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Health Insurance Alternatives: Texas FAQ
Straight answers to the questions Texans ask most.
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We'll look at direct primary care options in your area and contact you with your estimate.
Prefer to talk now? Call (214) 307-8614Frequently asked questions
Is health care sharing the same as health insurance?
No. Health care sharing is a group of members who agree to share each other's eligible medical bills under written guidelines. Nobody is required to pay, so sharing isn't guaranteed. It isn't regulated as insurance, and it isn't Minimum Essential Coverage under the ACA.
Is it legal in Texas?
Yes. Chapter 1681 of the Texas Insurance Code says a qualifying health care sharing ministry isn't treated as insurance, which also means insurance consumer protections don't apply. Texas Occupations Code § 162.253 says direct primary care agreements aren't insurance. There's no state penalty for going without insurance.
What is an Initial Unshareable Amount (IUA)?
It's the part of each medical Need you pay yourself before other members can share the rest. It works per Need, not per year, so it isn't a deductible. With the program we most often recommend, you choose the amount when you join (our price table shows $500 to $2,500), and no more than three IUAs apply in a membership year.
What isn't shared?
Routine and preventive care (except some screenings), most ongoing prescriptions after the first 120 days, routine dental, glasses and contacts, alternative medicine, and counseling above $750 a year. That's why we pair sharing with primary care and a dental plan.
What about pre-existing conditions?
Conditions with symptoms, treatment or medication in the 36 months before joining are phased in: not shareable in year one, up to $25,000 in year two, up to $50,000 in year three, and fully shareable after that.
Can I use any doctor or hospital?
For health sharing, yes, including hospitals across the state line. There's no provider network, so you pay as a self-pay patient and submit eligible bills. The virtual primary care membership is a specific practice that you reach by video and phone.
How do I pay a big bill?
You pay the provider up to your IUA, open a Needs case and upload itemized bills within six months. The program negotiates bills over $1,000, and shared money is paid to you so you can pay the provider.
Is there an age limit?
New members must be 18 to 64. At 65, members need Medicare Parts A and B to stay.
What if I need care while I'm working away from home?
Health sharing has no network, so you can use any licensed hospital wherever you are, in Texas or out of state, and your virtual primary care team is a phone or video call away. For an emergency, notify the sharing program within 48 hours.
My Marketplace insurer is leaving Texas for 2027. What now?
Baylor Scott & White and Cigna are leaving the Texas Marketplace at the end of 2026. Choose a new plan at HealthCare.gov during open enrollment (Nov 1, 2026 to Jan 15, 2027; by Dec 15 for a Jan 1 start). If you want to compare the alternatives too, we'll show you prices and limits. We don't sell insurance.
I fall in Texas's coverage gap. Can you help?
Check HealthCare.gov and Texas Medicaid and CHIP first, because there are exceptions for children, pregnant women and some parents. Community health centers charge on a sliding scale. Health sharing isn't insurance, but some households in the gap use it; we'll talk it through honestly.
Can I keep my HSA?
Generally no. Health sharing isn't a high-deductible health plan, so you usually can't add new money to an HSA while you rely on it. Money already in an HSA stays yours. Ask your tax preparer about your situation.
Do you charge for help?
No. There's no cost to talk with us. We may be paid by some programs we recommend; our Referral Marketing Disclosure explains how.
Sources
- Texas Insurance Code ch. 1681, health care sharing ministries (§ 1681.001 criteria, § 1681.002 notice)
- Texas Occupations Code § 162.253, direct primary care is not insurance
- Texas Medicaid eligibility and the coverage gap (healthinsurance.org, updated Sep 17, 2026)
- Texas Marketplace guide: 2026 and proposed 2027 rates, insurers, enrollment, open enrollment (healthinsurance.org, updated Aug 27, 2026)
- Sedera SELECT+ Membership Guidelines, v231001 (rules on IUA, pre-existing conditions, maternity, prescriptions)
Have a question that isn't here?
Call us or send a short note. We'll answer it plainly, even if the answer is that insurance fits you better.
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