Biggest Health Insurance Companies in Texas for 2023

In Texas, the biggest health insurance companies are a crucial part of the state's healthcare system. Blue Cross Blue Shield of Texas is one of the largest health insurance companies in the state, serving over 5 million members.

UnitedHealthcare is another major player, offering a range of plans to individuals, families, and employers. The company's network of providers includes over 90% of Texas hospitals.

Aetna is also a significant player in the Texas health insurance market, offering plans to individuals, families, and small businesses. The company has a strong presence in the state, with over 2 million members.

Blue Cross Blue Shield of Texas is a statewide health insurance company that offers coverage across all three metal tiers, including bronze, silver, and gold plans. They have a 24/7 nurse line and virtual visits with doctors through MDLIVE.

Their plans have varying deductibles, from $0 to $9,450, and out-of-pocket maximums range from $9,100 to $18,900. You may also qualify for financial assistance programs that help lower your costs. Blue Cross Blue Shield of Texas has worked with state non-profits for 90 years to offer health-focused programs.

Some of their plans include:

Baylor Scott and White is another major health insurance company in Texas, offering HMO and EPO options depending on the county you live in. They have deductibles ranging from $0 to $9,450 and out-of-pocket maximums between $9,400 and $18,900. Their plans also offer a 24/7 doctor visit service through the myBSWHealth mobile app.

Molina is a health insurance company that has been serving Texas residents since 2005. They offer a range of plans that cater to individuals and families, with deductibles ranging from $525 to $6,400 for individuals and $1,050 to $12,800 for families.

Molina emphasizes quality care, easy access, and friendly customer service. Their benefits include government-sponsored care programs, a 24-hour nurse advice line, online health plan portal, and a large network of providers.

One of the unique features of Molina is their health education courses, which include weight management, help to stop smoking, and maternity education and services. These courses are designed to promote healthy habits and prevent chronic diseases.

Molina offers coverage in 14 counties surrounding major Texas cities, including El Paso, Dallas, Houston, San Antonio, and Laredo. Their individual deductibles range from $0 to $7,000, with copays averaging around $30.

Molina also offers virtual care through Teladoc, which is available 24/7 at no cost online, through a mobile app, or a traditional phone call. This feature allows customers to consult with doctors remotely, saving time and hassle.

Here are the four levels of Silver coverage offered by Molina, each with four steps within those levels:

Molina also offers two Gold metal plans, as well as Adult Vision services as an added feature on select plans. Their My Molina Portal offers health perks, including the opportunity to earn a gift card by answering health questions and completing an annual physical.

Medicare Advantage markets have been a topic of interest in recent years. A significant number of markets, 71%, were highly concentrated in 2022, down from 87% in 2017.

This change is concerning, as it can lead to reduced competition and higher prices for consumers. In 31% of MSAs, one health insurer held a market share of at least 50%. This means that a single company has a significant amount of control over the market.

The largest health insurers by market share are worth noting. UnitedHealth Group was the largest in 42% of MSAs, followed by Humana in 22% of MSAs, and CVS (Aetna) in 7% of MSAs.

Here's a breakdown of the 10 largest health insurers by market share at the national level:

These numbers highlight the dominance of a few large health insurers in the market.

Blue Cross Blue Shield of Texas offers a 24/7 nurse line for immediate medical advice.

You can use their provider finder tool to locate doctors and hospitals in your area.

Their virtual visits allow you to have a live consult with doctors from the comfort of your own home.

BCBS offers bronze, silver, and gold plans, which cover 60, 70, and 80 percent of your medical costs, respectively.

Blue Cross Blue Shield of Texas has worked with state non-profits for the past 90 years to offer health-focused programs.

You may qualify for financial assistance programs that help lower your costs with BCBS.

Baylor Scott & White offers a wide range of health insurance plans in Texas, with options to suit different budgets and needs.

They have Bronze, Silver, and Gold plans, with varying deductibles, coinsurance rates, and out-of-pocket maximums. For example, the BSW Vital Bronze HMO 007 plan has a deductible of $7500/$15,000 and coinsurance of 50%.

Their Silver plans include the BSW Prime Silver HMO – 008, which has a deductible of $5900/$11,800 and coinsurance of 40%. Another Silver plan, BSW Prime Silver HMO – 005, has a deductible of $1200/$2400 and coinsurance of 0%.

