7 Health Insurance in Texas for Low-Income Adults

🏄🩺

Texas HHSC • HealthCare.gov • HRSA • KFF — Verified March 2026

A plain-language guide to every health coverage option available to low-income adults in Texas right now — with verified income limits, honest explanations of the coverage gap, and step-by-step guidance on what to do if you do not qualify for Medicaid. Free information. Always in your corner.

💡 10 Key Things Every Low-Income Texan Should Know About Health Coverage

Texas has the highest uninsured rate in the United States — approximately 16.7% of Texans have no health coverage, compared to a national average of roughly 8%. That statistic is not an accident. It is the direct result of Texas being one of just ten states that has declined to expand Medicaid under the Affordable Care Act, leaving hundreds of thousands of low-income adults without a path to affordable coverage. A Texas A&M Bush School study found that hundreds of thousands of Texans may forgo health insurance due to increased ACA costs in 2026. But options do exist — including ACA Marketplace plans, targeted Medicaid programs, community health centers, and specialized programs for certain conditions. Here is what every low-income Texan needs to know right now.

1
Has Texas expanded Medicaid? What does that mean for me? No — Texas rejected Medicaid expansion most recently in April 2025. This means healthy adults aged 19–64 without disabilities or dependent children do not qualify for Medicaid, no matter how low their income is.
In the 40 states plus D.C. that expanded Medicaid under the ACA, adults earning up to 138% FPL ($22,025/year for one person) qualify for free comprehensive health coverage. Texas chose not to expand, leaving adult Medicaid eligibility at pre-ACA levels — which means only parents with dependent children earning below roughly 12% FPL ($185/month for a single parent) qualify. Adults without children or a qualifying disability are effectively ineligible for Medicaid in Texas regardless of income. The Texas Legislature has thus far maintained this position; 73% of Texans support expansion according to polling, but no change is expected in the current legislative session.
2
What is the Texas coverage gap and how many people are in it? Approximately 570,000–920,000 Texans earn too much for Texas Medicaid but too little (below 100% FPL) to qualify for ACA Marketplace subsidies. They fall in a coverage gap with very limited options.
The coverage gap in Texas traps adults whose income falls between roughly 12% FPL (the Medicaid limit for parents) and 100% FPL ($15,650/year for one person), the minimum income to qualify for ACA premium tax credits. For a single adult, this means anyone earning between about $1,900 and $15,650 per year has neither Medicaid nor affordable marketplace options. For a family of four, the gap affects households earning between $2,760 and $32,150 annually. Workers in retail, food service, agriculture, and construction are disproportionately affected. Federally Qualified Health Centers (FQHCs), free clinics, and patient assistance programs are the primary resources available for people in this gap.
3
Can I get Medicaid in Texas if I have a disability? Yes — Texans with qualifying disabilities can receive Medicaid through STAR+PLUS regardless of whether they are parents, and may qualify automatically if they receive SSI. Apply at YourTexasBenefits.com or call 2-1-1.
STAR+PLUS is Texas’s Medicaid managed care program for adults who are age 65 or older or have disabilities. It covers the full range of Medicaid services plus long-term services and supports (LTSS) such as personal care assistance, adult day care, nursing home care, and home modifications. If you receive Supplemental Security Income (SSI), you are automatically enrolled in Texas Medicaid without needing a separate application. Adults with disabilities who do not receive SSI must apply and demonstrate a qualifying disability through Social Security or state medical review. Apply at YourTexasBenefits.com, call 2-1-1, or visit your local Texas HHS office.
4
Are there ACA Marketplace plans available in Texas and how affordable are they? Yes — 16 insurers participated in the Texas ACA Marketplace for 2026. Texans earning between 100% and 400% FPL qualify for premium tax credits that can reduce monthly costs. About 75% of enrollees (below 200% FPL) had access to at least one $0-premium plan.
According to research by Texas 2036, approximately 75% of Texas Marketplace enrollees — those earning below 200% FPL ($30,000 for an individual) — can still find at least one $0-premium Bronze or Gold plan in 2026 even after the expiration of enhanced subsidies. An estimated one million uninsured Texans could qualify for a $0-premium plan but have not enrolled. Gross premiums (before subsidies) increased approximately 30% on average for Texas in 2026, per KFF analysis, due to the enhanced subsidy expiration. Use the KFF calculator at kff.org/interactive/subsidy-calculator to find your exact cost. Apply at HealthCare.gov or call 1-800-318-2596.
5
Do my children qualify for Medicaid or CHIP even if I don’t? Likely yes — Texas covers children through Medicaid up to 133%–198% FPL depending on age, and through CHIP up to 201% FPL. Children’s eligibility is dramatically more generous than adult eligibility in Texas.
A parent’s Medicaid ineligibility does not affect a child’s eligibility. Children aged 0–1 qualify at up to 198% FPL; children aged 1–5 at 144% FPL; and children aged 6–18 at 133% FPL for Medicaid. Above those levels, CHIP covers children up to 201% FPL at low or no cost. One application at YourTexasBenefits.com automatically screens the entire family for Medicaid, CHIP, and other benefits simultaneously. As of January 2026, Texas had over 244,000 pending children’s applications with an average wait of 54 days — apply immediately to avoid delays. Children are covered by the Children’s Medicaid STAR program, which includes dental and vision through Texas Health Steps.
