There are a number of ways to purchase comprehensive, affordable insurance in Texas. There are eight health insurance companies available in Texas on the state exchange. BlueCross and BlueShield of Texas are the only one to offer plans in every county. However, several other insurance companies offer health insurance in various jurisdictions across the state.
Highlights and updates
- Texas uses the federally run marketplace at Healthcare.gov.
- Open enrollment for 2022 health plans in Texas will begin November 1, 2021, for coverage that begins on January 1, 2022.
- Texas residents with qualifying events can still enroll or make changes to their 2020 coverage.
- More than 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.
How to buy health insurance in Texas
Some Texans may already receive health insurance through an employer, or through the federal government. For those who do not, there are several private insurance companies that offer comprehensive packages to suit a number of individual needs. Most private Texas insurers offer health insurance in five tiers: Catastrophic, Bronze, Expanded Bronze, Silver, and Gold. It’s important to understand your specific health insurance needs before selecting an insurance company and a health insurance tier.
How to apply for health insurance in Texas
The open enrollment for 2022 health insurance plans in Texas begins on November 1, 2021. Health insurance plans in Texas are available to residents via both the federal exchange, and through private insurance companies. For 2020 coverage, more than 1,110,000 Texans enrolled in a private individual market plan on the Texas marketplace – the second highest enrollment figure nationally, and only one of few states where enrollment figures grew.
Through the federally run marketplace at HealthCare.gov, Texas has the third-highest exchange enrollments in the country (Florida and California have higher exchange enrollment).
Health Insurance Carriers In Texas
There are eight health insurance carriers In Texas that are available on the state exchange. Only BlueCross and BlueShield of Texas offer plans in every county. In addition to Blue Cross, the insurance carriers offering health insurance to Texas residents are FirstCare, CHRISTUS, Community Health Choice, Inc., Celtic Insurance Company, Sendero Health Plans, Inc., Oscar Insurance Company and Molina Healthcare of Texas, Inc.
How Has Obamacare Helped Texas’ Uninsured?
Before the introduction of the Affordable Care Act (ACA), the uninsured rate in Texas was the highest in the country, sitting at about 22% in 2013. Since the introduction of the ACA, the uninsured rate in Texas has dropped even lower, and currently sits at approximately 17.7%. However, Texas state leaders have opposed ACA, and Medicaid has not been expanded in the state, which is why the uninsured rate in Texas remains well above the national average.
Texas Health Insurance Costs Overview
The cost of health insurance in Texas will depend on many factors, including the carrier you choose, the tier of package you need, and personal factors such as your age and general health status.
The following premiums are calculated for the average 40-year-old.
How Much Does Health Insurance Cost in Texas?
For 2021, the average monthly health insurance premium for a 40-year-old in Texas is $408.
What is the Cheapest Health Insurance Plan in Texas?
Insurers in Texas adjust their premiums every year due to fluctuations in health costs and changes in life expectancy. Premiums for the forthcoming year are set by an insurer, and approved by the federal health insurance exchange.
Cheapest Texas Health Insurance Coverage by Metal Tier
Gold plans are ideal for those with a high number of health issues and medical needs. The premiums are therefore significantly higher than other tiers, but the out-of-pocket cost is lower. The cheapest monthly premium is $342.
Ambetter Secure Care 1 with 3 Free PCP Visits
Estimated monthly premium: $342
Out-of-pocket maximum: $6,350
Silver plans are ideal for people of average health, making them the most popular insurance plan tier in Texas. Texans living in low-income households may qualify for a cost-sharing reduction subsidy that helps towards out-of-pocket costs, which is only available with Silver plans.
Ambetter Balanced Care 5
Estimated monthly premium: $295
Deductible/Out-of-pocket maximum: $7,350
Bronze plans are ideal for those looking for a low monthly premium. It is therefore most popular among young, healthy Texas residents.
