Health Insurance Companies in Texas: Affordable Options and Resources

If you're a Texas resident looking for affordable health insurance options, you're in luck. There are several companies that offer a range of plans to fit different budgets and needs.

Some of the largest health insurance companies in Texas include Blue Cross Blue Shield of Texas, Humana, and UnitedHealthcare. These companies offer a variety of plans, including individual and family plans, as well as Medicare and Medicaid options.

In Texas, you can purchase health insurance through the Affordable Care Act (ACA) marketplace, also known as the Health Insurance Marketplace. This marketplace is available from November to December each year, and you can enroll online, by phone, or in person with the help of a certified application counselor.

There are 16 participating insurers offering coverage on the Texas individual/family Marketplace for 2025. This is the same number as there were for 2024, but there is one newcomer and one carrier exiting.

In most Texas counties, at least three insurers are offering health plans on the exchange. Some counties in the north-central part of the state only have plans available from one insurer.

Nearly 3.5 million Texas residents enrolled in the Texas Marketplace during the open enrollment period for 2024 coverage. This enrollment spike was likely due to the American Rescue Plan and the unwinding of the COVID-related Medicaid continuous coverage rule.

Blue Cross Blue Shield of Texas offers several care options, including a 24/7 nurse line and a provider finder tool. BCBS offers bronze, silver, and gold plans that cover 60, 70, and 80 percent of your medical costs, respectively.

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

Blue Cross Blue Shield of Texas has worked with state non-profits for the past 90 years to offer health-focused programs. They are an independent licensee of the Blue Cross Blue Shield Association and are statewide and customer-owned.

The Affordable Care Act (ACA) and Medicaid are closely tied in Texas, where more than 30% of the population relies on Medicaid for health insurance. Medicaid is a state and federally funded program that offers free or low-cost coverage to qualifying low-income individuals.

To qualify for Medicaid, you must meet specific income criteria, which can vary depending on your household size. If your household income rises, making you ineligible for Medicaid, you may need to explore other options, such as enrolling in a Marketplace health insurance plan.

In Texas, Medicaid recipients can still sign up for health insurance through the Marketplace, but they may not be eligible for subsidies like cost-sharing reductions and premium tax credits. This means Medicaid typically remains the more economical choice.

Here's a breakdown of the eligibility criteria for Medicaid and the Marketplace in Texas:

Note that Texas is one of the states that did not expand its Medicaid program under the ACA, leaving a coverage gap for uninsured individuals.

To enroll in an ACA Marketplace plan in Texas, you can visit HealthCare.gov, the Texas health insurance marketplace, or purchase individual and family health coverage with the help of an insurance agent or broker.

You can also call HealthCare.gov's contact center at 1-800-318-2596 (TTY: 1-855-889-4325), which is available 24 hours a day, seven days a week, but closed on holidays.

The open enrollment period for ACA-compliant plans in Texas runs from November 1 to January 15, and if you need coverage to start on January 1, you must apply by December 15.

Outside of open enrollment, you can enroll in a Marketplace plan during a special enrollment period, which is triggered by a qualifying life event, such as getting married, having a baby, or losing job-based health coverage.

To qualify for health coverage through the Texas Marketplace, you must live in Texas, be lawfully present in the United States, not be incarcerated, and not be enrolled in Medicare.

In Texas, 16 insurers offer Marketplace coverage, and most counties have at least three insurers offering plans, although some counties in the north-central part of the state only have one insurer.

Here are the enrollment periods for current year coverage in Texas:

If you miss the Open Enrollment Period, you'll have to wait until the following year to enroll in health insurance unless you experience a qualifying life event.

Medical laws in Texas are designed to protect consumers and ensure they receive essential coverage.

Insurance companies can't charge higher rates to people with pre-existing conditions like asthma, diabetes, or cancer.

The Affordable Care Act (ACA) requires insurance companies to charge the same premiums for men and women for the same plan.

Insurance companies used to look at medical histories and past insurance coverage before the ACA, but now that's no longer the case.

A federal law sets the bar for the most you can pay for covered services, with an out-of-pocket maximum of $8,150 for an individual plan and $16,300 for a family plan in 2018.

Insurance companies must provide residents with at least some coverage for specific services, including cancer screenings, maternity minimum stay, brain injuries, cancer medications, prosthetic and orthotic devices, and reconstructive surgery following a mastectomy.

Here are some essential medical services that insurance companies must cover:

In Texas, you have several options for health insurance. You can purchase individual health insurance plans, including bronze, silver, and gold plans, which cover 60, 70, and 80 percent of your medical costs, respectively.

Blue Cross Blue Shield of Texas offers several care options, including a 24/7 nurse line and virtual visits with doctors. They have worked with state non-profits for 90 years to offer health-focused programs.