6
I am a woman diagnosed with breast or cervical cancer. Is there special Medicaid coverage for me? Yes — the Texas Medicaid for Breast and Cervical Cancer (MBCC) program provides full Medicaid benefits to uninsured women aged 18–64 with income up to 200% FPL who have been diagnosed with breast or cervical cancer or a pre-cancerous condition.
The MBCC program is one of the few pathways to full Medicaid for adults in Texas who would otherwise fall in the coverage gap. It provides all Medicaid benefits including unlimited prescriptions, cancer treatment, reconstruction, and a nurse service coordinator through the STAR+PLUS managed care program. To apply, contact a Breast and Cervical Cancer Services (BCCS) provider in your area or call 2-1-1. The BCCS provider assesses eligibility and submits the application on your behalf. For questions, contact the MBCC program at 512-776-7796 or email HHSC. Coverage renews every six months as long as active treatment continues.
7
Where can I get health care in Texas if I have no insurance at all? Texas has 71 Federally Qualified Health Centers (FQHCs) operating more than 700 service sites statewide. They provide primary care, dental, behavioral health, and pharmacy services on a sliding-fee scale based on income — at zero cost for people at or below 100% FPL.
FQHCs are legally required to see every patient regardless of insurance or ability to pay, charging fees based on income and family size on a sliding-fee schedule. The Texas Department of State Health Services reports 71 FQHCs and 8 FQHC look-alikes operating more than 700 delivery sites across Texas. They serve Medicare, Medicaid, CHIP, insured, and uninsured patients equally. Many also offer on-site prescription assistance and help patients enroll in Medicaid, CHIP, and Marketplace plans. Find your nearest FQHC at FindAHealthCenter.hrsa.gov or call 1-800-221-2393.
8
Does Texas Medicaid cover adults aged 65 and older and how do I apply? Yes — seniors aged 65 and older who meet income and asset limits can qualify for Texas Medicaid through STAR+PLUS, which also coordinates with Medicare for dual-eligible seniors. The nursing home income limit is $2,982/month for individuals.
Texas Medicaid for seniors is administered through the STAR+PLUS managed care program and the Medicaid for Elderly and People with Disabilities (MEPD) program. Single seniors applying for nursing home Medicaid must have income under $2,982/month and countable assets under $2,000 (home and one vehicle are exempt). If income exceeds $2,982, a Qualified Income Trust (Miller Trust) can redirect the excess to establish eligibility. The Community Spouse Resource Allowance protects up to $162,660 in assets for the at-home spouse. Apply at YourTexasBenefits.com or call 2-1-1. Processing takes 45–90 days.
9
What is the fastest way to apply for any health coverage in Texas? Apply online at YourTexasBenefits.com, which screens for Medicaid, CHIP, SNAP, and TANF in one application. For ACA Marketplace plans, apply at HealthCare.gov or call 1-800-318-2596. For immediate care, call 2-1-1 to find a community health center.
YourTexasBenefits.com is the official Texas HHSC portal that automatically screens all household members for Medicaid, CHIP, SNAP, and TANF with a single application. You can also apply by calling 2-1-1 (or 1-877-541-7905), visiting any local HHSC benefits office, or mailing a paper application. Texas Health and Human Services maintains local offices in every region. As of January 2026, average Texas Medicaid processing time is 54 days — exceeding the federal 45-day limit due to a backlog of 244,000 pending applications. Follow up proactively if you have not received a determination within 45 days.
10
Are there free help resources to navigate all these Texas health coverage options? Yes — ACA Navigators at LocalHelp.HealthCare.gov provide free, unbiased enrollment help. Foundation Communities in Central Texas and other nonprofits assist thousands of Texans annually. SHIP counselors (1-877-839-2675) serve Medicare-eligible seniors. Dial 2-1-1 for local social services referrals 24/7.
During the 2026 open enrollment season, navigator organizations like Foundation Communities helped thousands of Texans find $0-premium plans and navigate the subsidy expiration. ACA Navigators are certified by the federal government and cannot sell insurance, creating a conflict-free service. Call 1-800-318-2596 to speak with a trained Marketplace representative 24/7 in over 150 languages. For Medicare-related questions (Medicare Savings Programs, Extra Help, plan comparisons), SHIP counselors at 1-877-839-2675 provide free expert advice in every county. BenefitsCheckUp.org (NCOA) screens for 2,000+ programs in minutes with just your zip code.

Sources: HealthInsurance.org Texas Medicaid guide (Texas not expanded; 12% FPL parent limit; coverage gap 570,000+); BenefitsUSA.org Texas Medicaid 2026 (16% uninsured; 4.2M enrolled; gap $1,900–$15,650 single; 617,000 in gap; 54-day avg processing; 244,000 pending); Texas 2036 Dec 2025 (75% enrollees below 200% FPL; $0-premium plans available; 1M uninsured could qualify); Baker Institute 2025 (4M enrolled; $1.5B subsidies 3.4M Texans 2024; 27% uninsured rate increase projected); KUT Radio Nov 2025 (30% avg premium increase; Foundation Communities; navigator help); KERA News Dec 2025 (4M Marketplace enrollees; enhanced subsidy expiration impact); CheckMedicaid.com Texas 2026 (100% FPL $15,650 individual; 12% FPL parents); Texas HHSC hhs.texas.gov STAR+PLUS (age 65+; disability; MBCC 200% FPL; 2-1-1; apply YourTexasBenefits.com); MedicaidPlanningAssistance.org TX 2026 ($2,982 nursing home; $2,000 asset; $162,660 CSRA; Miller Trust; 45–90 day processing); DSHS Texas FQHCs (71 FQHCs; 700+ sites); HRSA FindAHealthCenter.hrsa.gov; shiphelp.org (1-877-839-2675); Texas A&M Bush School study (hundreds of thousands may forgo insurance); Texas Legislature rejected expansion April 2025; 73% Texans support expansion per polling