Their Gold plan, BSW Elite Gold HMO – 004, has a deductible of $1100/$2200 and coinsurance of 25%. It's worth noting that Gold plans can sometimes be comparable in premium to Silver plans, especially in cases where the Marketplace has increased costs for the Silver plan tier.

Here's a comparison of some of their plans:

Their plans also include various copays for primary care visits, specialist visits, emergency room visits, and more. For example, the BSW Vital Bronze HMO 007 plan has a $50 copay for adult primary care visits and $0 copay for pediatric visits.

Medicare coverage in Texas is a complex topic, but don't worry, we've got you covered.

Medicare is a federal health insurance program available to eligible individuals in Texas, including those 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD).

There are several types of Medicare coverage available in Texas, including Medicare Advantage and Medigap.

Medicare Advantage plans are offered by private insurance companies and provide all the benefits of Original Medicare, plus additional benefits like dental, vision, and hearing coverage.

Medigap, on the other hand, is a supplement to Original Medicare that helps cover out-of-pocket costs like deductibles, copays, and coinsurance.

In Texas, Medigap plans are standardized, meaning they offer the same benefits regardless of the insurance company.

Commercial health insurance in Texas can be a bit complex, but let's break it down. 73% of MSA-level markets were highly concentrated in 2022, up from 71% in 2014.

The largest health insurer by market share in 22% of MSAs is Elevance Health (formerly Anthem), followed by Health Care Service Corp. with a market share lead in 11% of MSAs and Highmark with a market share lead in 6% of MSAs.

Some of the biggest health insurance companies in Texas offer a range of plans, including Blue Advantage Plus, Blue Advantage Plus HMO, and My Blue Health. These plans have varying deductibles, coinsurance, and out-of-pocket max, making it essential to choose the one that suits your needs best.

Here's a brief overview of some of the key features of these plans:

Commercial markets are becoming increasingly concentrated, with 73% of MSA-level markets considered highly concentrated in 2022, up from 71% in 2014. This trend is concerning, as it can limit consumer choice and drive up prices.

In many areas, one health insurer dominates the market, holding at least 50% market share in 48% of MSAs. This lack of competition can make it difficult for consumers to find affordable options.

Elevance Health, formerly Anthem, is the largest health insurer by market share in 22% of MSAs, followed by Health Care Service Corp. in 11% of MSAs and Highmark in 6% of MSAs. These companies have significant market power, which can influence prices and services offered.

Here's a breakdown of the top 10 health insurers by national market share:

The health insurance marketplace in Texas categorizes plans into metal tiers: bronze, silver, and gold.

These tiers determine the level of coverage you'll receive, and with it, the monthly premium you'll pay.

A bronze plan offers 60 percent coverage, which means you'll be responsible for 40 percent of medical costs.

A silver plan, on the other hand, provides 80 percent coverage, leaving you with 20 percent of the costs.

The premium for a silver plan is $418 per month for a 40-year-old Texan, as shown in the table below.

In Texas, a gold plan premium costs about 60 percent more than a bronze plan, but it offers 80 percent coverage compared to bronze's 60 percent.

In Texas, you have several options for health insurance. Blue Cross Blue Shield of Texas is a statewide provider that offers health insurance plans across all three metal tiers that adhere to Affordable Care Act standards.

You can choose from bronze, silver, and gold plans, which cover 60, 70, and 80 percent of your medical costs, respectively. BCBS of TX has worked with state non-profits for the past 90 years to offer health-focused programs.

Some of the benefits of Blue Cross Blue Shield of Texas include a 24-hour nurse line, MDLIVE, where you can talk to a doctor virtually, and Blue365, a discount program for health, fitness, and vision/hearing services.

Here are some examples of Blue Cross Blue Shield of Texas plans:

In addition to Blue Cross Blue Shield of Texas, you can also consider employer-sponsored health insurance, individual health insurance plans, family health insurance plans, and government-sponsored programs like Medicare and Medicaid.

If you're a Texas resident looking to buy health insurance, you'll need to meet certain requirements. To qualify for health coverage through the Texas Marketplace, you must live in Texas and be lawfully present in the United States. You can't be incarcerated or enrolled in Medicare.

