Everything is bigger in Texas, so are the number of health coverage options. You will have no trouble finding a cheap health insurance plan in Texas that meets your budget and requirements.
How to Get Cheap Health Insurance in Texas?
There are two ways to get health insurance in Texas: One is private health insurance plans, and the other option is government-funded programs. Deciding which health plan works best for you depends on several factors, such as your income, age, health condition, and whether or not you run a business.
i) Private Health Insurance Plans
These include comprehensive health insurance policies governed by the Affordable Care Act (also known as Obamacare), Medicare Supplement plans, Medicare Advantage plans, and short-term health plans.
ii) Government-backed Health Insurance
These include Original or Traditional Medicare, CHIP or Medicaid insurance, TRICARE military coverage, and VA health insurance.
Buying Cheap Texas Health Insurance if you’re Below 65
If you are below 65 and do not qualify for a Medicare policy, your best option for getting cheap health insurance in Texas is an Obamacare plan. If you are below 30, you may want to look into another type of comprehensive low-cost plan that does not meet the criteria for ACA subsidies (like a catastrophic health insurance plan). Depending on your household income, Medicaid could serve as a good option. (For more information, see below.)
Texas Health Insurance if you are Low-income, Unemployed, or between Jobs
You might be able to obtain cheap or free health insurance in Texas through one of several plans, including a short-term plan, Obamacare, or catastrophic coverage. You can also buy coverage through a government-funded program, such as Medicaid or CHIP (Children’s Health Insurance Program).
Texas Health Coverage if You Have a Disability or a Chronic Disease
You may have regular doctor visits or higher medical costs if you have a disability or a chronic health condition. Thus, your cheapest option for getting Texas disability health insurance might be government-backed plans or a particular type of private Medicare coverage.
1) Texas and the Obamacare Plan
Texas does not have a government-run health insurance exchange. Instead, you can sign up for cheap health insurance using the Obamacare exchange at the state agency website.
When Can I Sign Up for Texas Health Insurance?
The Texas Open Enrollment period for Obamacare (or ACA) insurance usually runs from November 1 to January 15. If you miss the annual enrollment deadline, you might need to wait until the coming year to register for a health plan. Nevertheless, you may be eligible for a SEP (Special Enrollment Period. During this window, you can enroll in Texas coverage if you have a qualifying life event, such as marriage or pregnancy. Special Enrollment Periods are available throughout the year.
Texas Companies Offering Obamacare Health Insurance Plans
As of 2021, 14 insurance companies offer Obamacare (ACA) health plans, with 9 out of 10 of them offering subsidy-eligible plans on the insurance exchange.
- Aetna CVS Health (new)
- Bright Healthcare (new)
- Blue Cross Blue Shield of Texas
- CHRISTUS Health Plan
- Community Health Choice
- Friday Health Plans
- FirstCare Healthcare Plan (new)
- Molina Healthcare
- Moda Health (new)
- Oscar Health
- Scott & White Health Plan
- SenderoHealth Plans
- UnitedHealthcare of Texas (new)
2) Texas and Medicare
Medicare provides cheap health insurance to Texans aged 65 and above. As of 2020, approximately 2.5 million Texas residents were enrolled in the Original Medicare plan. Traditional Medicare includes Part A (hospital insurance) and Part B (medical insurance). You can also obtain these plans through private insurance companies. Continue reading to explore more about your Medicare coverage options.
Why should You Purchase a Texas Medicare Advantage Plan?
Nearly 1.7 million Texans have enrolled in the Medicare Advantage plan. It is an alternative method of receiving both Medicare Part A & Part B benefits.
Following are some of the critical features of Medicare Advantage plans:
Provides Extra Benefits: Medicare Advantage plans offer additional benefits that traditional Medicare does not. Many policies include prescription drug coverage and other benefits, such as vision, dental, and hearing care.
Extended Benefits Beginning in 2021: Texas Medicare Advantage plans will provide even more health services, such as in-home caregiver support, adult day-care, and access to safety equipment in 2021.
Affordable: You can find different Medicare Advantage plans (prescription drug coverage) in just a $20 monthly range for health coverage starting in 2021.
Many Opportunities to Register or Change Plans: You can enroll during your Initial Enrollment Period (IEP), which lasts seven months and includes three months before, three months during, and three months after your 65th birthday. Each year you get the opportunity to change or renew your Medicare plan during the Open Enrollment Period. The OEP lasts from October 15 to December 7. You can also switch to a new health plan or leave your coverage and return to traditional Medicare during Medicare Advantage Annual Enrollment Period (from January 1 to March 31).
Note: You will continue to pay your Part B premiums (some individuals get premium-free Part A) when you sign up for the Medicare Advantage plan. The Part B insurance premium is $148.50 in 2021.
3) Medicare Supplemental Insurance
With the Medicare Supplement plan, you pay a fixed monthly premium in exchange for the program covering some or all of your Medicare Parts A and B out-of-pocket expenses (coinsurance, copays, deductibles, etc.).