📊 The Texas Health Coverage Crisis — Key Numbers

🚨 Texas Uninsured Rate

16.7%

Texas has the highest uninsured rate in the United States — more than double the national average. Approximately 5.1 million Texans remain uninsured, driven largely by Texas’s refusal to expand Medicaid, which would cover adults up to 138% FPL.

👥 Adults in Coverage Gap

570K–920K

Texans who earn too much for Medicaid but too little to qualify for ACA premium tax credits. This is the most severe coverage gap in the nation. FQHCs, free clinics, and patient assistance programs are their primary resources.

💰 Potential $0-Premium Plans

~1 Million

Estimated uninsured Texans who could qualify for a $0-premium ACA Marketplace plan but are not enrolled, per Texas 2036 modeling using ACS data. About 75% of current enrollees below 200% FPL have access to at least one $0-premium plan.

⏱ Application Wait Time

54 Days Avg

Average Texas Medicaid application processing time as of January 2026, exceeding the federal 45-day requirement. Over 244,000 applications were pending, including 400,000 eligible children who remain unenrolled. Apply immediately and follow up.

⚠️ Critical Alert: Texas Has the Highest Uninsured Rate in the Nation

Texas has rejected Medicaid expansion most recently in April 2025. This single policy decision is the primary driver behind the state’s 16.7% uninsured rate — nearly one in six Texans. The Urban Institute projects a 27% increase in the Texas uninsured rate due to the expiration of enhanced ACA premium tax credits. However, for lower-income Texans (below 200% FPL), $0-premium marketplace plans remain available. If you or someone you know is uninsured in Texas, please take action today. The first call — 1-800-318-2596 or 2-1-1 — costs nothing and can change everything.

Sources: HealthInsurance.org Texas guide (16.7% uninsured; highest in US); Texas 2036 Dec 2025 (5.1M uninsured; 1M could qualify $0 plans; 75% below 200% FPL have $0 plan); Baker Institute 2025 (Urban Institute 27% uninsured increase); MoneyGeek ACA Premium 2026 (TX premium increases 30%+); Texas HHSC (Legislature rejected expansion April 2025)

📋 Texas Medicaid & Coverage Income Limits at a Glance

Income limits based on the 2026 Federal Poverty Level of $15,650/year ($1,304/month) for one person. Limits increase with household size. Texas HHSC updates FPL-based limits around March 1 each year; SSI-based limits updated January 1. Always verify at YourTexasBenefits.com before applying.

Population Group	Monthly Income Limit	Annual Limit	Program
Parents / Caretakers (1 adult)	~$185/mo	~$2,220/yr	Medicaid — ~12% FPL
Pregnant Women	$2,583/mo	~$30,996/yr	Medicaid — 198% FPL
Infants (0–1 year)	$2,583/mo	~$30,996/yr	Children’s Medicaid — 198% FPL
Children ages 1–5	$1,878/mo	~$22,536/yr	Children’s Medicaid — 144% FPL
Children ages 6–18	$1,734/mo	~$20,808/yr	Children’s Medicaid — 133% FPL
CHIP (children up to 19)	$2,620/mo	~$31,440/yr	CHIP — 201% FPL
Breast/Cervical Cancer (women 18–64)	$2,608/mo	~$31,300/yr	MBCC — 200% FPL
Seniors 65+ / Nursing Home	$2,982/mo	~$35,784/yr	MEPD / STAR+PLUS — LTC
Adults 19–64 (no disability, no children)	Not eligible	No income limit helps	Coverage gap — no TX Medicaid
ACA Marketplace Subsidies	$1,304–$5,213/mo	$15,650–$62,556/yr	Marketplace — 100%–400% FPL
FQHC Sliding-Scale Care	Any income	Any income	Free at 100% FPL; sliding scale above

Sources: Texas HHSC HHSC.gov (2026 income limits; MAGI categories; FPL update dates); CheckMedicaid.com TX 2026 ($15,650 individual FPL; 12% FPL parent limit ~$185/mo); BenefitsUSA.org ($2,982 LTC; CHIP 201%); Texas HHSC MBCC (200% FPL); MedicaidPlanningAssistance.org (nursing home $2,982; assets $2,000; CSRA $162,660). All limits are for a single-person household unless noted. Household size raises all limits. Verify exact limits at YourTexasBenefits.com.

🏆 Health Coverage Options for Low-Income Texans — Verified

⚠️ Verify Before You Apply — Texas Rules Are Strict and Change Annually

Texas Medicaid eligibility rules are among the strictest in the nation. Income limits, program categories, and asset rules all vary significantly by program and are updated at different times of year. SSI-based limits (seniors/disabled) updated January 1, 2026; FPL-based limits (children, parents, pregnant women) typically update around March 1. Always confirm current requirements at YourTexasBenefits.com or by calling 2-1-1 before applying.