Eligibility for financial assistance, such as premium subsidies and cost-sharing reductions, depends on your income. To qualify for financial assistance with the cost of your Marketplace plan, you must not have access to affordable health coverage offered by an employer. If your employer offers coverage but you feel it's too expensive, you can use their Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace.

Additionally, you can't be eligible for Medicaid or CHIP, nor can you be eligible for premium-free Medicare Part A. If you're married, you'll need to file a joint tax return. Finally, you can't be claimed by someone else as a tax dependent.

In Texas, you have several options for health insurance. You can get health insurance through your employer, which is the most prevalent type.

There are also individual health insurance plans and family health insurance plans available. Additionally, you can consider government-sponsored programs like Medicare and Medicaid.

You can choose from a variety of insurance companies, including Blue Cross Blue Shield of Texas, which offers health insurance plans across all three metal tiers that adhere to Affordable Care Act standards. They have a 24-hour nurse line and MDLIVE, where you can talk to a doctor virtually.

Blue Cross Blue Shield of Texas has a range of plans, including the Blue Advantage Plus – 202, which has a deductible of $1500/$3000 and coinsurance of 50%. They also offer a discount program called Blue365 for health, fitness, and vision/hearing services.

In Texas, there are 16 participating insurers offering coverage for 2025, including Wellpoint, which is a newcomer to the market. Some counties in Texas only have one insurer offering health plans on the exchange.

Here are some key features of Blue Cross Blue Shield of Texas plans:

You can also consider dental insurance to improve your smile. Texas Health Insurance Brokers offers dental coverage options, including coverage for a preferred dentist.

Choosing the right plan can be overwhelming with so many options available. In Texas, you can choose from employer-sponsored health insurance, individual health insurance plans, family health insurance plans, and government-sponsored programs like Medicare and Medicaid.

The level of coverage you need should be your top priority when selecting a plan. Do you need comprehensive coverage for routine doctor's visits, hospital stays, and prescriptions, or just basic coverage for doctor's visits and prescriptions? This will help you narrow down your options.

You'll also want to consider the out-of-pocket costs associated with each plan, including deductibles, copayments, and coinsurance. These costs can add up quickly, so it's essential to choose a plan that fits your budget.

In Texas, the health insurance marketplace offers plans from multiple insurers, and you may qualify for financial assistance to reduce your monthly premium and out-of-pocket expenses. The Marketplace provides access to health insurance products from numerous private insurers, with most areas of the state having plans available from multiple insurers.

Here's a breakdown of the average monthly premium for each plan type in Texas:

This table shows that a gold plan premium costs about 60 percent more than a bronze plan, but offers 80 percent coverage compared to 60 percent for bronze plans.

There are several big health insurance companies in Texas that offer a range of plans and benefits. Blue Cross Blue Shield of Texas is one of the largest, offering plans across all three metal tiers that adhere to Affordable Care Act standards.

They have a wide range of plans, including bronze, silver, and gold, with deductibles between $0 and $9450. Some of their benefits include a 24-hour nurse line, MDLIVE virtual visits, and a discount program for health, fitness, and vision/hearing services.

Aetna is another major player in Texas, offering six silver and four gold metal plans, as well as options for those who qualify for cost-sharing reductions. They have deductibles between $0 and $8390 and offer benefits like a $100 health allowance for members to use toward CVS Health brand products.

Here's a comparison of some of the major health insurance providers in Texas:

FirstCare offers plans in 143 counties and has a network of over 160,000 community members. They offer a range of benefits, including full coverage for preventive care and pharmacy benefits.

United Healthcare is a large health insurance provider in the US. They offer a variety of healthcare plans in Texas.

United Healthcare has a network of healthcare providers, such as physicians and clinics. This ensures that their members have access to quality care.

They partner with leading hospitals and healthcare systems to provide comprehensive coverage. Whether it's a routine checkup or complex medical procedure, United Healthcare's service is exceptional.

Here are some key facts about United Healthcare:

Cigna is a major health insurance provider that offers a range of plans, including HMO and PPO options. They provide access to a wide range of doctors and hospitals, making it easy to find quality care no matter where you live.

Cigna offers a 24/7 customer service line for members, ensuring that you can get help when you need it. They also have a discount program called Cigna Rewards, which allows you to earn points and up to $350 cash to spend on health-related items.

