Do I Qualify for an Obamacare Subsidy in Texas?

What the subsidy actually is

It's not an insurance discount: it's a tax credit that the government advances every month directly to the insurer to lower your premium. That's why it's calculated based on the income you estimate for the year you'll be covered, not last year's income.

If you end up earning more than estimated, part of the credit gets reconciled when you file taxes. If you earned less, you usually get the difference back. That's why it's best to report income changes during the year instead of waiting.

The three factors that decide your subsidy

In practice, it almost always comes down to three things we can review with you in minutes:

• Estimated annual household income (everyone filing together, not just the applicant).
• Household size: how many people you claim, including dependents.
• Access to other coverage: if you or your spouse have an employer offer considered affordable, that can limit the credit.

Texas didn't expand Medicaid: why it matters

In Texas, some very-low-income families don't qualify for adult Medicaid and fall below the subsidy floor; this is known as the coverage gap. At the same time, other households assume they earn 'too much' and don't even apply, when they actually qualify.

For 2026, the income range with subsidy access runs from 100% to 400% of the federal poverty level: for one person, from about $15,650 to over $62,600 per year; for a family of four, up to about $128,600.

The only reliable way to know is to run the numbers with your real figures. It's free and takes just a few minutes.

Immigration status: who can apply

You can apply for Marketplace coverage if you're a U.S. citizen or have a recognized lawful presence (permanent residency, certain humanitarian statuses, work or study visas, among others).

In mixed-status households, eligible members can enroll even if others aren't, and information about the non-applicant isn't used for immigration purposes. If you have questions about your case, reach out and we'll review it confidentially.

Mistakes that cost people money

We see these every week in Katy and Houston:

• Underestimating income to pay less now and ending up owing at tax time.
• Not counting a spouse's or working dependent's income.
• Choosing the cheapest plan without checking if your doctor and medications are in-network.
• Not reporting changes: new job, baby, marriage, move, or income change.
• Letting the plan auto-renew without comparing new-year prices.

Documents to have ready

To apply in one sitting, gather this before your appointment:

• Date of birth and Social Security number (or immigration document) for each person to be covered.
• Estimated annual income: pay stubs, 1099s, or a monthly average if self-employed.
• Texas address and an active email.
• List of doctors and medications you want to keep.