Best for Children & Pregnant Women

Texas Medicaid STAR — Children’s & Family Coverage

🏛️ Texas HHSC • Managed Care (MCO) • Apply Any Time

💰 Children: 133%–198% FPL by age • Pregnant women: 198% FPL • Parents: ~12% FPL

✅ Premium: $0 for qualifying households

✅ Covers: Doctor, hospital, Rx, dental, vision

✅ Texas Health Steps: Free checkups birth–age 20

✅ Dental via separate THP+ plan

✅ Pregnant women: 12-month postpartum coverage

✅ Newborns auto-enrolled if mother is on Medicaid

✅ No open enrollment — apply any month

⚠️ 244,000+ pending apps; 54-day avg wait

📞 Contact & Apply

☎️Apply: 2-1-1 or 1-877-541-7905 (Texas 211) — Mon–Fri 8 AM–6 PM

☎️HHSC: 1-800-252-8263 (Texas Health and Human Services)

🌐Online: YourTexasBenefits.com (fastest processing)

🌐TX Health Steps: 1-877-847-8377 (1-877-THSTEPS) • MyChildrensMedicaid.org

🌐Info: hhs.texas.gov/services/health/medicaid-chip

STAR is the primary Medicaid managed care program for Texas children, pregnant women, and parents who qualify. It uses private health plans (MCOs) like Aetna Better Health, Amerigroup, Community Health Choice, and Molina. The plan you are assigned covers the same broad set of Medicaid services regardless of which MCO you use. Texas Health Steps, a component of STAR, provides free medical and dental checkups for children from birth through age 20 — one of the most comprehensive preventive care programs in Texas. If you apply at YourTexasBenefits.com, the system automatically determines whether your children qualify for STAR (Medicaid) or CHIP with a single application.

Children 0–18 Pregnant Women 198% FPL 12-Mo Postpartum Free Dental via THP+ Apply Any Time

Best for Children Above Medicaid Income

CHIP — Children’s Health Insurance Program

🏛️ Texas HHSC • Federal + State Program • No Open Enrollment

🧒 Age: Birth through 18 • Income: Medicaid upper limit up to 201% FPL

✅ Premium: Low or zero depending on income

✅ Doctor visits, dental, vision, Rx, hospital

✅ Covers children whose parents earn too much for Medicaid

✅ No open enrollment — apply any time of year

✅ Same single application as Medicaid

⚠️ 400,000 eligible TX children remain unenrolled

📞 Contact & Apply

☎️Apply: 2-1-1 or 1-800-318-2596 (Marketplace / CHIP)

☎️CHIP line: 1-877-KIDS-NOW (1-877-543-7669)

🌐Online: YourTexasBenefits.com (screens for Medicaid + CHIP together)

🌐Info: InsureKidsNow.gov • hhs.texas.gov/services/health/medicaid-chip

CHIP fills the gap between Medicaid’s income limits and what families can afford privately. Texas sets the CHIP income limit at 201% FPL — for a family of four this is approximately $57,720/year. A family earning $50,000/year with uninsured children should apply. One application at YourTexasBenefits.com screens the entire family for both Medicaid and CHIP; there is no need to submit separate applications. CHIP and Medicaid are both year-round enrollment programs with no open enrollment window — apply the moment your child loses coverage or you realize they are uninsured.

201% FPL Texas Birth to Age 18 Dental + Vision Apply Any Month

Best for Seniors 65+ and Adults with Disabilities

STAR+PLUS — Medicaid for Elderly and Disabled Adults

🏛️ Texas HHSC • Medicaid Managed Care • MEPD Program

🧓 Age: 65+ or disability • Income: $2,982/mo nursing home; SSI recipients auto-enrolled

✅ Full Medicaid benefits including LTC

✅ Personal care assistance at home

✅ Adult day care, respite care, home modifications

✅ Dual eligible: works alongside Medicare

✅ Service coordinator assigned to each member

✅ SSI recipients: automatic enrollment (no application)

✅ Value-added services vary by health plan

⚠️ HCBS waiver waitlists may apply

📞 Contact & Apply

☎️Apply: 2-1-1 or 1-877-541-7905

☎️Enrollment: 1-800-964-2777 (STAR, STAR+PLUS, CHIP, Dental) • 1-877-782-6440 (STAR+PLUS MBCC / Nursing Facility)

☎️Ombudsman: 1-866-566-8989 (managed care issues)

🌐Online: YourTexasBenefits.com

🌐Info: hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-members/starplus

STAR+PLUS is the primary Medicaid program for Texans who are aged 65 or older or who have a qualifying disability. It combines traditional Medicaid health benefits with long-term services and supports (LTSS) such as personal care, home health, adult day care, and nursing facility care — all through a chosen managed care organization. The program is specifically designed to help people with complex needs remain living at home rather than in nursing facilities whenever possible. People who receive SSI are automatically enrolled in Texas Medicaid and STAR+PLUS without a separate application — no action required. STAR+PLUS can serve both Medicare and Medicaid enrollees simultaneously.