Their plans are listed primarily by deductible level, with over 20 options to choose from. You can select a plan with a deductible as low as $0 or as high as $9,450, depending on your needs.

Cigna also offers plans designated for Native American and Alaskan Native residents, which often have a zero-dollar deductible. They also have their own dental insurance company, which offers three different coverage levels.

Here are some key details about Cigna's plans:

Their plans also cover various medical services, including primary care visits, specialist visits, virtual visits, emergency room visits, and more.

Aetna is a popular insurance option in Texas, offering comprehensive plans and competitive rates. It's a great choice for those who need extensive coverage.

Aetna plans give access to over 500 hospitals and 200 physicians' offices, all of which are located within 60 miles of each other. This convenience can be a huge time-saver.

Vision and dental coverage are included in Aetna's package, making it a one-stop-shop for all your health needs. This can help simplify your insurance experience and reduce costs.

However, it's worth noting that Aetna is limited to 41 of the 254 Texas counties. This may affect your ability to access their services.

In 2024, Aetna no longer offers a Bronze metal tier in the state, but they do offer six silver and four gold metal plans, along with over a dozen options for those who qualify for cost-sharing reductions. This can be a bit confusing, but it's essential to review your options carefully.

Aetna's benefits include a health allowance of $100 for members to use toward CVS Health brand products, as well as Zero-dollar 24/7 virtual and walk-in clinics in locations across Texas. This can be a huge perk for those who value convenience.

Here are some of Aetna's plan details:

Aetna is also one of the few insurance companies that offer a plan schedule for American Indians and Alaskan Natives. This can be a valuable resource for those who qualify.

To purchase Aetna's dental network, you'll need to purchase your policy off-market. This doesn't affect your ability to adhere to ACA standards, but it does require a bit more effort on your part.

BlueCross Blue Shield is a well-established healthcare provider in Texas, offering a range of insurance plans to suit different needs. They have been working with state non-profits for the past 90 years to provide health-focused programs.

Their plans are available statewide, making them a convenient option for those living in Texas. BlueCross Blue Shield of Texas is known for being available everywhere, but being an HMO, you are required to remain within your physician network or pay out-of-network fees.

They offer a 24-hour nurse line and MDLIVE, where you can talk to a doctor virtually. This is a great option for those who need immediate medical attention but can't make it to the doctor's office.

Their plans include bronze, silver, and gold options, which cover 60, 70, and 80 percent of your medical costs, respectively. You may also qualify for financial assistance programs that help lower your costs.

Here are some of the key benefits of BlueCross Blue Shield of Texas:

Their rates have even experienced a .24 percent rate decrease for 2024, making them a more attractive option for those on a budget.

Ambetter is a prominent health insurance provider in Texas that offers affordable and comprehensive health insurance plans for individuals and families.

They have established partnerships with a wide network of healthcare providers, hospitals, and specialists, making it easier for customers to access quality care.

Ambetter prioritizes customer satisfaction and strives to make healthcare more accessible through innovative digital tools and personalized support.

Their plans offer a range of deductibles, from $0 to $6,300, depending on the plan selected.

Ambetter also offers Gold metal plan options, as well as a Medicare Advantage plan known as Allwell.

Here are some key features of Ambetter plans:

Ambetter contracts with healthcare providers like primary care doctors, specialty physicians, hospitals, pharmacies, and more, ensuring customers have access to a wide range of care options.

Their plans also offer benefits like a rewards program and maternity programs, making them a great option for families and individuals with varying health needs.

Ambetter is both an HMO and an EPO, with the main difference being that HMOs allow customers to go out of network with permission, while EPOs do not.

UnitedCare offers a wide range of health insurance plans, including HMO and PPO options. They also provide access to a vast network of doctors and hospitals, making quality care available no matter where you live.

One of the unique features of UnitedCare is their unique plan structure, which allows subscribers to choose between four different plan levels. Each plan level has its own set of advantages, including varying deductibles and copays.

Here's a breakdown of the different plan levels offered by UnitedCare:

UnitedCare also offers a unique feature called "Plus" which is available on the Advantage and Gold plans, adding Adult Dental and Vision coverage to the policy. This is a rare offering in the insurance industry, where Vision and Dental Insurance are usually separate policies.