Health Insurance

6 Free or Low-Cost Health Insurance Options in Texas

Talor Bianchini
Talor Bianchini23 Aug 2022

Health insurance helps to protect you from high and unexpected medical costs. This can tend to be very expensive, so it's important to know all of the available options that are at your disposal. In Texas alone, 6 affordable healthcare options could save both you and your family money. 

Deciding what kind of health coverage you need can be confusing, but Mira can make it easier. By signing up today, you’ll receive discounted urgent care visits, up to 80% savings on prescriptions, and same-day lab testing for only $45/month. Don’t make sacrifices for your healthcare needs. Sign up for Mira to get care at an affordable cost. 

Best Low-Cost Health Insurance Options in Texas

Starting the process of looking for health insurance can be difficult, especially with the number of available choices. First, it is good to understand how health insurance works and what kind of coverage you need to get. After determining your basic needs, compare the costs and what is feasible for you. Below is a list of the most affordable options currently in the state of Texas:

  1. Texas Medicaid
  2. Texas Children’s Health Insurance Program (TCHIP)
  3. Health Insurance Premium Payment Program
  4. STAR Managed Care Program
  5. Texas Marketplace Health Insurance
  6. Mira

Let’s review each of these more in-depth to determine which is right for your needs. 

Texas Medicaid 

Medicaid is a program that provides free or low-cost healthcare coverage to people by the combined efforts of the state and federal governments. This care has set guidelines, but the programs vary from state to state. Texas Medicaid’s goal is to improve the health of those who otherwise would go without health insurance and most likely wouldn’t seek out care for themselves or their family due to high costs. 

There are certain basic criteria that one must meet to apply for the program. To be eligible for Medicaid in Texas, you must be a low or very low-income resident of the state, a U.S. citizen, a national, a legal alien, or a permanent resident who needs insurance assistance. In addition, you must be:

  • 65 years or older
  • Blind
  • Have a disability/household family member with a disability
  • Pregnant
  • Responsible for a child under the age of 18

Annual Household Income Limits Before Taxes to Qualify 

Household Size

Maximum Income Level (Per Year)

1

$25,503

2

$34,492

3

$43,481

4

$52,470

5

$61,460

6

$70,449

7

$79,438

8

$88,427

Source: benefits.gov

TexCare Children’s Health Insurance Program (CHIP)

CHIP was designed for families who cannot afford to buy their own health insurance but have too high an annual income to qualify for Medicaid. This program provides no-cost or low-cost health coverage in Texas. It’s possible that a parent’s job could offer health insurance, but it is out of the family’s budget or doesn’t provide health coverage to children. This is also funded by a combined effort of state and federal governments and provides the same benefits to children as a normal Medicaid package. Children who receive this coverage pay no more than $50 every year for health insurance (most families only pay $35 or less). 

To qualify for this program, you must meet the following criteria:

  • Resident of Texas
  • 18 years of age or younger/primary caregiver with a child 18 or younger
  • Uninsured
  • U.S. citizen, national, or legal alien

However, patients in an institution for mental diseases and inmates of a public prison do not meet the qualifications for CHIP. 

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Annual Household Income Limits Before Taxes to Qualify 

Household Size

Maximum Income Level (Per Year)

1

$26,018

2

$35,189

3

$44,360

4

$53,530

5

$62,701

6

$71,872

7

$81,043

8

$90,124

Source: benefits.gov

Texas Health Insurance Premium Payment Program (HIPP)

The Texas Health Insurance Premium Payment Program is meant for families with at least one member who receives Medicaid. It assists low-income families in paying for employer-provided health insurance plans. There are no age restrictions for the program. Therefore the household family members who receive Medicaid and employer-sponsored health coverage can be of any age to qualify. Families often receive HIPP if it costs Medicaid less to cover your family under your employer’s insurance rather than cover your whole family under Medicaid. 

By enrolling in HIPP, your family will receive more coverage and opportunities than Medicaid would provide alone. You’ll have access to more doctors, you won’t lose any of your current benefits, and your portion of your employer-provided health insurance premium will be covered. The group plan you receive from your employer must provide coverage for the family member on Medicaid to apply for HIPP. In addition, the program requires that your employer insurance covers at least 60% of the costs for the following:

This information can be obtained from your employer by asking for a list of healthcare benefits associated with your insurance plan. 

STAR Managed Care Program

STAR is another Medicaid-managed care program that supports low-income families, children, and pregnant women. A managed care program is a type of health insurance where you pick a health plan based on your needs and the area you live in. Medical professionals provide their services at a reduced cost in partnership with Medicaid. By enrolling, members are eligible for an array of Medicaid benefits, including:

  • Primary care checkups
  • Vision and hearing care
  • Prescriptions and vaccines
  • Lab tests
  • X-rays
  • And more

STAR health plans can provide value-added benefits in addition to the ones listed above. 

STAR Kids

A feature of the STAR managed care program; STAR Kids provides Medicaid benefits to those under the age of 20 with disabilities. Members must currently receive Supplemental Security Income-related Medicaid or be in a community-based services waiver program. Benefits include those listed above, medical supplies and equipment, behavioral health services, and private nursing. 

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STAR+PLUS

STAR+PLUS is another feature of the STAR managed care program and is meant for adults 65 and older or with disabilities. The program provides them with Medicaid healthcare and long-term care services through their home or a nursing facility. Examples of these services include help around the house or with basic daily activities. In addition, members are paired with a service coordinator to help them plan out the long-term service they may need. 

Texas Marketplace Health Insurance

If your annual household income does not meet the above criteria for government-assisted health insurance programs and your employer does not provide healthcare services, the next option may be to look at health insurance in the private Texas marketplace. Many factors contribute to the cost of health insurance. You will be responsible for a premium and cost-sharing with your provider. Typically, you will have to meet a deductible and cover both copayments and coinsurance. 

The average cost of health insurance in Texas is $509 per month (per person). These costs can really add up when you pay out of pocket for both you and your family. This amount was estimated for a 40-year-old man, so that the cost may vary depending on age, location, or medical history. The most affordable plan for a low-income consumer is a Silver Plan, which comes with a cost-sharing reduction (if you qualify). You can therefore save money on your deductible, copayments, and coinsurance. 

Health Insurance Alternatives 

Navigating through all of the options available on the health insurance market can be confusing and take up a lot of time. Even after going through all the effort, the plan you pick may still have a high deductible, increase in price each year, and not provide you with the member care you need. 

Mira is a more affordable way for you to get the healthcare you need as early as today. For just $45/month, you will have access to more affordable preventative care, up to 80% off on over 1,000 different prescription medications, and same-day lab testing. Mira is partnered with CareNow Urgent Care in Houston and surrounding communities. 

Bottom Line

As a Texas resident looking for healthcare, it’s important to have a comprehensive understanding of all of your available options. Purchasing health insurance can be expensive, and you shouldn’t have to break the bank to cover your basic medical needs. Currently, 15% of Texans are uninsured, and they shouldn’t have to go without care. If you don’t qualify for government-assisted care and you’re having a hard time finding an affordable plan, Mira may be the right alternative for you. Sign up today.

Talor Bianchini

Talor graduated from Penn State University with a B.S. in Biobehavioral Health, and minors in Spanish and Diversity & Inclusion in May of 2022. She has a passion for health equity and diversity in health. In the future, Talor hopes to work in public health policy reform to help eliminate health disparities. She enjoys reading, cooking, and listening to podcasts in her free time.