Health Insurance for Green Card Holders in Texas (2026)

Most green card holders in Texas get health insurance through an employer or a HealthCare.gov Marketplace plan, because Texas has not expanded Medicaid and most new permanent residents must wait five years before Medicaid is even possible. Green card holders who are 65 or older and have not yet lived in the US for five years usually cannot get Medicare yet either, so a Marketplace plan is their main long term option, with a short bridge plan covering the first weeks after arrival.

Key facts at a glance

• No Medicaid expansion: KFF's tracker lists Texas as one of 10 states that have not adopted the Medicaid expansion.
• Very low adult limits: KFF puts the Texas Medicaid income limit for parents at 15% of the federal poverty level as of January 2026, and adults without children have no pathway based on income alone.
• Five year wait: according to KFF, most lawful permanent residents must wait five years before enrolling in Medicaid or CHIP, though Texas covers lawfully residing children without that wait, per Medicaid.gov.
• Marketplace: Texas uses the federal HealthCare.gov platform, and KFF counts 4,172,233 Texans who selected a Marketplace plan for 2026.
• Medicare: KFF notes that immigrants without enough US work history must have lived in the US for five years immediately before enrolling in Medicare.
• Uninsured rate: KFF data show 16.8% of Texans were uninsured in 2024, roughly double the national rate of 8.2%.

Can green card holders get health insurance in Texas right away?

Yes. A green card makes you lawfully present, and HealthCare.gov lists lawful permanent residents among the statuses that can buy Marketplace coverage. You do not have to wait for open enrollment: HealthCare.gov lists moving to the US from a foreign country as a change that can open a Special Enrollment Period, which normally gives you a limited window, typically 60 days, to pick a plan.

An employer plan may be simpler if you start a job with benefits, but many employers apply a waiting period. Either way, the first weeks after you land are the most exposed. Our guide to the ACA Marketplace for green card holders walks through the application itself.

Why is Medicaid so limited for green card holders in Texas?

Two rules stack up. Federally, most green card holders must wait five years after receiving qualified status before Medicaid or CHIP can cover them; refugees and asylees are the usual exceptions. And because Texas never expanded Medicaid, even a US citizen adult generally cannot qualify on low income alone.

Children are the bright spot. Medicaid.gov's April 2026 table shows Texas uses the federal option to cover lawfully residing children in both Medicaid and CHIP, including those still inside their first five years. If you arrive with kids, apply for them even if the adults in your family cannot qualify.

There is also a newer gap for low earners. According to KFF, since January 1, 2026 lawfully present immigrants with incomes below 100% of the poverty level no longer qualify for Marketplace tax credits. In a state like Texas, where adults at that income level usually cannot get Medicaid either, a recent arrival with very low income may find no subsidized option at all. Community health centers that charge on a sliding fee scale are the fallback HealthCare.gov itself points to.

What are the options for green card holders over 65 in Texas?

Older green card holders, often parents sponsored by an adult child, face the hardest version of the gap. Medicare is the usual answer at 65, but KFF explains that immigrants without enough US work history must have lived here for five years immediately before enrolling. Until then, a newly arrived parent is usually outside Medicare entirely.

After five years, many older immigrants still lack the work credits for premium free Part A. Medicare.gov lists the 2026 cost of buying Part A at $311 or $565 a month, depending on work history, and the standard Part B premium at $202.90 a month.

During the first five years, a Marketplace plan is the main comprehensive option. HealthCare.gov notes that once you have Medicare Part A you no longer qualify for Marketplace savings, but a parent who is not yet eligible for Medicare is not in that position. Two details matter:

• Price rises with age: HealthCare.gov says premiums can be up to three times higher for older people than for younger ones, before any tax credit.
• Tax household: Marketplace eligibility follows the tax household. If you claim your parent as a dependent, their eligibility is judged as part of your household, not on their own income.

For parents who arrived through a family petition, also read our explainer on affidavit of support health insurance, because the sponsor's I-864 affects how Medicaid treats them later.

What medical insurance is there for green card holders over 70 in Texas?

The Marketplace does not cap enrollment by age and HealthCare.gov states that all plans must cover pre-existing conditions from the day coverage starts, which matters a great deal for a parent in their 70s with diabetes or heart disease. Short bridge plans are a different product. The new immigrant plans you can compare on Ombrela are travel medical style policies with age rules and no cover for pre-existing conditions:

• IMG's Patriot Lite, Patriot Plus and Patriot Platinum accept ages 14 days to 99 years, but IMG's terms limit Patriot Lite and Patriot Plus to $10,000 of coverage for travelers over 80, and acute onset of pre-existing conditions is only covered under age 70 on Patriot Plus and Patriot Platinum.
• Trawick's Safe Travels USA plans stop at age 89. Safe Travels USA Comprehensive pays acute onset up to the policy maximum at 69 and under, up to $35,000 for ages 70 to 79 and up to $20,000 at 80 and above.
• None of these plans covers ongoing treatment of a known condition, so they complement a Marketplace plan rather than replace it for older relatives.

