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The Texas Department of Insurance’s online resource, Your Health Care Coverage, also briefly covers special health plans for small employers, coverage available through the Texas Health Insurance Risk Pool, the Children’s Health Insurance Program and employers’ self-funded health plans.

Private Insurance Coverage

Self-employed individuals and workers who do not have access to health insurance through their employers may purchase individual and/or group health policies. The following resources may help you:

TDI’s Web site may help you understand health insurance options. TDI has lists of:

  • Companies authorized to offer consumer choice benefit plans;
  • Companies offering small employer accident and health coverage;
  • Insurance companies authorized to sell individual health policies;
  • Insurance companies authorized to offer Preferred Provider Organization health plans;
  • Insurance companies authorized to offer medical savings accounts; and
  • Insurance companies authorized to offer dental plans.

If you cannot obtain health insurance as a result of a pre-existing medical condition, or qualify as a “Federally Eligible” individual, you may be able to purchase insurance through the Texas Health Insurance Risk Pool.

If you have insurance through your employer and leave the company, a federal law allows you to continue your insurance coverage through your former employer for up to 18 months, although you will have to pay the entire premium. Get more information about COBRA continuation of coverage.

Government Programs

Medicare is a federal health insurance program that covers those age 65 and older, as well as disabled individuals. Supplemental insurance may be purchased to help offset the costs not covered by Medicare. These resources will help you learn more about Medicare coverage:

Medicaid provides access to health care for qualified low-income pregnant women and children as well as people who are elderly or who have a disability. Applications for Medicaid and other services for low-income families are taken at local Medicaid offices, or may be made online. Call the toll-free Texas Medicaid Hotline at 800/252-8263 between 7:30 a.m. and 5:30 p.m., Monday through Friday for assistance, or visit the Texas Medicaid Web. Additional information is available here.

The Children’s Health Insurance Program provides coverage for children whose family income exceeds the amount to qualify for Medicaid but do not earn enough to buy private health insurance. Families pay premiums and share the cost of services based on their income for doctor visits, prescription drugs and emergency care. To find out more, call toll-free 800/647-6558 or visit the CHIP Web site. Additional information is available here.

Resources are available to help individuals find coverage if they cannot obtain it from their employer. In addition, public programs are available to help those unable to afford to buy private insurance coverage.

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Resources for Businesses

Texas has several options to help employers provide health insurance coverage to their workers:

Small Businesses

Mid-Sized/Large Employers
 

Charity Care

If you cannot afford to purchase insurance and do not qualify for Medicare, Medicaid or CHIP, you may be eligible to receive free care under a hospital’s charity care policy. These resources may assist you:

Access to Health Care/Charity hospital care in Texas (Attorney General of Texas/Consumer Protection)  

Low-cost Health Care - Searchable directory of primary care centers for underserved populations. (Bureau of Primary Health Care)

Obtaining Free Care - Information on receiving free or reduced cost care under the Hill-Burton program. (Health Resources and Services Administration)