Age 65+ or Disability SSI Auto-Enrolled Home Care Option Dual Medicare + Medicaid Service Coordinator

Best for Uninsured Women with Cancer Diagnosis

Medicaid for Breast and Cervical Cancer (MBCC)

🩹 Texas HHSC • STAR+PLUS Program • Women Ages 18–64

💰 Income: Up to 200% FPL ($2,608/mo) • Must be uninsured • Active treatment required

✅ Full Medicaid benefits (not limited to cancer)

✅ Covers cancer treatment & reconstruction

✅ Unlimited prescriptions included

✅ RN care coordinator assigned to each member

✅ Ages 18 through 64th birthday

✅ Includes pre-cancerous conditions

✅ Available for both breast and cervical cancer

⚠️ Must renew every 6 months with treatment proof

📞 Contact & Apply

☎️Apply: Dial 2-1-1 — ask for BCCS (Breast & Cervical Cancer Services) provider

☎️MBCC office: 512-776-7796 (Texas HHSC MBCC program)

☎️STAR+PLUS MBCC: 1-877-782-6440

🌐BCCS Locator: HealthyTexasWomen.org (click “Breast & Cervical Cancer Services”)

🌐Info: hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-programs-services/medicaid-breast-cervical-cancer-program

The MBCC program is one of the only pathways to full Medicaid coverage for women aged 18–64 who would otherwise fall in the Texas coverage gap. A BCCS provider in your community assesses your eligibility and submits the application on your behalf — you do not navigate the application alone. Coverage provides the complete STAR+PLUS Medicaid benefit package, including cancer treatment, reconstruction, unlimited prescriptions, and an assigned RN care coordinator who helps manage your care and access community resources. Coverage continues as long as active treatment is documented every six months using Form H1551 from your treating physician.

Women 18–64 200% FPL Limit Full Medicaid Benefits BCCS Provider Applies For You RN Coordinator Included

Best for Adults 19–64 Earning 100%–400% FPL

ACA Health Insurance Marketplace — Texas

💻 HealthCare.gov • 16 Insurers in Texas • Open Enrollment Nov 1–Jan 15

💰 Income: 100%–400% FPL ($15,650–$62,556/yr individual) for tax credits • Below 200% FPL: $0-premium plans available

✅ 16 insurers offer plans statewide in 2026

✅ ~75% of enrollees below 200% FPL: $0-premium options

✅ ~1M uninsured Texans may qualify for $0 plans

✅ No denial for pre-existing conditions

✅ Cost-sharing reductions on Silver plans (100–250% FPL)

✅ Texas: 40% Silver plan load = larger Bronze/Gold subsidies

✅ Special Enrollment Period with qualifying life event

⚠️ Enhanced subsidies expired Jan 1, 2026

📞 Contact & Apply

☎️Helpline: 1-800-318-2596 — 24/7, 150+ languages

☎️TTY: 1-855-889-4325

🌐Apply: HealthCare.gov • CuidadoDeSalud.gov (Spanish)

🌐Free local help: LocalHelp.HealthCare.gov (navigators near you)

🌐Subsidy calculator: kff.org/interactive/subsidy-calculator

The ACA Marketplace is the primary coverage path for low-income Texas adults aged 19–64 who do not qualify for Medicaid. Texas implemented a 40% Silver plan cost-sharing load in 2026 (up from 35% in prior years), which effectively makes Bronze and Gold plans even more affordable relative to Silver for many Texans. An estimated one million uninsured Texans earning 100%–200% FPL could qualify for a $0-premium Bronze or Gold plan but remain uninsured, often because they do not know they qualify. The most important step is to check the KFF calculator with your actual income before assuming you cannot afford coverage. Navigator assistance is free and available in person, by phone, and online through LocalHelp.HealthCare.gov.

16 Insurers Texas 2026 Enhanced Subsidies Expired $0-Premium Below 200% FPL 40% Silver Load = Better Gold/Bronze No Pre-Condition Denial

Best If Uninsured or in the Coverage Gap

Federally Qualified Health Centers (FQHCs) — Texas

🏥 71 FQHCs • 700+ Sites Across Texas • HRSA-Funded • No Insurance Required

✅ No insurance required • Sliding-fee scale by income • Free at or below 100% FPL

✅ Primary care, preventive care, immunizations

✅ Dental care at many locations

✅ Behavioral health & mental health services

✅ Pharmacy assistance on-site at many

✅ Open-door policy — cannot refuse patients

✅ 71 FQHCs in Texas; 700+ delivery sites

✅ Help enrolling in Medicaid, CHIP, Marketplace

✅ 340B drug pricing discounts at FQHC pharmacies

📞 Contact & Find a Center

☎️HRSA: 1-800-221-2393 (HRSA Health Center Finder)

🌐Find nearest: FindAHealthCenter.hrsa.gov (search by Texas zip code)

🌐Texas DSHS: dshs.texas.gov/texas-primary-care-office-tpco/federally-qualified-health-centers-fqhc

🌐TX HHS FQHCs: hhs.texas.gov/providers/health-care-facilities-regulation/federally-qualified-health-centers

ℹ️Note: No insurance, no documentation, and no citizenship verification required to be seen

Texas has 71 FQHCs and 8 FQHC Look-Alikes operating more than 700 delivery sites statewide — one of the largest FQHC networks in the country. They serve Medicare, Medicaid, CHIP, insured, and uninsured patients equally, charging on a sliding-fee scale based on income and family size. For patients at or below 100% FPL ($15,650/year for one person), care is typically provided at zero cost. FQHCs are the primary safety net for Texans in the coverage gap who cannot access Medicaid or Marketplace plans. Many sites also offer enrollment assistance for Medicaid, CHIP, and ACA Marketplace plans while you are there.

