Best Health Insurance in Texas 2021

Last modified: March 6, 2021

Finding affordable health insurance in Texas may prove challenging for a number of people as insurance costs have substantially increased since last year. Here, we list down insurance providers offering the best health insurance in Texas at affordable rates. This article is to be a Texas Health Insurance Guide for all those who want to know more about available healthcare plans. You can also access more about health insurance requirements at healthcare.gov.

For most people, the State Marketplace is the go-to option for health insurance plans. The marketplace is a part of the Affordable Care Act, where state-regulated healthcare providers offer subsidized health insurance plans to applicants in a live enrolment session. We bring you 12 healthcare providers and plans to help you find affordable health insurance, even if you do miss the enrolment period for Health Insurance Marketplace Texas.

List of Providers and Comparison of Plans

There are several health insurance companies in Texas that you can choose from. Here we mention a few of our top picks to help you in your search for the best health insurance provider.

Oscar

Oscar Health Insurance is a modern health insurance provider. The company uses technologically advanced tools, simplifying the way health insurance works. You can get your Digital ID card and forget about having to carry a physical health insurance card. The company aims to provide affordable healthcare to its clients by using technology to cut down operational costs. 

It provides health insurance services in Texas through licensed health agents. Some of the benefits you obtain with Oscar include 24/7 calls with medical professionals and a dedicated healthcare agent to manage all your healthcare needs. Oscar can get you in touch with medical professionals within 15 minutes or maybe even less if you are running out of prescription or need urgent medical consultation.

The problem here is that Oscar’s service is limited to Bexar, Comal, Williamson, Travis, and Hays Counties in San Antonio and Austin. The company partners with some hospitals in the area and operates on Exclusive Provider Organizations. The packages only cover out-of-network medical costs in case of emergencies. 

You can choose from Simple, Classic, Off-exchange, and HSA Plans. No matter what plan you are on, you do need referrals. You can contact or book an appointment with an in-network doctor or specialist. 

Ambetter from Superior HealthPlan

Ambetter has one of the cheapest Texas health insurance plans in the state marketplace. In Texas, you can get Ambetter healthcare plans through the Superior Health Plan. You can choose from the Ambetter Essential Care, Balanced Care, and Secure Care options.

Ambetter Essential Care Categories offer Bronze Healthcare plans, Balanced Care offers Silver Care Plans, and Secure Care offers Gold tier plans. Your choice will depend on your healthcare needs and budget, as each category comes with a different deductible and out-of-pocket expense limits. However, all of Ambetter’s health care plans are Qualified Healthcare Plans and guarantee coverage of urgent healthcare. 

BlueCross BlueShield of Texas

The BlueCross BlueShield of Texas is another excellent option for people looking to get affordable healthcare plans. You can get a wide range of individual and family healthcare plans. All of the plans provide the list of mandatory coverage options as listed under the Affordable Care Act.

No matter what plan you choose, you get:

  • Maternity care
  • Pediatric and newborn care
  • Emergency care
  • Covers hospitalization expenses
  • Preventive care coverage
  • Disease management
  • Laboratory expenses
  • Prescription drugs cost
  • Substance abuse treatment
  • Mental health protection
  • Rehabilitative services

Molina Healthcare

If you want to access a marketplace with a variety of healthcare plans, Molina Healthcare is the place to go. Company professionals run a detailed assessment of your needs to find a healthcare plan that is easy on your pocket, keeps out-of-pocket expenses to a minimum, and provides access to high-quality healthcare. The company is accredited by the National Committee of Quality Assurance.

CHRISTUS Health Plan

Whether you are looking for individual or family healthcare plans, CHRISTUS has you covered. They offer insurance plans in three categories, namely Individual and Family plans, Medicare, and US Health Plans. The company helps you find the right plan for you and manages your prescriptions, regardless of whether you opt for a bronze, silver, or gold package.

If you are nearing retirement, you can get some of the best healthcare packages through the CHRISTUS Health Plan Generations and Generations Plus (HMO). These options in our Medicare Advantage plan cover your doctor, pharmacy, and medications as needed even during your retirement years.  