The Texas Medicare Supplement plan may be the best option for you if you meet the following criteria:
i) You need regular healthcare: Medicare Supplement plan (also known as Medigap) pays your deductible, coinsurance, copay, and deductible when you are admitted to the hospital or visit your primary care doctor.
ii) You have health issues: You can buy a cheap health insurance plan (Medigap) without undergoing medical examinations during your Medigap open enrollment window. This is a six-month period that begins when you reach the age of 65 and register in Medicare Part B. If you sign up during this period, you cannot be charged more for a policy because of your health condition (unless you are under the age of 65). Companies can refuse coverage outside of Medigap’s open enrollment period based on your health conditions.
iii) You frequently travel out of state or abroad: Standard Medigap policies can be used at any health insurance company across the United States that accepts Medicare coverage. Some plans will even pay nearly 80% of the standard costs for emergency treatment in a foreign country.
iv) You want access to various options to meet your budget and needs: Texas provides a wide range of cheap Medigap health insurance plans. In Texas, more than 60 carriers are offering Medicare Supplement plans. The following is a list of Texas Medicare Supplement insurance providers.
4) Texas Medicare if you are below 65 and have a Disability or a Chronic Illness
Medicare is a federal service program for people aged 65 and above. Nonetheless, if you are under the age of 65, you may be eligible for Medicare Part A and Part B coverage if one of the following applies to you:
You are disabled: You are automatically registered in Medicare Parts A and B after receiving Social Security or Railroad Retirement Board (RRB) disability benefits for at least 24 months.
You’ve been diagnosed with ALS: You will obtain Medicare Parts A and B coverage during the first month of getting disability services if you have ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s disease.
You have End-Stage Renal Disease (or Permanent Kidney Failure): You can apply for Medicare coverage through Social Security. It is best to register in Medicare Part A and Part B to receive the full range of ESRD benefits. Once you sign up, your coverage typically begins on the first day of the fourth month of dialysis treatment.
You may qualify for Medicare Part A coverage with no monthly premiums if you have obtained disability benefits for at least twenty-four months or have ESRD.
Furthermore, you may be eligible for Medicare Part A with no monthly premiums. The standard monthly premium cost for Medicare Part B in 2021 is $148.50. Suppose you are eligible for low-income status in Texas, you may be able to receive financial assistance to pay your premium (as well as any deductibles or copays) through a Medicare Savings Program.
5) Medicare Advantage Special Needs Plans in Texas
If you are shopping for the best commercial Texas health insurance for chronic diseases, a Medicare Advantage SNP (Special Needs Plan) may be the way to go. SNPs provide unique benefits, such as a primary care physician or care coordinator to assist you in managing your healthcare. Also, you can visit physicians who specialize in your health condition and get prescription coverage.
Typically, you cannot register for a Medicare Advantage plan if you have End-Stage Renal Disease (ESRD). However, you can purchase a Medicare Special Needs Plan for ESRD if it’s available in your area.
Texas Medicare Advantage Special Needs Plans are classified into three types:
Chronic Condition SNP: These plans are designed for people with specific medical needs. Because not all programs are the same, you should check to see if your chronic medical condition is covered before enrolling.
Dual-Eligible SNP: You can sign up for this plan if you qualify for Medicaid and Medicare programs.
Institutional SNP: To be eligible for this coverage, you must be a resident of a nursing facility or need nursing care at home.
As of 2019, Texas had more than 500 agreements offering Medicare Special Needs Plans, making it the third-largest supplier of Medicare SNPs.
In Texas, the most common SNPs are 18 dual-eligible SNPs, followed by chronic condition SNPs.
6) What is the Cheapest Health Insurance Plan in Texas?
Among the cheapest health insurance plan in Texas, you can buy an Obamacare bronze plan. Subsidies under Obamacare (also known as premium tax credits) can help you obtain metal plans at low monthly insurance costs. Metal programs come in bronze, gold, silver, and platinum. Bronze plans are frequently the least expensive as compared to other insurance policies.
The most affordable bronze plan costs nothing after Obamacare subsidizes. More than 1 million newly insured Texans became eligible for bronze coverage with no monthly premium in 2019.
7) Other Cheap Health Insurance Plan Options in Texas
Short-Term Health Insurance: Although short-term health plans are not considered qualified insurance under the Affordable Care Act, they typically cost half of the primary medical care. As of 2021, a short-term project for a 30-year-old woman in San Antonio would cost around $67 per month.
Catastrophic Medical Plans: Catastrophic premium costs are much lower than those of other ACA-regulated plans, but their deductibles (the amount you pay before benefits begin) are very high. Catastrophic plans are intended to protect you from significant out-of-pocket expenses in case of illness or accident.
Medicare Advantage Zero-Premium Policies: You can find MA (Medicare Advantage) plans for $0 premiums per month through different Texas insurance agencies. So, if you are 65 or below 65 and have a disability, you might be eligible to enroll in a zero-premium plan. You must pay for your Part B premiums (most individuals obtain premium-free Part A coverage) when you register for Medicare Advantage coverage. Furthermore, the Part B premiums will be around $148.50 in 2022.