71 FQHCs in Texas 700+ Sites No Insurance Needed Sliding-Fee Scale Free at 100% FPL 340B Drug Discounts

Best for Uninsured Adults with No Income or Documentation

Free & Charitable Clinics + Patient Assistance Programs

🏥 Nonprofit Networks • No Insurance • No Income Test at Most Locations

✅ No income limit • No insurance required • No citizenship requirement at most free clinics

✅ Free clinics: physician, dental, and pharmacy care

✅ NeedyMeds: 10,000+ free drug programs nationwide

✅ RxAssist: Manufacturer PAPs for brand drugs

✅ GoodRx: Up to 80%+ off generic drugs

✅ 2-1-1 Texas: Connects to local free health resources

✅ Hospital charity care: free care up to 250% FPL at many TX hospitals

📞 Contact & Resources

☎️2-1-1 Texas: Dial 2-1-1 — 24/7, connects to local free clinics and health resources

☎️NeedyMeds: 1-800-503-6897 • NeedyMeds.org

🌐Free clinics: freeclinics.us (Texas free clinic directory)

🌐Drug PAPs: RxAssist.org • NeedyMeds.org

🌐Drug coupons: GoodRx.com (no membership, no insurance)

For Texans in the coverage gap who cannot access FQHCs or choose not to use them, a network of free and charitable clinics provides physician care, dental, and mental health services entirely free of charge through volunteer medical professionals. Texas is home to dozens of free clinics in major metro areas including Houston, Dallas, Austin, and San Antonio. NeedyMeds connects patients to manufacturer Patient Assistance Programs (PAPs) that supply brand-name medications at zero cost to qualifying low-income patients without insurance. Many major Texas hospitals also have formal charity care programs providing free care for patients earning up to 200%–250% FPL — ask the hospital’s financial counselor.

No Insurance Needed Free Drug Programs GoodRx No Membership Hospital Charity Care Coverage Gap Solution

Sources: Texas HHSC hhs.texas.gov STAR program (198% FPL pregnant; 133% FPL children 6–18; THP+ dental; Health Steps 1-877-THSTEPS; MyChildrensMedicaid.org); Texas HHSC CHIP (201% FPL; 1-877-KIDS-NOW; YourTexasBenefits.com); Texas HHSC STAR+PLUS (age 65+/disability; 1-800-964-2777; 1-877-782-6440; 1-866-566-8989 ombudsman; SSI auto-enrolled; YourTexasBenefits.com); Texas HHSC MBCC (200% FPL; 512-776-7796; BCCS provider; 1-877-782-6440; HealthyTexasWomen.org; 6-month renewal H1551); HealthInsurance.org Texas ACA 2026 (16 insurers; 40% Silver load; one new/one left market; 570,000 coverage gap); Texas 2036 Dec 2025 (75% below 200% FPL have $0 plans; 1M uninsured could qualify; $0 plans available Bronze/Gold); DSHS Texas FQHCs dshs.texas.gov (71 FQHCs; 8 LALs; 700+ sites; sliding fee; cannot deny; 340B); Texas HHS FQHCs hhs.texas.gov; MedicaidPlanningAssistance.org TX 2026 ($2,982 LTC; $162,660 CSRA; Miller Trust); freeclinics.us; NeedyMeds.org 1-800-503-6897; GoodRx.com; 2-1-1 Texas (dial 211)

❓ Texas Health Insurance Questions Answered Plainly

💡 I Earn $14,000/Year. Do I Qualify for Anything in Texas?

At $14,000 per year, a single adult without a qualifying disability or dependent children is unfortunately in the heart of the Texas coverage gap — above the ~$2,220/year parent Medicaid limit and below the $15,650/year minimum to qualify for ACA marketplace subsidies. Here is what you can do: 1) Find your nearest FQHC at FindAHealthCenter.hrsa.gov or call 1-800-221-2393 — you will pay very little or nothing for primary care. 2) Call NeedyMeds at 1-800-503-6897 for help getting prescription drugs free or low-cost through manufacturer programs. 3) Check whether your hospital has a charity care program — many Texas hospitals provide free care for incomes up to 200%–250% FPL. 4) If you have any health condition that could qualify as a disability, apply through YourTexasBenefits.com or call 2-1-1 to discuss disability-based Medicaid eligibility. 5) If your income changes even slightly above $15,650, apply immediately for a marketplace plan.

💡 Can I Get Medicaid if I Am Pregnant in Texas?

Yes — pregnancy is one of the most protected eligibility pathways in Texas Medicaid. Pregnant women qualify for Medicaid up to 198% FPL, which is approximately $2,583/month for an individual in 2026. Coverage begins immediately upon application and determination — there is no waiting period. All prenatal care, delivery, and hospital services are covered at no cost. Postpartum coverage continues for 12 months after delivery under the American Rescue Plan Act permanent extension. Newborns are automatically deemed Medicaid-eligible from birth if the mother is enrolled — no separate newborn application is required. Apply at YourTexasBenefits.com immediately upon learning of pregnancy for the fastest path to coverage. Call 2-1-1 or 1-800-318-2596 for help by phone.

