What a quote takes
- Book a 15-minute call by phone or video, in English or Spanish. There is no fee.
- Have ready: your Texas ZIP code, everyone's ages, your doctors (in Houston, Dallas–Fort Worth or elsewhere), prescriptions, a rough income estimate for the HealthCare.gov side and your health history for the private side.
- Frank prices private plans from your health answers and Marketplace plans on HealthCare.gov from your income, and checks each network for your doctors.
- Next, a private application goes to the insurer for an underwriting decision; if approved, coverage can start the first of the next month. HealthCare.gov enrollment happens in open enrollment or a special enrollment period, with Frank's help.
Private plan vs. the Marketplace in Texas
| Feature | Private, medically underwritten plan | Marketplace plan (HealthCare.gov) |
|---|---|---|
| Priced on | Age, ZIP code and your health answers | Age and ZIP code; household income sets any subsidy |
| Coverage can start | The first of any month, if approved | After open enrollment, or after a qualifying event in a special enrollment period |
| Health questions | Yes, and approval depends on the answers | No |
| Networks | Many private plans use national PPO networks | Many Texas Marketplace plans are HMO or EPO networks inside the state |
| Benefits and pre-existing condition rules | Vary by plan; read the plan documents before you apply | Every plan covers essential health benefits and pre-existing conditions |
Texas used to allow long short-term plans, but under current federal rules they last only a few months and exclude pre-existing conditions. The private, medically underwritten PPO plans we quote are not short-term plans.
Texas rules that shape a quote
Texas buyers use HealthCare.gov, and the state has the second-largest Marketplace in the country with about 15 insurers filing for 2027. Texas requires insured group plans to offer state continuation, nine months for people without COBRA rights and six more months after COBRA ends, at the group rate plus 2 percent, though self-funded employer plans are exempt. Texas defines short-term plans by the federal rule rather than its own limit. Final 2027 individual increases average about 13 to 14 percent, with small-group plans up about 17 percent, which makes individual coverage reimbursement worth a look for small Texas employers.
Who usually starts with which
Price a private plan first
You are in good health, self-employed or a business owner, and your household income is above the Texas subsidy line of $63,840 for one person or $132,000 for a family of four. Above that line you pay the full HealthCare.gov premium, so a plan priced on health may cost you less.
Start with the Marketplace
You have health conditions that could affect a private approval, or your household income may qualify for a subsidy. Marketplace plans on HealthCare.gov cannot turn you down or charge more because of your health.
Common self-employed work in Texas: Oil and gas contractors in the Permian Basin and Houston, construction trades, owner-operator truck drivers on I-35 and I-10 and in Laredo freight, real estate agents, tech contractors in Austin, rideshare and delivery drivers, and ranching families.
Texas has about 3.5 million small businesses, and roughly 3.0 million of them have no employees, according to the SBA's 2025 profile built on 2022 Census data. The biggest group of these one-person firms is in transportation and warehousing, with about 396,000, followed by construction at about 376,000 and professional, scientific and technical services at about 357,000. Real estate adds about 257,000 more. Small businesses employ 5.1 million Texans, about 44 percent of the state's workers, yet most solo owners have no employer plan behind them.
Texas has the biggest individual market on HealthCare.gov. CMS counted 4,172,233 Texans choosing a plan in the 2026 open enrollment, about 5 percent more than the 3,966,226 a year earlier, and roughly 764,000 of them were new to the Marketplace. About 93 percent qualified for an advance premium tax credit, which leaves about 7 percent paying the full price, up from about 5 percent in 2025 after the enhanced credits expired. Census figures for 2024 show about 40 percent of Texas households earn $100,000 or more, and many of them sit above the subsidy line.
Business owners with employees
Texas small-group plans are rising about 17 percent on average for 2027, faster than the state's individual market. Insurance Code Section 1501.002 defines a small employer as one that averaged at least 2 and no more than 50 employees on business days in the prior year and has at least two employees when the plan year starts, so a one-person company does not qualify. Texas rules apply the same small-employer protections whether a plan is sold directly or through an association, and Chapter 1501 also lets employers band together in health group cooperatives.
Leaving a job or group plan
Texans leaving COBRA or state continuation shop on HealthCare.gov. Losing job-based coverage opens a 60-day special enrollment window, and you can apply up to 60 days before the old plan ends; choose a plan before then and the new one can start the first day of the next month. Dropping COBRA early by choice does not open a window, so time a voluntary switch for open enrollment. Questions about continuation rights go to the Texas Department of Insurance help line at 800-252-3439.
If you are self-employed in Texas, premiums for you and your family are often deductible on your federal return, whichever kind of plan you choose. General information, not tax advice — confirm with your CPA based on your specific entity structure.
2027 rates in Texas
Marketplace premiums in Texas are set to rise 13.1% to 14.1% on average for 2027 in finalized filings from 15 insurers, with small-group plans up about 16.9%; the Texas 2027 premium increase page has the details.
About your broker
Frank Caballero is a licensed health insurance broker, NPN 21032307, licensed in 31 states including Texas. He is based in Tampa and works with Texas clients by phone or video, in English and Spanish. There is no fee to the client. FC Insurance Solutions is BBB Accredited with an A rating and rated 4.9 on Google from 78 reviews. More about Frank · License list
Texas health insurance quote questions
Can I get a private health insurance quote in Texas outside open enrollment?
Yes. Private, medically underwritten plans can be quoted in Texas any time of year and, if approved, start the first of any month. Marketplace plans on HealthCare.gov need open enrollment or a special enrollment period, such as after losing other coverage.
How long does a Texas health insurance quote take?
About 15 minutes by phone or video. HealthCare.gov prices come from your ZIP code, ages and income estimate; private plans also need your health history, and the insurer decides after you apply.
Do I need to go through HealthCare.gov to get a Texas quote?
No. Texas uses HealthCare.gov. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027. A licensed broker can quote HealthCare.gov plans and private plans in the same call, and private plans are not sold through HealthCare.gov at all.
Is there a fee to use a health insurance broker in Texas?
No. Frank charges Texas clients nothing; the insurance company pays the broker, and you don't pay extra for the help.
What if I have a pre-existing condition in Texas?
Marketplace plans on HealthCare.gov cannot decline you or charge more because of your health, so HealthCare.gov is often the place to start. Private plans in Texas ask health questions, and approval depends on your answers.
Why is marketplace insurance so expensive in Texas without a subsidy?
Full price reflects the cost of covering everyone in the pool, including the sickest applicants, and Texas has a lot of them. A private plan is medically underwritten, so a healthy applicant pays a price based on their own health.
More for Texas
Official sources
FC Insurance Solutions LLC is a private, licensed insurance brokerage. It is not HealthCare.gov, a state exchange or a government agency.