Health Insurance

Individual, family, and supplemental health plans across leading carriers.

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Health insurance in Texas is more confusing than it should be — between ACA marketplace plans, employer coverage, short-term plans, Medicare, and supplemental policies. The right plan depends on your household income, expected medical use, prescriptions, and whether you want predictable monthly cost or low cost-at-the-doctor. We help individuals, families, and self-employed Texans pick a plan they actually understand, including subsidy eligibility on the ACA marketplace.

What's typically covered

ACA marketplace plans

Individual and family plans sold on healthcare.gov. Cover the 10 essential health benefits, can't deny for pre-existing conditions, and most households qualify for premium subsidies based on income.

Supplemental & Medicare

Medicare Advantage, Medicare Supplement (Medigap), and Part D prescription plans for Texans 65+. Plus accident, hospital indemnity, and critical illness policies that pay cash on top of major medical.

Dental & vision

Standalone dental and vision coverage for routine cleanings, fillings, exams, frames, and contacts. Often a few dollars a month and pays for itself within a year of normal use.

Short-term plans

Temporary medical coverage to bridge a gap (between jobs, waiting for a new plan to start). Lower cost and faster enrollment, but doesn't cover pre-existing conditions and isn't ACA-compliant.

What's typically NOT covered

Cosmetic procedures not deemed medically necessary
Most weight-loss surgery, unless the plan specifically includes it
Care received outside the plan's network at non-emergency rates
Experimental or investigational treatments
Pre-existing conditions on short-term plans

Common claim scenarios

Self-employed family of four

A self-employed couple with two kids and $95K of household income qualifies for premium tax credits on the ACA marketplace, dropping a mid-tier silver plan to a manageable monthly cost. We compare HMO and PPO networks so they keep their pediatrician.

Turning 65 and going on Medicare

A Texan approaching 65 needs to enroll in Medicare Parts A and B and decide between original Medicare + a Medigap plan + a Part D drug plan, or a Medicare Advantage plan that bundles it all. We walk through both paths against their doctors and prescriptions.

Bridging a job gap

Someone leaving a corporate job in September with new coverage starting in January takes a 3-month short-term plan to avoid going bare during the gap, then enrolls in an ACA plan during open enrollment.

What affects your price

Household size and income (drives ACA subsidy)
Age — premiums rise gradually until 65, then shift to Medicare
Tobacco use, on most plans
Plan metal tier — Bronze (low premium, high deductible) to Platinum
Network breadth (HMO vs. PPO vs. EPO)
ZIP code — Texas premiums vary noticeably by region

How Klever Coverage helps

We're licensed to write across multiple health carriers, so you see real apples-to-apples comparisons.
We check your doctors and prescriptions against each plan's network and formulary before you enroll.
We help self-employed Texans claim the ACA premium tax credit they're entitled to — it's the most-overlooked discount in health insurance.

Frequently asked questions

Do I qualify for an ACA subsidy?

Most households earning under roughly 400% of the federal poverty line do, and through 2025 the income cap was effectively removed. We can run the numbers based on your projected income.

When can I enroll?

Open enrollment runs November 1 through January 15 each year. Outside that window, you need a qualifying life event (job loss, marriage, birth, move) to enroll mid-year.

HMO vs. PPO — which is better?

HMOs are cheaper and require you to stay in-network and use referrals. PPOs cost more and offer broader networks with out-of-network benefits. If you have specialists you don't want to lose, a PPO usually wins.

Are short-term plans a good idea?

Only as a true bridge. They don't cover pre-existing conditions, can deny claims, and aren't ACA-compliant — but they're far better than going uninsured during a 1–3 month gap.

Can I keep my doctor?

We check that before you enroll — every plan has a network and a drug formulary, and we don't recommend a plan that drops your primary care or a key prescription.