Community Health Choice Calculator
Complete Guide to Texas STAR, CHIP & Marketplace Eligibility

Calculate My Eligibility →

The Community Health Choice Calculator is a free online tool designed to help Texas residents estimate their eligibility for health coverage through Community Health Choice — a nonprofit health plan and affiliate of the Harris Health System. Whether you’re a low-income family seeking STAR Medicaid, a working parent applying for CHIP, a pregnant woman needing prenatal coverage, an adult with disabilities looking into STAR+PLUS, or an individual shopping for Marketplace plans, this calculator provides instant estimates based on your household size, income, age, and county of residence.

With rising healthcare costs across Texas, understanding your options before applying can save you hundreds — or even thousands — of dollars annually. The calculator uses the 2025 Federal Poverty Level (FPL) guidelines, Texas-specific Medicaid expansion parameters, and Community Health Choice’s program structure to generate personalized results. By the end of this guide, you’ll understand exactly how to use the tool, interpret your results, and take the next steps toward enrollment.

How to Use the Community Health Choice Calculator — Step by Step

Using the calculator above is straightforward, but understanding each input ensures the most accurate estimate. Below is a detailed walkthrough of every field and how it affects your eligibility determination.

Step 1: Enter Your Household Size

Household size includes everyone you claim on your tax return, plus any dependents. For Medicaid and CHIP, this typically includes you, your spouse, and all children under 19 living with you. For pregnant women, count the unborn child as a household member. Select from 1 to 6+ people. This directly determines your Federal Poverty Level threshold — a family of 4, for example, has a 100% FPL of $31,200 in 2025.

Step 2: Provide Your Annual Household Income

Enter your total before-tax income from all sources: wages, self-employment, Social Security, child support, unemployment benefits, and any other regular payments. Do not include tax refunds or one-time gifts. The calculator compares your income to the FPL for your household size to determine which program you likely qualify for.

Step 3: Select Your Age Category

Community Health Choice offers different programs for different populations. “Child (0-18)” directs the calculator toward CHIP or STAR for children. “Adult (19-64)” evaluates STAR Medicaid (for very low income) or Marketplace plans. “Senior (65+ with disability)” checks STAR+PLUS eligibility. “Pregnant Woman” uses CHIP Perinate or STAR Medicaid pregnancy coverage, which has higher income limits (up to 198% FPL).

Step 4: Indicate Number of Children in Household

Even if you selected “Adult,” children in the household may qualify for separate CHIP or STAR coverage even if the adult does not. The calculator accounts for mixed-eligibility scenarios.

Step 5: Choose Your Texas County

Community Health Choice serves 20+ Texas counties including Harris, Fort Bend, Montgomery, Galveston, Brazoria, Liberty, Chambers, Waller, and more. Selecting your county confirms that Community Health Choice plans are available in your area. All eligible counties display the same programs, but rural counties may have different provider networks.

Step 6: Click “Calculate My Eligibility”

The calculator instantly processes your inputs and returns: your likely program (STAR, CHIP, STAR+PLUS, or Marketplace), estimated monthly premium, annual savings compared to private insurance, a detailed eligibility note, and a list of extra benefits you’ll receive at no additional cost.

Understanding Your Results: A Complete Breakdown

The Community Health Choice calculator returns four key pieces of information. Here’s what each means and how to act on it.

Likely Program

This tells you which Community Health Choice program you probably qualify for based on your income relative to the Federal Poverty Level.

• STAR (Medicaid): Income up to 138% FPL. $0 premium. Full benefits including doctor visits, hospital care, prescriptions, dental, vision, mental health, and transportation.
• CHIP / CHIP Perinate: Income 139%–200% FPL for children; up to 198% FPL for pregnant women. Low or $0 premiums. Comprehensive pediatric or maternity coverage.
• STAR+PLUS: For adults with disabilities or seniors 65+ who qualify for Medicaid. Combines medical care with long-term services and supports (LTSS).
• Marketplace (ACA): Income 100%–400% FPL (or higher in 2025 due to expanded subsidies). Premium tax credits available. Community Health Choice offers Silver, Gold, and Bronze plans.

Monthly Premium Estimate

This is your estimated out-of-pocket cost per month. For STAR and STAR+PLUS, premiums are $0. For CHIP, premiums range from $0 to $50 depending on income. For Marketplace plans, this is your estimated premium after applying Advance Premium Tax Credits (APTC). Many Texas families qualify for $0 premium Silver plans through Community Health Choice.

Annual Savings vs. Private Insurance

This figure estimates how much you save annually by enrolling in Community Health Choice compared to purchasing a comparable private health plan without subsidies. Savings typically range from $3,000 to $8,000 per year for families, and even more for individuals with chronic conditions.

Extra Benefits List

Community Health Choice is known for its value-added services — extra benefits that go above and beyond standard Medicaid and CHIP coverage. These include:

• 24/7 Nurse Help Line: Registered nurses available anytime to answer health questions.
• Sports & School Physicals: One free physical per year for members ages 4-19.
• Extra Vision Allowance: Members can use $120–$150 toward non-standard glasses or contact lenses.
• Well-Child Checkup Rewards: Up to $85 in gift cards for completing Texas Health Steps checkups.
• Asthma Care Supplies: Free allergy-free pillowcases and mattress covers for members in the asthma management program.
• Transportation Assistance: Rides to and from medical appointments.
• Gift Card Rewards: $25 for flu shots, $30 for diabetic eye exams, $85 for diabetic HbA1c testing.

2025 Federal Poverty Level Guidelines for Texas

The Federal Poverty Level (FPL) is updated annually by the Department of Health and Human Services. For 2025, the guidelines are:

Texas did not expand traditional Medicaid to all adults below 138% FPL, but parents of dependent children, pregnant women, children, and individuals with disabilities are covered. The calculator accounts for these nuances.

Community Health Choice Programs: Detailed Comparison

Real-Life Examples: Using the Calculator

Example 1: Single Mother with Two Children

A 34-year-old mother of two living in Harris County earns $32,000 annually. Household size: 3. Entering these values into the calculator returns: Likely Program = STAR (Medicaid) for the children, and the mother may qualify for limited Medicaid (if pregnant) or Marketplace coverage. Monthly premium for children: $0. Annual savings: approximately $5,200. Extra benefits include well-child rewards and vision allowance.

Example 2: Self-Employed Couple, No Children

A married couple (both 45) earning $55,000 annually with no children. Household size: 2. Calculator result: Marketplace (ACA) with premium tax credits. Estimated monthly premium after credits: $280. Annual savings vs. private insurance: $3,600. Eligible for SilverSneakers fitness and telehealth benefits.

Example 3: Pregnant Woman, Household of 2

A 28-year-old pregnant woman earning $28,000 annually (household size 2, counting unborn child). Calculator result: CHIP Perinate. Monthly premium: $0. Comprehensive prenatal, delivery, and 60-day postpartum coverage included. Extra benefits: transportation to appointments and 24/7 nurse line.

Frequently Asked Questions