The US health plan caters to the healthcare needs of an active performing and retired members, as well as eligible family members. No matter where an officer is stationed, the CHRISTUS Health Plan has you covered.

Community Health Choice

Community Health Choice is a non-profit organization offering affordable, no-cost health insurance plans to low-income families throughout Texas. The company started as a STAR Medicaid coverage provider to children from low-income backgrounds and has now grown into one of the largest network providers in South Texas with a wide range of health insurance plans.

Through Community, you can get the Texas STAR Medicaid Plan, Texas CHIP Plan, Texas CHIP Perinate Unborn, and the Medicare Dual Special Needs Plan. You can also get access to the Health Insurance Marketplace to find other affordable health insurance plans. 

Sendero

Sendero too started as a basic Medicaid plan provider to low-income families in 2012. Today, it is one of the largest non-profit, community-operated, and member-focused healthcare provider located in the Austin area. It offers free calls to the doctor 24/7 for all members. The company also takes pride in providing some of the lowest-priced health insurance plans with excellent care terms -and coverage. You can get low co-payments and don’t have to worry about any restrictions on pre-existing medical conditions. 

You may even qualify for special enrolment in the Health Insurance Market if you’ve experienced a major life change such as having a baby, losing a job, getting married, getting divorced, moving states, or a change in income level. 

FirstCare

FirstCare is a part of Baylor Scott and White Health. The company has been operational since 1985, offering a variety of health plans to its clients. Individuals and Families can choose from the Marketplace/ACA Plans, Medicare Dual Special Needs Plans, STAR Medicaid, and CHIP. Businesses seeking group healthcare plans for their employees can choose the Small Group Plans (for 50 employees), Large Group Plans (100), or one of the TRS plans. 

To get access to these plans, you can sign up or contact a sales rep. Members have 24/7 access to the self-service portal and several other member resources. They can also benefit from access to virtual care for telephonic or video visits and consultation with their doctor. 

Friday Health Plan

Getting a health insurance plan from Friday Health Plan is super simple and easy. All you need to do is create an account, make a payment, and become a member to get access to several insurance plans, including catastrophic, bronze, silver, and gold coverages. Most of these insurance plans also include free mental healthcare checkups at 0 costs to the insurance policyholder.  

Here individuals, families, and businesses can all find the perfect plan and package that fulfills their healthcare requirements. The company also offers multiple resources on their website that help you determine what your healthcare needs are and whether you qualify for a better, more affordable health care plan. 

Scott & White

Scott and White offer several health insurance plans at different coverage levels and costs across the bronze, silver, and gold metal tiers. Individuals, families, and employers can all find affordable plans offering access to high-quality healthcare. You can also become a Medicare, Medicaid, or Right Care member through Scott and White.

Baylor Scott & White

Scott and White and FirstCare are both parts of Baylor Scott and White. The company collectively caters to over 400,000 members across Texas. The company offers members access to a variety of healthcare tools, including virtual care, access to a wide network of qualified doctors and specialists in your area. 

You can also access various patient tools to manage your policy, make payments, update your plan, and more. The wide range of resources available on the website allows users to find the perfect Texas health insurance plans as per their medical condition and treatment and management requirements.

Cheapest Health Insurance Plan by Cities in Texas

Finding affordable coverage can be challenging as insurance costs vary by individual, medical condition, gender, city, and more. Here, we list some of the cheapest health insurance in Texas’s major cities.

  • Houston – the Ambetter Balanced Care 29 2021 is the cheapest health insurance plan in Houston, Texas. An average 40-year-old individual can get coverage for $470, a 40-year-old couple can get coverage for $939, and a couple with a child can get coverage for $1,221
  • Dallas – Mybluehealth Silver (sm) 405 is the cheapest plan in Dallas, available for $399 for an individual aged 40, $799 for a couple, and $1,038 for a couple with a child.
  • Austin – Like Houston, the Ambetter Balanced Care 29 2021 is the cheapest health insurance plan in Austin. An average 40-year-old individual can get coverage for $413, a 40-year-old couple can get coverage for $825, and a couple with a child can get coverage for $1,072.
  • El Paso – Friday Silver is the most affordable healthcare plan in El Paso, available at $397 to an individual, $795 for a couple, and $1,033 for a one-child family.