Estimated monthly premium: $256
Deductible/out-of-pocket maximum: $7,350
Texas Health Insurance Costs by Occupation
What is the average cost of health insurance for a student in Texas?
Adults in Texas can keep dependent children on their family insurance plan until those children turn 26. Children don’t have to live at home, be enrolled in school, or be claimed as a dependent on a tax return. Married children can be kept on a family insurance plan, but not their spouses or children. (Source)
Many post-secondary institutions in Texas offer medical insurance to their students. At the University of Texas, medical insurance for students is underwritten by Blue Cross and Blue Shield of Texas. It has an average monthly cost ranging from $254 to $1,969, depending on the enrollment term. (Source)
What is the average cost of health insurance for a self-employed person in Texas?
Self-employed individuals will not have access to the health insurance coverage provided by an employer, and must therefore purchase a plan for themselves or their families from a private carrier. The cost of this coverage will vary depending on individual and family needs. Please refer to our list of Cheapest Texas Health Insurance Coverage by Metal Tier.
What is the average cost of health insurance for small business owners in Arizona?
Small employers in Texas can offer health insurance to their employees. Texas insurance law defines a small employer as a business with two to 50 employees, regardless of how many hours the employees work; if a business owner provides health insurance, it must be offered to all employees who work 30 hours or more a week, and to their dependents. Business owners are able to enroll in their small-employer health plan if at least one of their employees enrolls.
Business owners are not required to pay an employee’s health plan premiums. The cost of these premiums will depend on the age of your employees, or individual factors, such as whether your employees smoke. (Source)
Texas Health Insurance Costs by Number of Participants
The number of individuals added to your insurance plan will affect monthly premiums. The average cost of an insurance plan with multiple participants, like a family insurance plan, will depend on the policy, location, household income, and family size.
What is the average cost of health insurance for families in Texas?
The cost of health insurance will depend on the number of people being insured. The cost of a Silver-tier plan for a family of four with two children under the age of 14, earning the average household income for Texas of $63,874, is $1,813 per month. With financial help available to individuals at this income level, those premiums could be as low as $206 per month.
What is the average cost of health insurance for individuals in Texas?
The cost of health insurance for an individual in Texas will depend on their plan tier and any changes to personal health or existing health conditions. The average cost of health insurance for an individual in Texas is currently $510.
What is the average cost of health insurance for a child in Texas?
Adding a child under the age of 14 to a family insurance plan typically increases the cost of a premium by $285. Families may qualify for the Texas Child Healthcare Insurance Plan (CHIP), which covers doctor visits, dental care and teeth cleaning, prescriptions, eye care, hospital care, and other needs for children under the age of 18. CHIP costs an average of $35-$50 per year. (Source)
STAR Kids, which is an insurance program for children with disabilities, special needs or chronic conditions, aged 20 or younger, is managed by Medicaid. (Source)
Other Types of Texas Health Insurance Coverage
Catastrophic health insurance in Texas
Catastrophic health insurance plans have low monthly premiums and high deductibles, and are often used to protect against worst-case scenarios, like getting extremely sick or seriously injured. Catastrophic health insurance is only available to individuals aged 30 or under or those of any age with a hardship exemption or affordability exemption. Those who enroll in catastrophic health insurance plans pay most of their own routine medical expenses. Under the ACA, the maximum deductible for all catastrophic plans for 2020 is $8,550.
Short term health insurance in Texas
Short-term health insurance plans in Texas can last 12 months or less, but sometimes can be renewed up to three years. These plans offer fewer benefits and have lower coverage amounts than major medical insurance plans.
Low-income health insurance in Texas
To qualify for Medicaid in Texas, your household income must be under a particular amount, depending on the size of your family. You must also be at least one of the following: pregnant, responsible for a child 18 years of age or younger, blind, have a disability or a family member in your household with a disability, 65 years of age or older. Other programs in Texas provide insurance cost subsidies, such as the American Rescue Plan Act and the Texas Child Health Insurance Plan.