8) Texas Medicaid Coverage
Medicaid is a state and federal government-funded program designed for low-income Texans. It includes pregnant women, adults caring for children, older people over the age of 65, and adults below the age of 65 with a disability (see below for more details on this group).
An Adult Caring for a Child: You need to meet two criteria to qualify for Medicaid coverage. First, you must care for and live with a child who is either a blood relative or a stepchild. Second, the child must be below 17 or 18 if they attend school full-time.
Pregnant Women: Medicaid is available to low-income pregnant women in Texas during pregnancy and for up to two months after childbirth.
Adults aged 65 and above must meet three conditions to become eligible for Medicaid coverage:
- You’ll need 30 days or more for continuous long-term care.
- You don’t have sufficient money to pay your coverage expenses.
- You do not own or pay for items worth more than a certain amount of money, such as burial insurance, a home, or a vehicle.
9) Health Insurance for Low-Income Children and Pregnant Women in Texas
The Texas CHIP (Children’s Health Insurance Program) provides cheap health insurance plans to children (up to 18) whose families earn enough money to qualify for the Medicaid program but cannot afford private health insurance. You spent no more than $50 per year to get coverage for all of your children. However, most Texas households pay $35 or less per year for CHIP coverage, depending on your monthly earnings.
If you are pregnant, you and your infant baby may be eligible for health insurance through the Texas Children’s Insurance Plan. Also, if you meet the Texas Children’s Insurance Plan income limits, you’ll be able to get prenatal care or labor and delivery for your child.
10) Texas Medicaid Coverage for Adults with Disabilities
Health insurance coverage through the Texas Medicaid policy may be a good option for you if you have a disability – expected to last for a year. You are eligible for Medicaid coverage if you have limited earnings and assets (such as auto, home, funeral insurance). Moreover, Medicaid expects you to cover your share of the costs for long-term care.
11) Short-Term Health Insurance in Texas
Unlike Obamacare programs, short-term medical plans are not governed by the ACA. They do not offer comprehensive health insurance and may deny coverage if you have pre-existing medical conditions. On the other hand, short-term health coverage may be best for situations where you are temporarily uninsured, such as losing coverage from a previous job or waiting for insurance coverage to begin at a new job.
12) Catastrophic Health Insurance in Texas if you are facing Financial Difficulties
Catastrophic coverage typically requires you to be under the age of 30. Nevertheless, suppose you are over the age of 30 and are experiencing hardship, such as eviction, bankruptcy, or high medical debt. In that situation, you may be eligible for a hardship exemption to purchase a catastrophic health plan.
Although these designs are not as comprehensive as conventional Obamacare plans, they include all of the ACA’s essential health benefits. Catastrophic programs are sold on health government online portals during Texas open enrollment.
13) Military Medical Insurance
If you are on active duty, having worked as an officer, or a family member of a service officer, you may be able to obtain health insurance through government-backed programs such as TRICARE or VA Health Care. These programs meet the ACA’s requirements for qualified coverage.
Tricare: The Department of Defense provides this health insurance to active-duty soldiers. Coverage can begin after 30 days of continuous active service.
VA health care: This coverage is available through the Department of Veteran Affairs to military veterans who did not receive a dishonorable discharge.
If you do not qualify for any military health insurance, you can still get cheap health insurance through Obamacare, Medicare, or Medicaid if you are eligible.
Is Health Insurance Cheaper in Texas?
The average monthly premium expense for Obamacare Texas health insurance is around $436 in 2021. The cost of coverage will vary depending on the area you live in, the type of plan you select, and the insurance company providing the health plan. In 2021, A 21-year-old earning $35,000 (274 percent of the federal poverty threshold) in Dallas, TX may buy an Obamacare silver plan for $351 before subsidies and $145 after premium tax credits.
Metal Tier (Average Cheapest Plan)
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(second cheapest-silver plan)
Average Marketplace Premium for Health Insurance in Texas
According to the most recent data, the average cost of health insurance in Texas is $6,324 per person. For a family consisting of four members, this equates to $25,294. This is $658 per person, less than the national average for health insurance coverage. However, health insurance varies greatly depending on the cost of care and the population insured. Insurance coverage in Texas is not cheaper as compared to other states. Let’s compare the average per-person health insurance costs in Texas to those in South Dakota.
Is Health Insurance Cheaper in South Dakota vs. Texas?
For the approximately 30,000 consumers who enrolled in insurance through South Dakota’s exchange for 2021, the average full-price monthly premium was $694. However, the vast majority of enrollees – approximately 93 percent – received premium subsidies averaging nearly $622 per month.
What is the cost of a health plan in South Dakota? A primary major medical individual health insurance plan in South Dakota will cost an average of $231.24 per person, comparatively cheaper than health insurance in Texas ($658). Prices will vary, and if you are in good health, your premiums might be lower.
|Average monthly premium|
Average Monthly Premium for Health Insurance in South Dakota
This is the average cost of a health insurance plan in South Dakota, but actual costs vary depending on area code, gender, age, and other factors. Request a personalized quote to see what options are available for you.