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Understanding COBRA Insurance Coverage in Texas

In Texas, COBRA insurance allows employees who lose their jobs or have reduced work hours to continue their existing employer-sponsored health coverage. This applies to employers with 20 or more employees. Employees must have been covered under the employer’s health plan on the day before the qualifying event and have 60 days to elect COBRA coverage. They must pay the full premium, including the portion previously covered by the employer, plus a 2% administrative fee. Coverage typically lasts up to 18 months, with possible extensions in certain situations.

Texas Continuation Coverage (Mini-COBRA)

Texas offers a continuation coverage law, sometimes referred to as Texas Mini-COBRA, for smaller employers with 2-19 employees. This allows employees to continue their health coverage for up to nine months after their federal COBRA coverage ends or if they are not eligible for federal COBRA. Employees must have been covered by the group health plan for at least three months before the qualifying event, elect continuation coverage within 60 days of termination, and pay the full premium.

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Continuing Health Insurance Coverage In Texas

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No Pre-Existing Conditions
Term Medical Gap Coverage

Available in some states, as low as $44/month

Coverage For
Pre-Existing Conditions

$400 – 700/month per individual

Medicare
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Texas’ Mini-COBRA Law

Texas law 1251.251, part of the Texas Insurance Code, provides employees and their dependents with continuation or conversion privileges upon termination of group health insurance coverage. This law allows eligible individuals to maintain their health insurance coverage for a certain period after their employment has ended, even if they are no longer eligible for COBRA.

Specifically, under Texas state continuation, eligible individuals and their families can remain covered under their former employer’s group health plan for up to nine months if they are not eligible for COBRA coverage or have exhausted their COBRA benefits.

Texas state continuation also provides for a conversion privilege, which allows eligible individuals to convert their group health insurance coverage to individual policies, even if they are no longer employed or are no longer eligible for continuation coverage. This option can be particularly useful for individuals who have been with their employer for a long time and want to maintain their current level of coverage or for those with pre-existing medical conditions who may find it challenging to obtain coverage through individual insurance plans.

Source: Texas Insurance Code § 1251.251

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Federal Open Enrollment
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Getting Coverage For Pre-Existing Conditions In Texas

It is important for Texans to have a major medical plan and sufficient health insurance coverage. Pre-existing conditions are medical conditions that existed prior to obtaining a health insurance policy and may include chronic or acute conditions.

Texas residents can rely on major medical plans that are certified under the Affordable Care Act, which provide comprehensive health insurance coverage. These plans cover hospitalization, surgery, and other medical services that may be required due to pre-existing conditions, even if COBRA coverage is not available or has been exhausted.

Marketplace / Obamacare

Sometimes state and federal subsidies help offset the premium for individual marketplace insurance.

A loss of work health insurance is a qualifying event to find new healthcare through the public healthcare exchange.

In 2023, the average ACA health plan premium in Texas is $454/month per individual, according to the Kaiser Family Foundation.

You May Qualify For A Subsidy

Apply For COBRA

Employer Has 20+ Employees

As an employee, you may continue your most recent work health insurance for up to 18 months. Family members may access the plan for up to 36 months.

You sign up for COBRA with your former employer or their third party.

The premium will be $400 – 700 / month, per insured person.

Short-Term Health Insurance Plans Allowed in Texas

Texas residents have the option to utilize Short-term medical insurance as a temporary coverage solution in the event of an insurance gap, such as during a job change or while waiting for alternative coverage to commence.

Short Term Medical Insurance: New Illnesses & Injury Coverage

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Core Health Insurance provides guaranteed acceptance Limited Indemnity Medical coverage for your basic medical needs, helping to provide a medical option for people who do not have the luxury of being covered by a comprehensive health insurance plan.

Coverage begins as early as midnight tonight.

Medicare

After your workplace insurance ends, you’ll sign up for Medicare within 8 months.

In general, you can sign up for Part A and Part B starting three months before your 65th birthday and ending three months after your 65th birthday.

Learn more about Medicare deadlines and how Medicare Advantage plans can replace original Medicare at no cost to you.

COBRA Is Available in All 50 States

Employee continuation of health insurance coverage is not required in all states. When a state lacks laws governing the continuation of work-related medical benefits, the federal COBRA Act protects these rights. Find out more about your state.

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