Texas insurance questions and answers

These are the questions Texas residents ask us most often about health, Medicare, dental, vision, life, and final expense coverage. Answers are general and educational: your county, your eligibility, and the plan documents always control what is actually available to you. RGI Group is licensed in Texas and works with clients statewide by phone and virtual appointment, in English or Spanish.

Health insurance and the ACA Marketplace

Texas uses the federally facilitated Health Insurance Marketplace, so Marketplace applications and official plan information live at HealthCare.gov.

  • What is the Health Insurance Marketplace, and does Texas run its own? The Marketplace is the place where individuals and families who do not have coverage through a job or a government program can apply for individual health plans. Texas does not run a state-based exchange, so Texans use the federally facilitated Marketplace at HealthCare.gov.
  • Can I qualify for help paying for a Marketplace plan? Eligibility for premium tax credits and cost-sharing reductions depends on your household size, expected income, and whether you have access to other qualifying coverage. HealthCare.gov determines eligibility when you apply; we can walk you through the questions, but we cannot promise an amount.
  • What should I compare besides the monthly premium? Look at the deductible, copays and coinsurance, the out-of-pocket maximum, whether your doctors and hospitals are in the plan's network, and how your prescriptions are covered on the plan's drug list. A lower premium can come with higher costs when you actually use care.
  • Do you help with employer or group coverage questions? We can explain how an offer of employer coverage affects your individual and Marketplace options. Decisions about a specific employer plan should also be reviewed with that plan's documents or your employer's benefits contact.

Medicare

Medicare rules are federal, and the plans available in a Texas county can change from year to year.

  • What are the parts of Medicare? Part A covers inpatient hospital care and certain skilled nursing, hospice, and home health services. Part B covers outpatient and medical services. Part C (Medicare Advantage) is a private plan that delivers Part A and Part B benefits, often with extras. Part D covers prescription drugs. Medicare.gov explains each part in detail.
  • Should I look at Medicare Advantage or Original Medicare with a supplement? Both approaches are common, and the better fit depends on how you use care, which providers matter to you, your prescriptions, and how you feel about networks and referrals. We can review the options we are able to offer in your area so you can compare them side by side.
  • When can I enroll in or change a Medicare plan? There is an initial enrollment window around Medicare eligibility, an annual period each fall when many people can change plans for the following year, and additional special periods for certain situations such as moving or losing other coverage. Confirm current dates for your situation on Medicare.gov or with 1-800-MEDICARE.
  • How do I see every Medicare option available to me? Use the plan finder on Medicare.gov, call 1-800-MEDICARE, or contact the Texas Health Information, Counseling and Advocacy Program (HICAP). We do not offer every plan available in your area, so those resources are the complete picture.

Dental and vision coverage

Dental and vision benefits are usually separate from major medical coverage, and the details vary a great deal between plans.

  • Is dental or vision coverage included with my health plan? Adult dental and vision benefits are frequently not included in a major medical plan and are bought separately. Pediatric dental is treated differently under the Marketplace, so it is worth checking each plan's summary of benefits.
  • What should I check before buying a dental plan? Read how the plan treats preventive, basic, and major services, whether there are waiting periods for larger procedures, whether an annual maximum applies, and whether your dentist participates. The plan documents control the actual terms.
  • How do vision plans usually work? Vision plans commonly help with routine eye exams and provide an allowance toward frames, lenses, or contacts on a set schedule. Because allowances and frequencies differ by plan, compare the benefit summary rather than assuming a standard design.

Life insurance and final expense

Life insurance is underwritten, so eligibility, pricing, and the amount of coverage available depend on the individual and the carrier.

  • What is the difference between term and permanent life insurance? Term coverage lasts for a set number of years and pays a death benefit if the insured dies during that term. Permanent coverage is designed to last for life and may build cash value. Which one fits depends on what you are protecting and for how long.
  • How much life insurance do I need? There is no single correct amount. It is more useful to add up what you would want covered — outstanding debts, a mortgage, income replacement for the years your household would need it, education goals, and final expenses — than to rely on a rule of thumb.
  • What is final expense insurance? Final expense policies are typically smaller permanent life policies intended to help a family with funeral, burial, and related end-of-life costs. Costs vary widely by location and by the arrangements a family chooses, so it is worth getting local estimates before deciding on an amount.
  • Will I need a medical exam? It depends on the product and the carrier. Some policies use a full exam, others rely on health questions and records, and some are designed for simplified underwriting. We can explain what a specific application involves before you start it.

