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Individual Health Insurance

Texas Health Insurance for Individuals and Families

The Affordable Care Act requires that you have health insurance. Applying is simple and coverage is guaranteed even if you have pre-existing conditions.

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When can I enroll?

Open Enrollment for 2017 coverage starts November 1, 2016 and ends January 31, 2017. Details on enrollment deadlines can be found at here.

Outside Open Enrollment, you can buy a health insurance plan only if you qualify for a Special Enrollment Period. This is true for plans available outside the Marketplace too.

You can apply for Medicaid and the Children’s Health Insurance Program (CHIP) any time, all year. If you qualify, you can enroll immediately. Members of federally recognized tribes and Alaska Native shareholders can enroll in Marketplace coverage any time of year. There’s no limited enrollment period for these groups, and they can change plans as often as once a month.

Do I qualify for a premium subsidy?

You might qualify for a premium subsidy to reduce your premiums if your household income is between 100% and 400% of the Federal Poverty Level. To find out if you qualify or apply for this coverage, please visit https://www.healthcare.gov/lower-costs/. We are not able to assist with subsidy inquiries or applying subsidies to your premiums.

What are the penalties/fees if I don’t have coverage?

If you don’t have health insurance in 2017, you’ll pay the higher of these two amounts:

  • 2.5% of your yearly household income

  • $695 per person ($347.50 per child under 18) The maximum penalty per family using this method is $2,085. (These amounts are based on 2016. The 2017 penalties will be adjusted for inflation.)

  • Learn about the fee for not having health coverage.

What if I don’t want to apply through the Marketplace?

You do not have to apply through the Marketplace at Healthcare.gov unless you think you might qualify for a premium tax credit. If you know that you do not qualify or are not interested in obtaining premium tax credits, Watkins Insurance Group can help you navigate the process, starting with plan evaluation through submitting the application.

How can I get a quote and enroll?

We are not currently assisting with open enrollment. However, for the convenience of our clients, we have linked access directly to the Blue Cross Blue Shield quoting website where you can access quotes for their plans and apply online. 

Once you find a plan that fits your needs, simply click on the application link provided in your quote and apply online.

(Due to changes in the Marketplace for 2017, we are extremely limited in the number of carrier options available.)

Blue Cross Blue Shield of Texas

PLEASE NOTE: Before you apply for a plan, contact your doctor or provider to make sure they are in the network for your plan. Please also be advised that the Blue Advantage plans are HMO plans.

What kind of plans are being offered?

Health Maintenance Organization (HMO): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.

Watkins Insurance Group is here to make the process as streamlined and stress-free as possible.