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Where To Buy Health Insurance In Texas

What Is The Cheapest Individual Health Insurance In My State

Where to Get Affordable Texas Health Insurance

Important note

The cheapest health insurance policy is not always the plan with the lowest premium. Instead, the most affordable option is the policy that provides the right amount of health insurance coverage â depending on your medical needs and health â at your best rate.

The best affordable health insurance policy for you is a plan that provides adequate health coverage for you and your family. In most situations, this means that it covers the basics, but is also there if there is a serious medical emergency that ends up being expensive during the plan year.

We recommend beginning your search by looking at a Silver health insurance policy if you are buying coverage from your health insurance marketplace. As mentioned above, these plans have modest premiums with minimal out-of-pocket expenses in case you or a loved one gets sick or injured. Furthermore, the Silver policy deductibles are usually lower and easier to reach.


Texas Chip Health Insurance For Low

The Texas Childrens Health Insurance Program offers low-cost coverage to children whose families earn too much to qualify for Medicaid but cannot afford private health insurance. You pay no more than $50 a year to cover all your children, but most Texas families pay $35 a year or less for CHIP, depending on your monthly income.

If youre pregnant, you and your unborn child can get health coverage through the Texas Childrens Health Plan. If you meet the Texas Childrens Health Plans income limits to qualify for coverage, youll get benefits like prenatal care and labor and delivery for your baby.

Is A Catastrophic Insurance Plan Right For Me

A catastrophic plan may be right for you if:

  • You want lower premiums or can’t afford more expensive coverage.
  • You are generally healthy and rarely see the doctor.
  • You don’t mind having high out-of-pocket costs.
  • You want to be prepared against high medical bills in a “worst-case scenario.”
  • You don’t qualify for Medicaid.
  • You don’t qualify for a subsidy based on your income. Or, you do qualify, but don’t mind forgoing your right to those savings .

Every situation is different, and you’ll have to carefully consider your health needs, budget, and priorities to determine what’s best for you. If you have questions about catastrophic coverage or other plan options, feel free to contact eHealth to discuss your needs with a licensed insurance agent.

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What Do Individual Health Plans Cover

Individual health insurance plans offer comprehensive coverage.

Before the ACA, individual health plans courage varied widely. Insurance companies could deny applications for insurance or set exorbitant premiums if you had a health condition.

Now, a health insurance company has to cover you regardless of your health history. You qualify for individual health insurance even if youre pregnant, have a long-term condition like diabetes or a serious illness, such as cancer.

Health insurance plans additionally cant cap the amount of benefits you receive. Theyre further limited on how much out-of-pocket costs you have to pay in a year.

In addition, all individual health plans must cover a standard set of 10 essential health benefits:

  • Outpatient care, including doctors visits
  • Emergency room visits
  • Mental health and substance abuse treatment
  • Prescription drugs
  • Services and devices for recovery after an injury or due to a disability or chronic condition
  • Lab tests
  • Preventive services, including health screenings, immunizations and birth control. You pay nothing out of pocket for preventive care when you see health care providers in your plans network.
  • Pediatric services, including dental and vision care for kids.

Enrolling In A Catastrophic Insurance Plan

Tips for Buying Texas Individual Health Insurance ...

To enroll in a catastrophic health plan, you must meet one of the following eligibility requirements:

  • Be under 30 years old, or
  • Qualify for a “hardship exemption” .

If you and all other individuals covered by your health plan are under 30, you may be eligible to purchase a catastrophic health plan.

If you are over 30 and interested in catastrophic health coverage, you must qualify for a hardship exemption. Some examples of hardship exemptions include if you were homeless in the last three years or if you were found ineligible for Medicaid because your state didn’t expand its Medicaid program. Other situations may apply for more information, see this article on hardship exemptions.

If you think you may qualify for an exemption because of financial hardship, you’ll need to apply for a hardship exemption through the Marketplace. If you receive a notice stating that you qualify for a hardship exemption, you have the option to purchase a catastrophic insurance plan, and an eHealth licensed insurance agent would be happy to help you find a plan that may work for you. Or you can choose to enroll in a major medical plan instead.

Keep in mind that if you qualify for lower health-care costs because of income , you cannot apply these savings towards a catastrophic health plan. This includes premium tax credits and cost-sharing subsidies. So you’ll pay the standard premium amount for your catastrophic insurance plan, regardless of your income level.

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Types Of Health Insurance Plans

When purchasing health insurance, your choices typically fall into one of three categories:

  • Traditional fee-for-service health insurance plans are usually the most expensive choice. They offer the most flexibility in choosing health care providers.
  • Health maintenance organizations offer lower co-payments and cover the costs of more preventive care. Your choice of health care providers is limited to those who are part of the plan.
  • Preferred provider organizations offer lower co-payments like HMOs but give you more options when selecting a provider.

