Medicaid or Marketplace in Texas with one application

The short answer: one application checks both

If you qualify for Medicaid in Texas, you aren’t eligible for savings on a Marketplace plan. The Marketplace application checks both at once. If anyone in your household looks eligible for Medicaid or CHIP, HealthCare.gov sends your information to the Texas state agency, which takes it from there.

You don’t have to guess which door to knock on first: you fill out one application. If you’re weighing health insurance options for your family, here is what HealthCare.gov and Texas Health and Human Services say about who decides, where you apply and which dates matter.

What Medicaid and CHIP cover in Texas

Medicaid and CHIP give health coverage to low-income children, families, seniors and people with disabilities. Medicaid follows federal guidelines, but income levels, what’s covered and what it costs are set state by state. Texas rules aren’t the same as another state’s rules.

Texas Health and Human Services runs several programs under that umbrella. Among them:

• Medicaid for Pregnant Women, for coverage during pregnancy.
• CHIP Perinatal, another route for coverage tied to pregnancy.
• Medicaid for Parents and Caretakers, for adults caring for children in the household.
• Children’s Medicaid and CHIP, for kids in the family.

You can read the program list on the Texas Health and Human Services Medicaid and CHIP page.

One detail that changes your timing

You can apply for Medicaid and CHIP any time of year. There’s no open enrollment window for them. That’s different from Marketplace plans, which follow fixed dates.

What the Marketplace offers and who gets lower costs

The Marketplace is where you buy a private health plan and, depending on your household income, pay less for it. Premium tax credits are for people with incomes between 100% and 400% of the federal poverty level. Below that range, the rules change.

HealthCare.gov describes a coverage gap in states that haven’t expanded Medicaid. Some adults fall into it: too little income for Marketplace savings, and not eligible for Medicaid under their state’s rules. It applies to adults with income below 100% of the federal poverty level who don’t qualify through disability, age or other factors. The application checks whether that’s your case, based on your household and on Texas rules.

The federal poverty level is a measure of income that the Department of Health and Human Services updates each year. It is used to decide eligibility for Marketplace savings, Medicaid and CHIP. Household size changes the number. Marketplace savings are based on your expected household income for the year you want coverage, not last year’s income.

If you want the broader picture of how Marketplace plans work before you apply, we break it down on our Obamacare plans page.

What changes for immigrants on January 1, 2027

Starting January 1, 2027, only these immigration statuses may qualify for income-based savings in the Marketplace: lawful permanent resident (Green Card holder), Cuban or Haitian entrant, and COFA migrant. If your status is different, don’t assume the answer either way: ask an agent before you apply.

HealthCare.gov keeps the current list on its page for lawfully present immigrants. Check it with your immigration document in hand.

The 2027 dates, exactly as HealthCare.gov gives them

Open Enrollment for 2027 coverage started November 1, 2026. December 15 is the last day to enroll in or change plans for coverage that starts January 1. January 15 is the last day of Open Enrollment. If you enroll between December 16 and January 15, your coverage starts February 1.

Those four dates decide whether your coverage starts January 1 or February 1.

Date	What it means for you
November 1, 2026	Open Enrollment started for 2027 coverage.
December 15, 2026	Last day to enroll in or change plans for coverage to start January 1.
December 16 to January 15	If you enroll in this window, coverage starts February 1.
January 15, 2027	Last day of Open Enrollment.

Medicaid and CHIP don’t follow this calendar. You can apply for those any time of year.

Where to apply, step by step

There are two ways to apply for Medicaid: through the Marketplace application, or directly with the state Medicaid agency. Both roads lead to Texas Health and Human Services. In Texas you can apply at YourTexasBenefits.com, or get help through 2-1-1 Texas if you’d rather talk to someone.

If you think Medicaid or CHIP is your path

1. Have income information at hand for everyone who lives with you and files taxes with you.
2. Apply at YourTexasBenefits.com, or call 2-1-1 Texas for help with the application.
3. Wait for the answer from Texas Health and Human Services.

If you think the Marketplace is your path

1. Start the Marketplace application and enter your expected income for 2027 and your household size.
2. The application tells you if anyone in the household looks eligible for Medicaid or CHIP and forwards that information to the Texas agency.
3. If your household qualifies for lower costs on a Marketplace plan, compare plans by network, deductible and what each one charges for the doctors and medications you already use.
4. Finish before the date that matches the start date you need: December 15 for January 1, or January 15 for February 1.

Univista Insurance does not enroll anyone in Medicaid: that goes through Texas Health and Human Services. Our licensed agents help you with the Marketplace side: they compare the 2027 plans available to you and the costs you would pay, in English or Spanish.

Frequently asked questions

More answers about health coverage are on our health insurance FAQ page.

Can I get Marketplace savings if I qualify for Medicaid?

No. If you qualify for Medicaid, you aren’t eligible for savings on a Marketplace plan. The Marketplace application checks this when you apply. If anyone in your household looks eligible for Medicaid or CHIP, your information goes to the Texas state agency for a decision.

Can I apply for Medicaid or CHIP outside Open Enrollment?

Yes. You can apply for Medicaid and CHIP any time of year, with no enrollment window. In Texas, you apply at YourTexasBenefits.com or get help through 2-1-1 Texas. Marketplace plans are different: those follow the Open Enrollment dates set by HealthCare.gov.

What if I enroll after December 15?

Your coverage starts later. December 15 is the last day to enroll in or change plans for coverage to start January 1. If you enroll between December 16 and January 15, coverage starts February 1. January 15 is the last day of Open Enrollment.

Check whether you qualify for savings before Open Enrollment closes. Compare 2027 health plan rates with a licensed Univista Insurance agent by phone, online or in person at a Univista Insurance office in Texas. Get your free quote.