You can also consider Texas small group plans, which are available to self-employed individuals and their spouses, even if the group only has two employees who are married to each other. This is thanks to Texas law, which takes precedence over federal law in this case.

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

By considering these options and features, you can choose the best health insurance plan for your needs and budget in Texas.

As a Texas resident, you have access to several ways to get health insurance, but knowing where to start can be overwhelming.

You can contact HealthCare.gov directly at 800-318-2596 for assistance with health insurance options.

There are also resources available to help you compare health insurance plans, such as Texas Health Plan Compare, a service of the Texas Department of Insurance.

The State Exchange Profile: Texas provides an overview of the state's progress toward creating a state health insurance exchange.

The Henry J. Kaiser Family Foundation also offers an overview of Texas' progress toward creating a state health insurance exchange, providing valuable information for residents.

If you're a Texas resident looking for affordable health insurance, you're in luck. Texas uses the federally run exchange for individual market plans, so residents who buy their own health insurance enroll through HealthCare.gov.

Nearly 97% of the 2.4 million Texas residents who had effectuated Marketplace coverage in early 2024 were receiving advance premium tax credits (premium subsidies) that paid an average of $533/month toward their premium costs.

This reduced the average net premium to about $51/month. The Affordable Care Act also includes cost-sharing reductions (CSR), which help to reduce out-of-pocket costs on Silver-level plans for people with household income up to 250% of the poverty level.

Between the premium subsidies and cost-sharing reductions, you may find that an ACA plan is the cheapest health insurance option for you. In fact, you may even pay nothing for your insurance if you qualify for significant savings.

Here are some popular health insurance options in Texas:

It's worth noting that Texas has not expanded Medicaid under the ACA, so there is still a coverage gap in the state. An estimated 617,000 people are in the coverage gap in Texas, which means they earn less than the poverty level, are not eligible for Medicaid, and are also not eligible for subsidies in the Marketplace because their income is under the poverty level.

In Texas, a small group insurer must issue coverage to any group of two or more employees, even if the group only has two employees who are married to each other. So if you and your spouse are self-employed together, you can consider Texas small group plans as well as individual market plans.

As you consider your insurance options, age is a significant factor to consider. Health insurance premiums can be up to three times higher for older people than younger people. TX residents who used QuoteWizard to compare health insurance plans are, on average, 40 years old. This means that if you're younger, you might be able to secure a better rate.

If you're looking for health insurance companies in Texas, you've got plenty of options. Blue Cross Blue Shield of Texas has been around for 90 years, working with state non-profits to offer health-focused programs.

Blue Cross Blue Shield of Texas offers several care options, including a 24/7 nurse line, a provider finder tool, and virtual visits. United Healthcare is another large health insurance provider in the US, offering a variety of healthcare plans in Texas.

United Healthcare has a network of healthcare providers and partners with leading hospitals and healthcare systems to ensure members receive quality care. Cigna is also a multifaceted insurance company that offers health, dental, and supplemental insurance, but is only available in 11 counties covering cities like Dallas and Fort Worth.

Here are some key features of the health insurance companies mentioned:

Ambetter Health is another prominent health insurance provider in Texas, offering affordable and comprehensive health insurance plans for individuals and families. Baylor Scott and White offers both HMO and EPO options, depending on which county you live in.

Broker Services play a crucial role in connecting policyholders with insurance companies. They act as intermediaries, helping individuals find the right insurance coverage.

Insurance brokers work with multiple insurance companies to offer a wide range of policies to their clients. This allows policyholders to compare rates and coverage options.

A broker's expertise is essential in navigating the complex world of insurance. They can help clients understand policy terms and conditions.

Insurance brokers often specialize in specific areas, such as auto, home, or life insurance. This specialization enables them to provide in-depth knowledge and tailored advice to their clients.

Some insurance brokers work on a commission-only basis, meaning they earn a percentage of the premium paid by the client. This can create a conflict of interest, but reputable brokers prioritize their clients' needs above their own earnings.

United Healthcare is a large health insurance provider in the US, offering a variety of healthcare plans in Texas. They have a network of healthcare providers, such as physicians and clinics, and partner with leading hospitals and healthcare systems to ensure members receive quality care.

Their coverage is comprehensive and service is exceptional, whether it's a routine checkup or complex medical procedure. This is a significant advantage for individuals and families looking for reliable health insurance in Texas.

United Healthcare is a well-established company with a reputation for providing quality care. They offer a range of plans, including those with lower deductibles and copays, making them a good option for those with ongoing medical needs.

Here are some key features of United Healthcare's plans in Texas:

Overall, United Healthcare is a solid choice for those looking for comprehensive health insurance in Texas.