Enrollment periods and special enrollment

Most coverage can only be started or changed during a defined window. Because those windows move, always confirm current dates with the official source before you plan around them.

  • When can I enroll in a Marketplace health plan? Marketplace coverage is generally chosen during the annual Open Enrollment Period, with a Special Enrollment Period available after certain life events. HealthCare.gov publishes the current dates and the qualifying events.
  • What counts as a qualifying life event? Common examples include losing other health coverage, moving, marriage or divorce, having or adopting a child, and certain income or household changes. Documentation is often required, and HealthCare.gov lists what applies.
  • What if I miss the enrollment window? Depending on your situation you may still have options, such as a Special Enrollment Period if you have a qualifying event, or programs like Medicaid and CHIP that accept applications year-round. Dental, vision, and life products often follow different timing rules.
  • How do I prepare for an enrollment conversation? Have your ZIP code, who needs coverage, the doctors and prescriptions that matter to you, and a general budget in mind. Please do not send Social Security numbers, Medicare ID numbers, dates of birth, income figures, diagnoses, or prescription details through this website.

Working with RGI Group

RGI Group is an independent agency licensed in Texas. You are always free to enroll on your own through the official government resources.

  • Does RGI Group have an office in my city? No. RGI Group has one office, in Austin, and serves Texas residents statewide by phone and virtual appointment. Paperwork can usually be completed electronically, so you do not need to travel to meet with us.
  • Is there a cost to review my options with RGI Group? You do not pay RGI Group a separate fee to review coverage options. You are also free to enroll on your own through the official government resources linked on this page.
  • Can we talk in Spanish? Yes. Appointments and follow-up can be handled in English or Spanish, whichever you prefer.
  • Which plans and carriers are available to me? Availability depends on your county, eligibility, and the product you are looking at, and it can change from year to year. We can tell you what we are able to offer for your situation rather than promise a specific plan or price.
  • What should I have ready for a first conversation? Your ZIP code, who needs coverage, the doctors or prescriptions that matter to you, and a general sense of your budget. Please do not send Social Security numbers, Medicare ID numbers, date of birth, income, diagnoses, or prescription details through this website.

Forms, contact, and privacy

The forms on this site are request forms. Submitting one starts a conversation; it does not enroll you in coverage and does not confirm an appointment.

  • What happens after I submit a request? A licensed agent follows up using the contact method you selected to confirm a time and talk through your options. Nothing is scheduled or submitted to a carrier until we confirm it with you.
  • Will I get text messages? Only if you choose text as your contact method and give consent on the form. Message and data rates may apply, and you can ask us to stop at any time.
  • What information should I keep off the form? Leave out Social Security numbers, Medicare ID numbers, dates of birth, household income, diagnoses, and prescription details. Those items are handled in a direct conversation, not through this public form. Our Privacy Policy explains what the form collects and why.

Statewide and virtual service

RGI Group works from one office in Austin and serves Texas residents everywhere in the state.

  • Do I have to meet in person? No. Most conversations happen by phone or virtual appointment, and paperwork can usually be completed electronically. If you prefer to meet at the Austin office, let us know and we can arrange a time.
  • Do you serve small towns and rural counties? Yes. We work with Texans statewide. What is available in your county can differ from a large metro area, which is one reason we start by confirming your ZIP code.
  • Are you licensed outside Texas? This site covers Texas only. If you move out of state, we would let you know rather than continue advising you about coverage we are not licensed to place.

Official resources

  • HealthCare.gov — https://www.healthcare.gov (Texas uses the federally facilitated Health Insurance Marketplace. Official Marketplace information and enrollment live at HealthCare.gov.)
  • Medicare.gov — https://www.medicare.gov (Official Medicare information, plan finder tools, and all options available in your area.)
  • Texas Department of Insurance — https://www.tdi.texas.gov (The state regulator for insurance in Texas, with consumer help lines and company license lookups.)

Talk with a licensed Texas agent

Call or text (346) 888-8811. Office: 5900 Balcones Drive, Ste 100, Austin, TX 78731. Open 24 hours, 7 days a week. Licensed in Texas. Guidance available in English and Spanish.