Holdout States Haven’t Expanded Medicaid Leaving 2 Million People In Limbo

Then there’s Medicaid, the health insurance program for people with low incomes, that covers around 80 million people nearly one in four Americans. It’s funded by both the federal and state governments, but run by each state, so whether you’re eligible depends on where you live.

For practically everyone else, the place to go is Healthcare.gov, where you can shop for insurance in the marketplaces created by the Affordable Care Act, also known as Obamacare.

This is where you look for health insurance if you don’t fit any of the categories we mentioned previously, Corlette says if, for example, “your employer doesn’t offer you any coverage you’re not eligible for Medicare because you’re not old enough and you’re not poor enough for Medicaid. You can go to the marketplaces, apply for financial help depending on your income, and choose a plan there.”

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Best For Preventative Care: Kaiser Permanente

Kaiser Permanente

  • Only available in 8 states

  • History of skimping on behavioral healthcare

Kaiser Permanente is another health insurance company with a strong reputation. The company was founded in 1945 and it doesnt have a rating with AM Best. Kaiser Permanente earned high scores of at least 4.0 and up to 5.0 with NCQA along with standout rankings from the J.D. Power 2021 U.S. Commercial Member Health Plan Study.

Kaiser Permanente has faced some scrutiny from the state of California, though. The company has been subject to several state sanctions and fines for skimping on behavioral healthcare. Some members were still struggling to get care at the end of 2019, according to the Los Angeles Times.

Kaiser Permanente offers health insurance in Washington, D.C., and eight statesCalifornia, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washingtonfor 12.5 million members. The companys network includes 39 hospitals, 727 medical officers, 23,597 physicians, and 63,847 nurses.

You may have access to a variety of health plans that include Medicare, Medicaid, high-deductible health plans, health savings account-eligible plans, and catastrophic plans. Plan availability depends on where you live.

The claims process may depend on your health plan and must be within 12 months of the date of your service. There are some additional steps to submit a claim for an emergency or urgent care visit away from home.

Hospital & Doctor Insurance

What Will it Cost to Buy Insurance on the Marketplace?

Health ProtectorGuard fixed indemnity insurance,3 underwritten by Golden Rule Insurance Company, can supplement your major medical plan by paying cash for eligible, covered medical services, like a doctor visit, a trip to urgent care or a surgical procedure.

  • No deductibles or copays to pay first
  • Benefits paid regardless of other insurance
  • Money to pay costs not covered by major medical plans, like a deductible

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How Much Does It Cost To Buy Health Insurance On Your Own

Generally, the less you pay out of pocket for the deductible, copays and coinsurance, the more you spend on premiums.

Platinum plans charge harmer premiums than the other three plans, but you wont pay as much if you need health care services. Bronze, meanwhile, has the lowest premiums but the highest out-of-pocket costs.

When deciding on the level, consider the medical services you used over the past year and what you expect next year. For instance, if you plan on starting a family, consider how much out-of-pocket costs youll have to pay if you go with a Bronze plan.

eHealth reported the average monthly premium by metal level:

  • Bronze — $448
  • Gold — $569
  • Platinum — $732

Bronze and Silver are the most popular plans — 42% have Bronze plans and 34% have Silver plans. Only 14% have Gold plans and 2% have Platinum plans.

How To Get Cobra

Group health plans must give covered employees and their families a notice explaining their COBRA rights. Plans must have rules for how COBRA coverage is offered, how beneficiaries may choose to get it and when they can stop coverage. For more COBRA information, see COBRA Premium Subsidy. The page links to information about COBRA including:

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What Is The Best Company To Buy Texas Health Insurance From

This is a question that comes up frequently and does not have a great answer unfortunately. The big national players in health insurance all work across Texas with a few exceptions. Your present health conditions along with previous things that you have been treated for will impact which company is right for you as well. Here are some key factors to consider when looking at a Health Insurance company to choose.

  • Type of Plan
  • ACA Compliant
  • Network of Available Physicians, Clinics, Care Centers, and Hospitals
  • Nationwide or Statewide Coverage?

The major companies all have stories about claim and coverage experiences that range from low-budget horror flicks up to concierge service. It’s more important to make sure that you understand if any specific needs or physicians will be inside their scope of coverage.

As we roll into Open Enrollment, Insurance For Texans is here to help you find the right plan for your family. Schedule a time to talk today with one of our agents to determine your best course of action.

Buying A Policy On The Health Insurance Marketplace In Texas


Like most people, you likely have a few questions about the policies that you can buy to protect you and your family’s health. There are a few things to keep in mind when shopping on the health insurance marketplace in Texas:

  • The level of coverage needed. If you’re in good health and rarely see the doctor, you may want to opt for a plan that offers you the bare minimum. Inversely, if you have kids, a more extensive level of coverage is advisedand most family members should have dental coverage too.
  • The amount of coverage you can afford. Be sure your coverage is affordable. Chances are, you may qualify for a subsidy to help lower premium costs.
  • The insurance companies you want to deal with. When shopping on the health insurance marketplace, Texas residents will be happy to know that HealthMarkets licensed agents have access to thousands of different plans from insurance companies recognized nationwide. Youll have lots of options, and we will help you pick the best one.
  • Options outside the government exchange.New regulations have made it easier to purchase alternative health insurance policies that arent included on the national exchange. Call us to discuss lower-cost, less-comprehensive plans.