For a relative with a managed chronic condition, prioritize getting the Marketplace plan active as fast as the rules allow. Our guide to the five year Medicaid bar for immigrant parents covers the trade offs in more depth.

When does a bridge plan make sense in Texas?

A bridge plan is for recent arrivals: the weeks between landing in Houston, Dallas or San Antonio and the first day your Marketplace or employer coverage begins. It is not a long term answer for someone who has lived in Texas for years. Trawick's plans must be bought within 364 days of arrival, and IMG's Patriot plans can be purchased after you arrive.

Check eligibility by home country before you rely on one. The catalog shows IMG's Patriot plans are not available to residents of Nigeria, Ghana, Cuba, Venezuela, Iran and several other countries, and Trawick's Safe Travels USA plans exclude residents of Nigeria, Ghana, the Dominican Republic, Haiti, Cuba, Venezuela, most of the European Union and others. If your home country is excluded from both, focus on starting Marketplace or employer coverage as early as possible.

What changes for Texas immigrants in 2027?

According to KFF, from January 1, 2027 subsidized Marketplace coverage is limited to lawful permanent residents, Cuban and Haitian entrants and people from the Compact of Free Association nations. Green card holders keep tax credits; refugees, asylees, TPS holders and visa holders lose them but can still buy at full price.

HealthCare.gov lists open enrollment for 2027 coverage from November 1 to January 15. Enroll by December 15 for coverage that starts January 1; plans chosen December 16 to January 15 start February 1. This article is general information, not legal advice; for questions about your own status, speak with an immigration attorney or accredited representative.

Download the Texas new resident coverage checklist

Download our free Texas New Resident Coverage Checklist below. It turns this guide into a one page plan: a Marketplace eligibility check, the Texas Medicaid limits that apply to your family, a side by side bridge plan comparison, options for senior parents, the documents to gather and the key dates that decide when your coverage starts.

How to get covered

Start the Marketplace application as soon as you have your green card or immigrant visa details, then cover the days before it starts. You can compare new immigrant insurance quotes on Ombrela by age, arrival date and home country. Premiums depend on age, coverage length, policy maximum and deductible, so check live quotes rather than averages, and use the medical cost estimator to see what an uncovered emergency could cost in Texas.

Frequently Asked Questions

Can a new green card holder get Medicaid in Texas?

Usually not. Most green card holders face a five year wait before Medicaid, and Texas has not expanded Medicaid, so adults generally need very low income and a qualifying category such as parent or pregnancy. KFF lists the Texas parent limit at 15% of the poverty level. Children are different: Texas covers lawfully residing children in Medicaid and CHIP without the five year wait, according to Medicaid.gov.

Can green card holders over 65 in Texas buy a Marketplace plan?

Generally yes, if they are not yet eligible for Medicare. Recent arrivals without enough US work history usually cannot enroll in Medicare until they have lived here for five years, so the Marketplace is their main comprehensive option. Premiums can be up to three times higher than for younger adults, and eligibility for tax credits depends on the tax household, including whether a child claims the parent as a dependent.

Will a bridge plan cover my parent's pre-existing condition?

No. The new immigrant plans on Ombrela state that pre-existing conditions are not covered. Some include limited cover for a sudden, unexpected flare up of a known condition, with age limits: IMG's Patriot Plus and Platinum only for travelers under 70, and Trawick's Safe Travels USA Comprehensive up to $35,000 for ages 70 to 79. For ongoing care, a Marketplace plan is the appropriate product.

Do green card holders in Texas keep Marketplace subsidies in 2027?

Yes. According to KFF, from January 1, 2027 Marketplace tax credits are limited to lawful permanent residents, Cuban and Haitian entrants and residents from the Compact of Free Association nations, so green card holders remain eligible if their income qualifies. HealthCare.gov describes tax credits for household incomes between 100% and 400% of the federal poverty level, and since 2026 lawfully present immigrants below 100% no longer qualify.

Texas leaves little public coverage for new adult immigrants, so the order of steps matters: apply on HealthCare.gov, enroll children in Medicaid or CHIP, and cover the first weeks on arrival. When you are ready, get new immigrant quotes on Ombrela and compare plans that match your age and home country.