💡 I Am 64 Years Old. What Changes When I Turn 65?

At 65, you become eligible for Medicare — the federal health insurance program for older Americans. This opens entirely new options. You can enroll in Medicare Part A and B (often called Original Medicare), and if your income is low, you may qualify for Texas Medicare Savings Programs (QMB, SLMB, or QI) through your state Medicaid office, which can pay your Medicare premiums and out-of-pocket costs. If you also have very low income and assets, you may qualify for full dual Medicare + Medicaid coverage through STAR+PLUS, which covers everything Medicare does not — long-term care, dental, vision, and Medicare cost-sharing. Call 1-800-MEDICARE (1-800-633-4227) or a free SHIP Medicare counselor at 1-877-839-2675 to plan your transition well before your 65th birthday. Medicare enrollment windows are specific — missing them can result in lifelong premium penalties.

💡 I Was Denied Texas Medicaid. Can I Appeal?

Yes. Every Texas Medicaid denial notice must include your appeal rights and instructions. You have the right to request a fair hearing within 90 days of receiving your denial. Your denial letter will specify the exact deadline and how to request a hearing. Common correctable denial reasons include incorrect income calculation (using net instead of gross income), missing documentation, household composition errors, or eligibility for a category the worker did not check. A free ACA Navigator at LocalHelp.HealthCare.gov or the Texas Legal Services Center (1-855-LEGAL-HELP) can help you file an appeal or identify which program you actually qualify for. You can also call 2-1-1 for referral to a local benefits counseling organization. Always appeal within the 90-day window — reapplication after denial does not preserve your original application date.

💡 My Employer Offers Insurance But I Can’t Afford It. Am I Still Eligible for Marketplace Plans?

It depends on affordability. For 2026, an employer-sponsored plan is considered “affordable” if your share of the monthly premium for the lowest-cost employee-only plan is less than 9.02% of your household income. If your employer’s plan costs more than 9.02% of your household income, you may qualify for ACA Marketplace premium tax credits even with an offer of employer coverage. Calculate this carefully — if your employer offers a plan costing $300/month and you earn $36,000/year, that is 10% of your income and exceeds the affordability threshold, potentially making you eligible for marketplace subsidies. Use the KFF calculator at kff.org/interactive/subsidy-calculator or call 1-800-318-2596 to determine your specific situation. A Navigator can also walk through this calculation with you at no charge.

💡 What If I Need a Doctor Immediately and Am Uninsured in Texas?

Step 1 — Go to FindAHealthCenter.hrsa.gov or call 1-800-221-2393 and locate your nearest FQHC in Texas. They see patients on a sliding-fee scale — often the same week — with no insurance required and no citizenship verification for services. Many have on-site pharmacies. Step 2 — Simultaneously, apply for Medicaid at YourTexasBenefits.com. If you qualify, Medicaid coverage can be retroactive up to 3 months in most circumstances, potentially covering medical bills you incur during the application period. Step 3 — For prescriptions you need immediately, visit GoodRx.com or pick up a free GoodRx card at your pharmacy. GoodRx typically reduces generic drug costs by 80% or more with no membership or insurance. Call NeedyMeds at 1-800-503-6897 for help with expensive brand-name drugs through manufacturer assistance programs.

Sources: Texas HHSC MAGI income rules (gross income used; 198% FPL pregnant; $2,583/mo); Medicaid.gov postpartum 12-month extension (permanent; ARP); BenefitsUSA.org TX 2026 (single adult gap $1,900–$15,650; 90-day appeal window; Medicaid retroactivity); HealthCare.gov affordability threshold 2026 (9.02% of household income); KFF subsidy calculator; DSHS Texas FQHCs (71 FQHCs; 700+ sites; same-week access; sliding fee); NeedyMeds.org (1-800-503-6897); GoodRx.com (no membership; 80%+ generic savings); Texas Legal Services Center 1-855-LEGAL-HELP; Medicare.gov (1-800-633-4227); shiphelp.org (1-877-839-2675)

📍 Find Health Coverage Resources Near You in Texas

Allow location access when prompted to see resources closest to your home. All services listed are free to apply for. No insurance is required to visit an FQHC or free clinic.

Finding Texas health resources near you…

✅ Five Steps to Health Coverage in Texas Starting Today

Step 1: Apply at YourTexasBenefits.com with a single application. One application at YourTexasBenefits.com simultaneously screens every household member for Medicaid, CHIP, SNAP, and TANF. You do not need to apply separately for each program. This is the fastest way to find out if anyone in your household qualifies for free or low-cost health coverage. If you prefer to apply by phone, call 2-1-1 or 1-800-252-8263 any weekday.
Step 2: If you earn 100%–400% FPL, check your exact ACA Marketplace cost before assuming it’s unaffordable. Use the KFF subsidy calculator at kff.org/interactive/subsidy-calculator with your actual annual income and household size. An estimated one million uninsured Texans could access a $0-premium Marketplace plan but have not enrolled — often because they assume they cannot afford it. Navigators at LocalHelp.HealthCare.gov will run these calculations with you for free.
Step 3: If you cannot get Medicaid or a subsidized Marketplace plan, find your nearest FQHC right now. Go to FindAHealthCenter.hrsa.gov or call 1-800-221-2393. Texas has 71 FQHCs with 700+ locations. No insurance is required. You pay based on income. Many are available for same-week appointments and provide primary care, dental, behavioral health, and pharmacy services.
Step 4: Get free help navigating all your options. ACA Navigators at LocalHelp.HealthCare.gov help with Marketplace and Medicaid enrollment at no charge. For Medicare-eligible Texans (65+), free SHIP counselors at 1-877-839-2675 explain Medicare Savings Programs, Extra Help, and plan options. Call 2-1-1 to be connected to local resources for health care, food, housing, and utilities in one call.
Step 5: For prescriptions you need right now — GoodRx and NeedyMeds. GoodRx.com provides free drug discount coupons at most Texas pharmacies with no membership or insurance, typically reducing generic drug costs by 80% or more. For expensive brand-name medications, NeedyMeds (1-800-503-6897) connects you to manufacturer Patient Assistance Programs that may provide the medication free of charge. No insurance is needed for either resource.