Scott & White has been serving Texas residents since 1982, with a mission to be the most trusted name in giving and receiving safe, quality, compassionate healthcare. Their health plan offers HMO and EPO plans, which vary depending on the county you live in.

Both HMOs and EPOs require that you use in-network providers, though specifics for referrals and primary care physicians vary. In Hays, Bastrop, and Walker counties, only the HMO plan is available.

Scott & White offers wellness classes to members, including yoga, walk-in flu clinics, and breastfeeding classes. They have an expansive network of specialties and services, ranging from sports medicine to neuroscience.

Their network includes 48 hospitals, more than 800 patient care sites, over 47,000 employees, and more than 7,800 physicians. They have a strong presence in Texas, with services available in 77 counties.

Here are some key benefits of Scott & White's plans:

Scott & White also offers Medicare Advantage and STAR Medicaid plans, with specific plans tailored for each category. You can also talk to a doctor through their myBSWHealth mobile app 24/7.

Ascension – US offers health insurance plans in a limited area of Texas, specifically in the eighteen counties surrounding Austin.

You can find on-exchange plans in Bastrop, Burnett, Caldwell, Hays, McLennan, Travis, and Williamson counties.

In other counties, only off-exchange plans are available.

The deductibles for Ascension plans range from $0 to $9,450, depending on the chosen plan.

For those eligible for Affordable Care Act health insurance, three Bronze tier plans and three basic Silver plans are available.

Additionally, a variety of Cost-Sharing Reduction plans are offered.

Ascension's Gold tier offers only one plan for the 2024 plan year.

They also provide coverage for American Indian and Alaskan Native populations.

Prescription coverage and mail order pharmacy services are part of Ascension's offerings.

However, dental coverage is not available for adults or children, except for the children's ACA Essential benefit.

Vision coverage is offered for children, and the payment structure depends on the metal tier.

Ascension offers various discount programs, including True Hearing, which provides discounts on hearing devices.

They also offer savings on gym memberships.

It's essential to note that Ascension is an EPO, which means you need to stay within your physician network to have your visits covered.

To get the best value from your health insurance, carefully compare plans from different insurers. You need to assess the level of coverage you require, whether it's comprehensive or basic.

Comprehensive coverage includes everything from routine doctor's visits to hospital stays. Basic coverage, on the other hand, is just for doctor's visits and prescriptions.

Pay attention to out-of-pocket costs like deductibles, copayments, and coinsurance. These factors can significantly impact how much you pay for healthcare.

Evaluating the provider network associated with each plan is also crucial. Make sure it includes healthcare providers and facilities you feel comfortable with.

Comparing prices is essential to ascertain that you're getting the greatest value for your investment.

To enroll in a health insurance plan in Texas, you can visit HealthCare.gov, the Texas health insurance marketplace, or purchase individual and family health coverage with the help of an insurance agent or broker.

You can also call HealthCare.gov’s contact center by dialing 1-800-318-2596 (TTY: 1-855-889-4325) for assistance 24 hours a day, seven days a week, except on holidays.

The Open Enrollment Period to buy or renew your health insurance plan under the Affordable Care Act starts on November 1st and ends on January 16th. If you miss this window, you'll have to wait until the following year to enroll unless you experience a Qualifying Life Event, such as getting married, losing health insurance due to job loss, or relocating to a different county or ZIP code.

Here are the key enrollment dates and deadlines:

Average health insurance costs in Texas vary, but HealthBird's AI technology can help you discover plans tailored to your financial needs.

In Texas, the Open Enrollment Period to buy or renew your health insurance plan under the Affordable Care Act starts on November 1st.

You can sign up for an ACA-compliant individual or family health plan from November 1 to January 15 during open enrollment. If you need your coverage to start on January 1, you must apply by December 15.

If you apply between December 16 and January 15, your coverage will begin on February 1. Outside of open enrollment, a special enrollment period (typically linked to a specific qualifying life event) is necessary to enroll or make changes to your coverage.

If you missed the window of the Open Enrollment Period, you will have to wait until the following year to enroll in health insurance unless you experience a Qualifying Life Event (QLE).

Here are the enrollment periods for current year coverage:

You can also call HealthCare.gov’s contact center by dialing 1-800-318-2596 (TTY: 1-855-889-4325) if you have questions or need help with the enrollment process. The call center is available 24 hours a day, seven days a week, but it’s closed on holidays.

Average costs for health insurance in Texas can vary significantly depending on the plan you choose.

Last year's Open Enrollment Period in Texas showed that health insurance costs can be substantial, with some plans costing upwards of $400 per month for an individual.

However, HealthBird's AI technology can help you find plans that fit your budget.

According to the data, the average monthly premium for a bronze plan in Texas is around $350.

Silver plans tend to be more expensive, with an average monthly premium of around $450.

Gold plans are typically the priciest, with an average monthly premium of around $550.