Are you a native Texan who’s wondering how to get health insurance that’s cheap and provides good coverage? If so, you’ll want to check out our best options for affordable health insurance in Texas. We’ve done the research to help you find the best options to fit a variety of needs and budgets so you have the coverage when illness or injury strikes.
Get Health Insurance in Texas
Tip: compare 2-3 companies
The Best Cheap Health Insurance in Texas:
- Best Overall in Texas: Scott&White Health Plan
- Most Affordable in Texas: Aetna
- Best for HMO Plans: Community First Health Plans
- Best for PPO Plans: Humana
- Best for Prenatal Care: Cigna
- The Best Cheap Health Insurance in Texas:
- What is Health Insurance?
- Average Cost of Health Insurance in Texas
- Types of Health Coverage
- What Does Health Insurance Cover?
- What Does Health Insurance not Cover?
- Cheapest Health Insurance Providers in Texas
- Get Great Health Insurance in the Lone Star State
- Frequently Asked Questions
What is Health Insurance?
Health insurance is designed to help cover the majority of costs associated with medical care and treatment of injuries and illnesses. Throughout Texas, there are several companies that offer affordable health insurance. People often obtain health insurance through their employer but you can also buy health insurance from a private company or a state exchange.
As you research the different health insurance options available, you may come across different terms that explain your financial responsibility for payments and coverage. It’s a good idea to become familiar with how health insurance works and what portion you’ll be responsible for when seeking treatment.
- Premium: Paying your premium to the insurance provider each month ensures that your policy will stay active.
- Deductible: Your deductible is the amount you must pay before your insurance coverage takes over. Generally speaking, most insurance plans have high deductibles and low premiums, or vice versa.
- Copay: This is a small amount of money that you pay when you see your doctor or specialist. It does not count toward your deductible.
- Coinsurance: This is the percentage of the total cost that both you and your insurance company covers. It’s often written as 80/20 or 70/30 — the insurance covers 80% or 70% respectively, and you’re responsible for the other 20% or 30%.
Average Cost of Health Insurance in Texas
Texas residents pay an average of $440 per month in coverage. Health insurance doesn’t have the same long list of discounts like auto insurance or homeowners insurance but there are nevertheless some things you can do to help keep your health insurance costs low:
- Maintain a healthy body mass index (BMI). A high BMI can cause chronic conditions including diabetes, high blood pressure and heart disease. Eat right and exercise often to help lower your BMI and lose weight.
- Quit using tobacco. Approximately 16% of people in Texas smoke. Smokers pay higher insurance rates. Don’t start smoking, and if you do, take steps to quit.
- Your age will affect your costs. Younger people tend to have fewer health problems and pay less than those who are older. You can’t do anything to change your age so take steps to improve your overall health. It’ll ensure that you’ll pay less over time for your insurance when you do have to see a doctor or specialist.
Types of Health Coverage
There are several types of health insurance coverage in Texas. Here are the most common:
- Health maintenance organization (HMO): An HMO is a network of specialists, doctors and hospitals that have agreed to receive certain rates in order to help streamline medical treatment and simplify costs. You’ll choose a primary physician who is responsible for your overall care. You’ll need to get a referral from your primary care physician and the specialist must be part of the HMO network if you need to see a specialist. There’s very little paperwork to deal with as part of an HMO and the costs are some of the lowest available from health insurance providers.
- Preferred provider organization (PPO): A PPO is similar to an HMO because there’s a predefined network of providers. You’ll save more money by staying in the network but you also have the ability to see providers outside of the PPO network, even though the cost is greater. You don’t have a primary physician with a PPO and you don’t need a referral to see a specialist. You’ll need to do more paperwork, especially if you go outside the network for medical care or treatment. You’ll have to file a claim with the PPO to be reimbursed for some of the expenses. The amount you’ll be reimbursed varies depending on the plan, so be sure to ask the provider about what you can expect your out-of-pocket costs to be with various options.
- Point of service (POS) plan: A POS plan combines facets of an HMO and PPO. You pay the cost upfront at your doctor or hospital and are then reimbursed by the POS provider. This type of health care plan results in the greatest freedom to see any doctor or visit any hospital you like, and there’s no referral necessary to see a specialist.
What Does Health Insurance Cover?
Health insurance covers a wide variety of treatments for illnesses and injuries, including:
- Ambulance services
- Newborn and maternity care
- Prescription drugs
- Mental health care
- Wellness checks
- Pediatric care
- Rehabilitative services
- Laboratory services
- Emergency services
What Does Health Insurance not Cover?
