Highlights and updates
- Texas uses the federally run marketplace at HealthCare.gov.
- Open enrollment for 2021 runs November 1, 2020 – December 15, 2020.
- Texas residents with qualifying events can still enroll or make changes to their 2020 coverage.
- Over 1.1 million Texas residents enrolled during 2020 open enrollment.
- Eight health insurance companies offer plans through the Texas marketplace.
- The average monthly premiums slightly decreased in 2020.
- Short-term health plans are available in Texas for up to 364 days.
Health Insurance Plans in Texas
In Texas, there are eight health insurance companies available on the state exchange, with BlueCross and BlueShield of Texas the only one to offer plans in every county.
Most Texas insurers offer Catastrophic, Bronze, Expanded Bronze, Silver, and Gold tier plans, but Silver plans are by far the most popular option for Texans – mainly due to the cost-sharing subsidies this type of plan offers.
Before you purchase a policy, it’s vital to learn more about the different tiers and coverage options available to you and your family.
The Texas Health Marketplace
Texas uses the federally run marketplace at HealthCare.gov, and has one of the highest exchange enrollments in the country – only Florida and California have higher exchange enrollment.
The Open Enrollment Period for 2020 health plans has ended, but Texas residents with qualifying events, such as marriage or job loss, can enroll or make changes to 2020 coverage. For plans effective in 2021, the Open Enrollment Period will begin November 1, 2020, and run until December 15, 2020.
Health insurance rate changes in Texas
Health insurance premiums change every year as a result of spiraling health costs and rising life expectancy. The insurer sets the premiums for the forthcoming year before being approved by the federal health insurance exchange.
The insurer sets the premiums for the forthcoming year
In Texas, health care premiums have nearly decreased across the board – only the Extended Bronze tier has seen an increase, albeit very small. Bronze, the most affordable plans, have reduced by 10.5% since 2018.
Short-term Health Insurance in Texas
If you missed the Open Enrollment Period or recently lost employer-sponsored coverage, short-term health insurance in Texas can provide you with temporary coverage. These policies can cover you for up to one year, and, if you wish to extend it, the policy can be renewed for up to 36 months.
Short-term health insurance plans are not bought on the state marketplace as they do not meet the Affordable Healthcare Act’s guidelines. This means that you could be declined coverage due to pre-existing conditions. If you do get approved, your policy won’t cover many essential needs, such as prescription drugs or mental health services.
While a short-term policy can temporarily help fill in coverage gaps, these policies are not an adequate replacement for permanent coverage.
How Much Does Health Insurance Cost in Texas
Health insurance rates vary based on location, age, and other factors. As such, it’s difficult to provide an accurate estimate of how much health insurance coverage would cost you in Texas without creating a quote based on your credentials.
For 2020, the average monthly health insurance premium for a 40-year-old in Texas is $508 – a decrease of 14% since 2018.
Best Cheap Health Insurance Companies in Texas
On the Texas state marketplace, there are currently eight separate health insurance companies for residents to compare:
- Blue Cross Blue Shield of Texas
- FirstCare Health Plans
- CHRISTUS Health Plan
- Community Health Choice, Inc.
- Celtic Insurance Company
- Sendero Health Plans, Inc.
- Oscar Insurance Company
- Molina Healthcare of Texas, Inc.
The best plan often depends on your location, age, and medical issues, and premiums fluctuate depending on your personal circumstance.
However, for many Texas counties, the Blue Advantage Silver HMO 205 provided by Blue Cross Blue Shield of Texas is the cheapest option. This is the plan that the average Texan will begin their healthcare comparing with as it is available in every Texas county, is the cheapest Silver plan sold by Blue Cross Blue Shield, and qualifies for additional subsidies for low-income families.
Premiums for the Blue Advantage Silver HMO 205 range from $459 to $585 per month, depending on the county.
Texas Health Ratings
Due to the state’s large population of uninsured residents, Texas suffers from low healthcare rankings.
The latest edition of the Commonwealth Fund’s Health System Performance Scorecard ranked Texas 49th out of the 50 states and the District of Columbia.
Similarly, Texas performs poorly in the 2019 America Health Ranking. The state placed 34th on the report citing a high percentage of uninsured persons, low rate of mental health providers, high prevalence of diabetes, and rising obesity levels as the main challenges Texas faces.
Has the ACA/Obamacare Helped Texans?
Although the uninsured rate in Texas remains well above the national average, it was even higher before the Affordable Care Act. In 2013, the Texas uninsured rate was 22% – the highest in the country. Since then, the amount has gradually decreased and currently sits at 17.7%.
