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State guide

How to pay less for medication in Texas

The state programs and rules that affect what you pay for prescriptions in Texas, plus the nationwide help that works everywhere.

Last checked October 1, 2026
Medicaid expansionNo
State insulin copay cap$25 per 30-day supply (state-regulated plans)
Health insurance marketplaceHealthCare.gov
State drug help programsKidney Health Care Program (Kidney disease)

Medicaid in Texas

Texas has not expanded Medicaid, so many adults without children can’t qualify based on income alone. If your income is low, check anyway: children, pregnant women, people with disabilities and some parents may qualify.

You can apply for Medicaid any time of year. Find your state agency through Medicaid.gov.

Insulin

Texas caps insulin at $25 for a 30-day supply in state-regulated health plans. Many job-based plans are self-funded and regulated federally instead, so ask your plan whether the cap applies to you.

All $35 insulin programs →

State drug help programs

The National Conference of State Legislatures lists this program in Texas:

  • Kidney Health Care Program: kidney disease

State programs change. Search the program name with “Texas” to confirm it’s still running and check who qualifies.

HIV medication

Texas runs an AIDS Drug Assistance Program (ADAP) that helps pay for HIV medication. See HIV.gov to find it.

On Medicare in Texas?

  • Your State Health Insurance Assistance Program (SHIP) gives free, unbiased Medicare help. Find it at shiphelp.org or call 877-839-2675.
  • Check whether you qualify for Extra Help, which can cut copays to a few dollars.
  • Open enrollment runs October 15 to December 7. Use our checklist.

Help that works in every state

Common questions

Did Texas expand Medicaid?

Texas has not expanded Medicaid, so many adults without children can’t qualify based on income alone. If your income is low, check anyway: children, pregnant women, people with disabilities and some parents may qualify.

Does Texas cap insulin costs?

Texas caps insulin at $25 for a 30-day supply in state-regulated health plans. Many job-based plans are self-funded and regulated federally instead, so ask your plan whether the cap applies to you.

Where do I buy a Marketplace health plan in Texas?

Texas uses HealthCare.gov.

Sources: KFF (Medicaid expansion) · American Diabetes Association (insulin caps) · NCSL (state programs) · healthinsurance.org (marketplaces). Last checked October 1, 2026.