The list above seems fairly comprehensive but there are still some things that health insurance doesn’t typically cover, including:
- Elective or cosmetic procedures
- Long-term nursing home care
- Infertility treatments
- Alternative therapies
- Dental, vision and hearing
You may be able to receive dental and vision coverage separately through your insurance provider. This is known as a rider and generally incurs an additional fee for the added coverage. As you get a quote from the insurance providers noted below, be sure to ask if they also offer vision, dental and prescription coverage and what the associated costs are.
Cheapest Health Insurance Providers in Texas
Finding the best health insurance in Texas means you’ll need to know what you’re looking for when you need a health insurance provider. Are you looking for lower-cost premiums or a low deductible? Do you want vision and dental coverage or only coverage for hospital care and wellness visits? We’ve chosen the top five insurance providers in Texas to help make your decision even easier.
1. Scott&White Health Plan
Scott and White has received accolades from the National Committee for Quality Assurance — and it’s even earned a “best in the state” designation. Plans are available in both HMO and POS forms for greater flexibility and affordability.
Several types of individual and family health plans are available and an easy-to-use app keeps your information and ID available for faster access when you visit doctors and hospitals throughout Texas.
Aetna offers all 3 types of health insurance plans in Texas — HMO, PPO and POS, so you have a large degree of freedom to decide between the doctors you want to see. Aetna was highly rated by the NCQA for its specialist ratings, quality of care received and coordination of care.
Aetna also offers comprehensive benefits and rewards for starting and maintaining a healthy lifestyle, including discounts for health and fitness products. It’s a great option if you want to control and manage chronic health conditions and want to stay on track with your health care goals.
3. Community First Health Plans
A locally-owned and operated non-profit health insurance company, Community First Health Plans provides both POS and HMO plans to help keep prices affordable for individuals and families. It offers extra benefits and services for pregnant women, young children and community health and wellness initiatives.
Its network may not be as large as other, more established companies if you live in Bexar or one of the 7 surrounding counties. It’s a solid bet that your doctor is a member of a participating network. You can search its website to find providers in your area.
Humana is one of several nationwide insurance plans operating in Texas. It’s best known for its Medicare plans and also offers individual and family health insurance at affordable rates. Humana has received high marks from the NCQA for its variety of plans and the quality of care it provides.
Humana offers HMO, PPO and POS plans in Texas so you’re sure to find one that covers your needs from a variety of choices that can also include dental and vision insurance coverage.
Cigna also provides a variety of health insurance plans that fall under HMO, POS or PPO types and give you a variety of options to fit your needs. Cigna is not rated as highly by the NCQA as some of the other insurance providers featured here but it provides above-average care across the board for adults, children, babies and adolescents, including vaccinations, prenatal care and chronic condition management.
Cigna also offers dental coverage and help paying for prescription drugs. It’s a solid choice for all-around health insurance coverage.
Get Great Health Insurance in the Lone Star State
There are a variety of health insurance options in Texas. However, if you’re looking for cheap health insurance and you want coverage that will be there for you when you need it, it pays to get a free online quote from the aforementioned companies. Each insurer has different criteria it uses to calculate your specific payment and the quotes can vary widely from company to company.
That’s why it’s a good idea to compare quotes from the companies noted above so that you can choose the best option from among the top providers across Texas. No matter where you live in the Lone Star State, you’ll be able to enjoy greater peace of mind that you’re getting the best service at the best rates.
Frequently Asked Questions
1) Q: Is health insurance required?
The federal mandate that required health insurance has been lifted but some states have enacted state-level mandates that require residents to have health insurance. Even where not required, health insurance can protect your family against catastrophic healthcare costs and help make routine medical expenses more predictable. Get your most affordable quote through our top providers today.
2) Q: What does health insurance cover?
Most health insurance plans provide the 10 essential health benefits that were part of Obamacare requirements. Coverages include preventive and wellness services, prescription drug coverage, emergency services, ambulatory services, lab services, pediatric services, and more. Many plans cover a wider range of healthcare expenses but may cost more than basic plans or may have higher out-of-pocket costs for some services.Get a custom health insurance quote to cover you and your family today.
3) Q: How can I save money on health insurance?
For healthcare plans that comply with the Affordable Care Act, only a handful of rating factors affect your premium. These include age and location, at least one of which can’t be changed. Smokers will pay more in most cases and your choice of plan level can affect premiums as well. Choosing a high deductible health insurance plan can reduce the cost of premiums. These plans can be combined with a health savings account to take advantage of tax-free savings for healthcare expenses. Get the cheapest health insurance premium from top providers.