The window that opened today
Open Enrollment for 2027 coverage opened today — November 1, 2026 — and runs to January 15, 2027 on HealthCare.gov, the federal marketplace Texas uses. The dates that govern every year, from HealthCare.gov's own dates page:
| Date | What it means |
|---|---|
| November 1 | Open Enrollment starts — first day to enroll in, renew, or change Marketplace coverage for the coming year. |
| December 15 | Last day to enroll or change for coverage that starts January 1. |
| January 15 | Open Enrollment ends. After this, enrollment needs a Special Enrollment Period (a life change — losing coverage, moving, a birth, and similar). |
| February 1 | Coverage starts for people who enrolled December 16 – January 15 and paid their first premium. |
Medicaid and CHIP take applications all year — there is no window to miss. Apply for coverage at HealthCare.gov or through the Marketplace Call Center, 1-800-318-2596 (TTY 1-855-889-4325).
The metal tiers, plainly
Marketplace plans come in four "metal" categories. HealthCare.gov is blunt about what the metals mean: they describe how you and the plan split costs — "The categories have nothing to do with quality of care." Every Marketplace plan covers the same essential health benefits, covers pre-existing conditions, and includes free preventive services.
| Tier | The split | The trade, in plain words |
|---|---|---|
| Bronze | Plan pays ~60% · you pay ~40% | Lowest monthly premium, highest costs when you actually get care; deductibles often run to thousands of dollars. |
| Silver | Plan pays ~70% · you pay ~30% | Moderate premium, moderate costs — and the only tier where extra savings (cost-sharing reductions, below) can apply. |
| Gold | Plan pays ~80% · you pay ~20% | Higher premium, lower costs at the doctor; low deductibles. |
| Platinum | Plan pays ~90% · you pay ~10% | Highest premium, lowest costs when care happens; very low deductibles. |
A fifth category, Catastrophic, exists for people under 30 or with a hardship/affordability exemption: very low premiums, very high deductibles.
The two kinds of help with the bill
Premium tax credit
A tax credit you can take in advance, paid straight toward your monthly premium to lower what comes out of your pocket. You choose how much of it to use each month; the rest settles when you file taxes. If your income changes, the credit changes — report changes so tax season holds no surprises. The credit can be used with any metal tier.
Cost-sharing reductions (the Silver secret)
A discount that lowers what you pay at the point of care — deductibles, copayments, coinsurance. Three conditions, all from HealthCare.gov: Marketplace coverage, income below a certain level, and enrollment in a Silver plan. With the extra savings, a Silver plan can pay 73–94% instead of 70%. (Secondary explainers commonly put the income band at roughly 100–250% of the federal poverty level; HealthCare.gov's own pages we fetched did not print the band, so we label the exact percentages not yet verified from an official page — the application itself will tell you what you qualify for.)
Texas, honestly: the coverage gap
Texas has not expanded Medicaid — it is one of 10 states that have not (KFF's tracker, updated August 21, 2026). That creates a trap with a name: the coverage gap. Marketplace subsidies start at 100% of the federal poverty level; in a non-expansion state, an adult below that line can be too poor for subsidized Marketplace coverage and still not qualify for Medicaid. KFF-derived reporting puts the Texas Medicaid income limit for parents at about 15% of the poverty level — the lowest in the country.
How many Texans sit in the gap? Published estimates disagree, and this house prints disagreements instead of picking the convenient one: one source says ~570,000; another gives a range of 617,000–920,000. We have not verified a single settled figure from an official Texas page, so we print both, labeled.
The Texas doors: Medicaid and CHIP applications run through YourTexasBenefits.com or by calling 2-1-1. Texas Medicaid comes in five types — Traditional, STAR, STAR Kids, STAR Health, and STAR+PLUS. CHIP covers children in families earning too much for Medicaid: enrollment fees of $50 or less per family per year, copays of $3–$5 at lower incomes and $20–$35 at higher ones (Texas HHS). CHIP questions: 800-964-2777.
Harris County's own safety net: Harris Health's Financial Assistance Program offers sliding-scale care at Harris Health facilities for Harris County residents — it is not insurance, and it is free to apply. Full details live on our Benefits shelf.
Medicare, in four parts
Medicare is federal health insurance mainly for people 65 or older, plus some people under 65 with certain disabilities, anyone with End-Stage Renal Disease, and anyone with ALS. From Medicare.gov:
| Part | What it helps cover |
|---|---|
| A — Hospital | Inpatient hospital care, skilled nursing facility care, hospice, home health. |
| B — Medical | Doctors and other providers, outpatient care, home health, durable medical equipment (wheelchairs, walkers, hospital beds), many preventive services. |
| C — Medicare Advantage | Private-company plans that bundle A + B (usually D too) as an alternative to Original Medicare. Networks and prior authorizations apply; they carry a yearly out-of-pocket limit and often extras like vision, hearing, dental. |
| D — Drugs | Prescription drug coverage from private insurers following Medicare's rules — a separate plan beside Original Medicare, or bundled into an Advantage plan. |
Original Medicare (A + B) lets you use any doctor or hospital in the U.S. that accepts Medicare; you can add Part D and a Medigap policy for the leftover costs like the 20% coinsurance.
The enrollment clocks
- Initial Enrollment Period: a 7-month window around your 65th birthday. Missing it can mean a Part B late penalty that lasts as long as you have Part B.
- General Enrollment Period: January 1 – March 31 each year; coverage starts the month after you sign up, and a late penalty may apply.
- Medicare Open Enrollment: October 15 – December 7 — current enrollees can change plans. That window is open right now.
- Special Enrollment Periods exist for life changes — e.g., 8 months after job-based group coverage ends (COBRA does not count as group coverage), losing Medicaid, disasters, release from incarceration.
Free, unbiased human help: 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048) answers 24/7. The SHIP program gives free local counseling — Texas's SHIP is called HICAP; find yours at shiphelp.org (Texas Area Agencies on Aging list HICAP at 1-800-252-9240).
Sources for this shelf
Collected November 1, 2026: HealthCare.gov (dates & deadlines; plan categories; savings programs; official application checklist, CMS Product No. 11896), Medicare.gov (parts of Medicare; when coverage starts; CMS Quick Guide to Medicare & Medicaid, Sept 2026), Texas HHS (Medicaid types; CHIP fees and copays), KFF Medicaid expansion tracker as reported August 21, 2026. Full citations in the project's SOURCES.md. Figures we could not verify from an official page are labeled in the text, never smoothed over.
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