📞 Texas Health Coverage Key Contacts in One Place

Texas Medicaid / CHIP / Benefits: YourTexasBenefits.com • 2-1-1 (or 1-877-541-7905) • 1-800-252-8263
Texas HHSC (general): hhs.texas.gov • 1-800-252-8263
ACA Marketplace (HealthCare.gov): 1-800-318-2596 (24/7) • TTY: 1-855-889-4325
CHIP for Children: 1-877-KIDS-NOW (1-877-543-7669)
FQHC Community Health Centers: 1-800-221-2393 • FindAHealthCenter.hrsa.gov
STAR+PLUS / MBCC Enrollment: 1-800-964-2777 (STAR, STAR+PLUS, CHIP) • 1-877-782-6440 (STAR+PLUS MBCC / Nursing Facility)
MBCC Program Office (Texas HHSC): 512-776-7796
SHIP Medicare Counselors (Free): 1-877-839-2675 • shiphelp.org
NeedyMeds Drug Assistance: 1-800-503-6897 • NeedyMeds.org
Emergency & Local Resources: Dial 2-1-1 (24/7 Texas 211 network)

© BudgetSeniors.com — This guide is independently researched and written. We are not affiliated with, compensated by, or endorsed by any insurance company, government agency, or health care provider. All income limits, program rules, and eligibility requirements are verified from official Texas and federal government sources as of March 2026. Texas Medicaid rules change frequently and are among the strictest in the nation — always confirm current requirements at YourTexasBenefits.com, hhs.texas.gov, or by calling 2-1-1 before making any coverage decisions. For personalized legal or financial guidance, consult a licensed professional. Texas Medicaid/CHIP: 2-1-1 • HHSC: 1-800-252-8263 • ACA Marketplace: 1-800-318-2596 • CHIP Kids: 1-877-543-7669 • Community Health Centers: 1-800-221-2393 • SHIP: 1-877-839-2675 • NeedyMeds: 1-800-503-6897 • Emergency: Dial 2-1-1

Primary sources: Texas HHSC hhs.texas.gov (Medicaid/CHIP; STAR; STAR+PLUS; MBCC 512-776-7796; 1-800-964-2777; 1-877-782-6440; 1-866-566-8989; YourTexasBenefits.com); Texas HHSC STAR+PLUS handbook; HealthInsurance.org Texas Medicaid guide (non-expansion; 12% FPL parent; 570,000+ coverage gap; 16.7% uninsured; $5–6B federal funds rejected/year); BenefitsUSA.org Texas Medicaid 2026 (244,000 pending; 54-day avg; 400,000 eligible unenrolled children; 617,000 coverage gap); CheckMedicaid.com Texas 2026 ($15,650 individual FPL; 12% FPL; SSI auto-enrolled; asset limits); MedicaidPlanningAssistance.org TX ($2,982 nursing home; $2,000 assets; $162,660 CSRA; Miller Trust; 45–90 day processing; hhs.texas.gov/services/health/medicaid-chip); Texas 2036 Dec 2025 (75% below 200% FPL have $0 plans; 1M uninsured could qualify; $0 Bronze/Gold plans; 40% Silver load); HealthInsurance.org ACA Texas 2026 (16 insurers; 40% CSR load; 570,000 coverage gap); MoneyGeek ACA 2026 (TX 30%+ premium increase); KUT Radio Nov 2025 (30% avg increase; Foundation Communities; navigator assistance; 4M ACA enrollees); KERA News Dec 2025 (enhanced subsidy expiration; $173 to $942 case study); Baker Institute 2025 ($1.5B subsidies 3.4M Texans; Urban Institute 27% TX uninsured increase; 2010 23.7% to 2023 17.4%); DSHS Texas FQHCs dshs.texas.gov (71 FQHCs; 8 LALs; 700+ sites; sliding fee; cannot deny; 340B); hhs.texas.gov FQHCs; HRSA FindAHealthCenter.hrsa.gov 1-800-221-2393; Texas HHSC MBCC (200% FPL; BCCS provider application; H1551 renewal 6-month; HealthyTexasWomen.org); Texas HHSC CHIP (201% FPL; single YTB application screens both); 2-1-1 Texas (dial 211; 24/7); shiphelp.org 1-877-839-2675; NeedyMeds.org 1-800-503-6897; GoodRx.com; HHS ASPE 2026 FPL ($15,650 individual; $15,960 continental US — TX uses $15,650); Texas Legislature rejected Medicaid expansion April 2025

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