Texas leaders have opposed the ACA, and the state still refuses to expand Medicaid, leaving many individuals and families without the assistance they need to afford healthcare – hence the high uninsured rate.
Texas Enrollment in Qualified Health Plans
Texas is amongst the states with the highest annual enrollment through the Open Enrollment Period. For 2020 coverage, over 1,110,000 Texans enrolled in a private individual market plan on the Texas marketplace – the second largest, and only one of few states where enrollment figures grew.
What About Medicaid and CHIP in Texas?
A Supreme Court ruling made it possible for states to opt-out of Medicaid expansion – an expansion that provides financial support for residents with incomes up to 138 percent of the federal poverty level.
Texas remains one of the few states that continues to reject the Medicaid expansion, and because of this, over 760,000 Texans are in the coverage gap, without access to financial assistance.
Medicaid in Texas remains notoriously strict. The financial assistance program is only available to parents with dependent children if their household income doesn’t exceed 15 percent of poverty.
Choosing Health Insurance Plans in Texas
If you’re looking for cheap health insurance in Texas, it’s wise to educate yourself on the metal tiers before buying a policy.
Health insurance plans on the Texas marketplace are divided into three main metal tiers: Bronze, Silver, Gold. These tiers all offer the same minimum benefits, but the higher the tier, the higher the proportion of medical expenses the plan covers. However, increased coverage, of course, comes with a more expensive monthly premium.
Going with the lowest premium you can find may be tempting, but depending on your health care needs may not be your most affordable option. You need to consider out-of-pocket costs before buying a policy.
Cheap Health Insurance Plans in Texas by Metal Tier
Finding a cheap health insurance plan in Texas is easy. With eight different insurance providers in Texas, there are plenty of different affordable policies to browse in each metal tier.
These quotes are based on an average 40-year-old Texas resident.
- If you want a Bronze plan, the Simple Bronze plan is the cheapest. The monthly premium is $256, and the deductible and the out-of-pocket maximum are $7,350.
- Ambetter Balanced Care 5 is the cheapest Silver plan, with a monthly premium of $295. The deductible and the out-of-pocket maximum are $7,350.
- Ambetter Secure Care 1 with 3 Free PCP Visits is the most affordable Gold plan in Texas. It has a monthly premium of $342, a deductible of $1,000, and an out-of-pocket maximum of $6,350.
Gold Plans – Ideal for High Medical Costs
The gold plan is made for individuals with numerous health problems and medical needs. While the premiums are significantly higher than the other tiers, the lower out-of-pocket costs make the plans more affordable for those with frequent health care needs.
Gold plans have lower deductibles, coinsurance, and copays, and make everything from doctor’s visits to prescription drugs more affordable.
Silver Plans – Ideal for Average Medical Costs and Low Incomes
Silver plans offer the perfect balance between high-tier and low-tier plans. The premiums and out-of-pocket costs sit in the middle of the tier, making them a good fit for people of average health. Because of that, these are the most popular health insurance plans in Texas.
Texans living in low-income households should primarily focus on Silver plans, as you may qualify for a cost-sharing reduction subsidy – something that’s only available with Silver plans.
If your income falls below 250 percent of the federal poverty level, you receive a subsidy that helps toward out-of-pocket costs. If you qualify, the out-of-pocket expenses are even less expensive than with a Gold plan!
Catastrophic and Bronze Plans – Ideal for Healthy, Young People
People who want cheap health insurance in Texas are often drawn to Catastrophic and Bronze plans because of the low premiums. Although the low premiums might be appealing, the high out-of-pocket costs can be prohibitive.
Young, healthy people who rarely use their insurance can benefit from these plans. Still, because of the high out-of-pocket cost, it’s critical to have enough money in savings to cover medical emergencies.
Out-of-pocket costs are limited to $7,900 for individuals, but even with the limit, it’s easy to get in over your head. If you don’t have enough savings to pay the out-of-pocket expenses, you could end up unable to receive treatment or thousands of dollars in debt.
Average cost of health insurance by family size in Texas
The cost of a family health insurance plan in Texas varies based on your policy, location, household income, and family size.
Of course, each family member added to your policy increases the monthly premiums by a certain amount. Children aged 14 and younger add $285 to a Silver plan, while an extra 40-year-old adult costs an additional $491.
Get Help Comparing Health Insurance Plans in Texas
Are you confused when looking at the different health insurance plans in Texas? You know you need coverage, but you aren’t certain which metal tier is right for you or how to find the most affordable policy that meets your insurance needs.
Instead of handling this on your own, call 1-855-881-0430 to speak to a licensed insurance agent. The agent will walk you through the entire process and help you select the right policy.