If you are on the search for affordable health insurance in Texas, make sure you do your research before choosing a service provider. Different providers offer different coverage levels at varying Premiums, so you should get quotes from multiple health insurance providers in Texas to ensure you benefit from the best deal.

Average Cost of Health Insurance by Family Size in Texas

As mentioned earlier, the average cost of health insurance in Texas is influenced by several factors, including family size. The average cost for a middle-aged individual is $509 per month. The costs have risen substantially in the past year as the demand for health insurance has increased because of the pandemic. Here we mention health insurance quotes in Texas by family size.

Family Size Premium  
Single parent + 1 child   $814
Couple $1,019
Couple + 1 child $1,324
Couple + 2 children $1,628
Couple + 3 children $1,933

The estimated costs mentioned in the table above are for middle-aged couples in their early 40s or late 30s. The figures represent what the premium will be for families purchasing a silver tier plan.

Texas Health Insurance Guide and Resources

Texas provides health insurance through the state marketplace network. In fact, Texas has one of the highest marketplace enrolment rates falling behind only California and Florida. To date, there are ten healthcare service providers offering access to the state marketplace.

Through the exchange, you can find health insurance plans for individuals, families, retirees, self-employed individuals, or employees working in small businesses that do not offer health insurance to employees. You can also find providers providing private health insurance Texas, offering health care plans for individuals, families, and groups.

You can also opt for Medicare or Medicaid health insurance plans. Anyone aged 65 and above automatically qualifies for Medicare. People with a disability, as declared by the Social Security Administration, are also eligible for Medicare Texas Health Insurance.

Texas Medicaid offers health insurance to people from low-income households. To be eligible, you must either be a US citizen, a permanent resident, legal alien, or a US national, residing in Texas with low or very low-income levels. You must also either be pregnant, be responsible for a child aged 18 or less, be 65 years or older, or have a disability.

To get State subsidized or private insurance, you can browse through our list of best health insurance companies in Texas.

Tips to Save on Health Insurance in Texas

If you want to save on health insurance in Texas, you should first understand the factors that contribute to the varying price factors. Your health is the biggest contributor. If you have a good body mass index, are a non-smoker, have no pre-existing health conditions, you are likely to get a good rate on your health insurance in Texas.

You may also be able to reduce the cost of insurance if you share costs with your partner. You should also consider finding a dedicated health insurance provider and purchasing insurance for your entire family at once from one provider, as it may qualify you for bulk insurance discounts or loyalty discounts. A near-flawless family medical and insurance history can also help you save costs.

Pros & Cons

The Pros

The Cons

Final Verdict

FAQs

When is Texas Open Enrollment for 2021 Health Insurance Coverage?

Texas enrollment dates for 2021 health insurance coverage were November 1st to December 15th, 2020.

Did Texas Expand Medicaid?

No, Texas did not expand Medicaid under the Affordable Care Act, which has drastically increased the coverage gap in the State, rendering many residents unable to afford healthcare and also ineligible for subsidized insurance coverage.

Is Health Insurance Mandatory in Texas?

Yes, it is mandatory for every individual to have health insurance in Texas. You will have to report your health insurance coverage status when you file for tax returns. However, there is no penalty for not being covered.

What is the Income Limit for Medicaid in Texas?

The income limit for Medicaid in Texas varies by household size. The maximum income limit for a one-person household is $25,265 per year; 2 people is $34,136; for 3 people, it is $43,006, moving on to $ 87,358 for an 8 person household.

What are Short term Health Insurance Conditions?

Short term health insurance plans cover only basic healthcare needs such as doctor visits, emergency care, urgent treatments, and prescriptions in some cases. Not all insurance companies offer short-term health insurance in Texas, so check with your insurance provider and discuss all terms and conditions before purchasing one.

What is the Uninsured Population Rate in Texas?

Nearly 12% of all residents in Texas are uninsured.