As part of our free service, well even help you enroll in a health insurance plan in Texas.

Licensed Texas insurance agents are standing by to help you get the policy you need today. Call us at for a free quote.


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Your Options Depend On Your Household Income

When you apply for Marketplace coverage youll estimate your income for the current calendar year.

How to estimate your income if youre unemployed

Its hard to predict your annual income if youre unemployed. Still, its important to make your best estimate based on all current or expected sources of income for the year.

Types of income to include on your application:

  • Unemployment compensation that you receive from your state. Visit CareerOneStop’s Unemployment Benefits Finder for more information about unemployment in your state.
  • All household members income
  • Additional types of income, including interest income, capital gains, and alimony
  • Most withdrawals from traditional IRAs and 401ks. for information on non-deductible contributions, and IRS Publication 590-B for information on Roth accounts.)

Note: Its very important to immediatelyupdate your income information with the Marketplace if your income changes during the year. This will ensure you get the right amount of savings based on your new annual income estimate.

Why Is Texas Health Insurance Important

This seems like an easy question to answer but for those of you new to health insurance for individuals in Texas it is probably a question of some importance. Well talk a little about why having a good policy is important. What it will do for you. Why you should learn about your health insurance policy, and how to best utilize your health insurance for individuals in Texas.

A good health insurance policy is of supreme importance. It is in place to protect your health, your familys health, and your pocket book. It is easy these days to become a tenant in the poor house by having a health struggle and not having proper coverage, even for those of us in good health. Accidents happen all the time and even a health scare that produces no results can be very expensive. In fact, I recently had to have a CT scan for a benign congenital cyst in my brain. No problems or issues but that 45 minute test cost $1600. My cost, $100. Health insurance for individuals in Texas will do the same for you as one test can cost more than several months premium.

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Texas Medicare If Youre Under 65 And Have A Disability Or Chronic Illness

Medicare is a federal government program thats generally for people 65 and older. But if youre under 65, you can get Medicare Part A and Medicare Part B if one of the following applies to you:

  • You have a disability: You automatically get Medicare Part A and Part B after you receive disability benefits from Social Security or the Railroad Retirement Board for 24 months.
  • You Have ALS: You get Medicare Part A and B during the first month you receive disability benefits if you have Amyotrophic Lateral Sclerosis, or Lou Gehrigs disease.
  • You Have Permanent Kidney Failure : You sign yourself up for Medicare through Social Security. Its best to enroll in both Medicare Part A and Part B to get the full benefits available for ESRD. Once you enroll, your coverage usually begins the first day of the fourth month of dialysis treatment.
  • You may be eligible for Medicare Part A at a $0 monthly premium if you receive disability benefits for 24 months or you have ESRD.6 Medicare Part B has a standard monthly premium, which is $148.50 in 2021.7 If you qualify for low-income status in Texas, you can get financial assistance to pay your premium through a Medicare Savings Program.

    President Expands Affordable Care Act Special Enrollment Period

    Obamacare 2021 Subsidy: Get $600 Per Month to Buy Health Insurance

    Americans have another chance to sign up for an ACA health insurance marketplace plan in 2021 after President Joe Biden signed an executive order to launch a special enrollment period.

    The ACA marketplace special enrollment period is until that use the federal ACA marketplace. The other states set their own enrollment periods, but most followed Bidens lead and expanded the enrollment period.

    Bidens move hopes to insure as many of the 15 million uninsured Americans as possible, including those who lost health coverage because of Covid-19. As of the beginning of May, the special enrollment period reportedly signed up about 500,000 more ACA plan members.

    The ACA marketplaces open enrollment is usually from in most states. Thats the only time someone can get an ACA plan unless they qualify for a special enrollment during other parts of the year.

    However, Bidens executive order means that people without insurance dont need to qualify for a special enrollment. Instead, anyone who isn’t eligible for other coverage, such as through an employer, can sign up for a plan until .

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    Choosing A Health Insurance Plan

    Reading the fine print is important when choosing health care plans. These questions may help:

    • Can I go to any doctor, hospital, clinic, or pharmacy I choose?
    • Are specialists, such as eye doctors and dentists covered?
    • Does the plan cover special conditions or treatments such as pregnancy, psychiatric care, and physical therapy?
    • Does the plan cover home care or nursing home care?
    • Will the plan cover all medications my physician may prescribe?
    • What are the deductibles? This is the amount you must pay each year before your insurance company will begin paying claims.
    • Are there any co-payments? This is the amount of money you pay each time you receive medical services or a prescription.
    • If there is a dispute about a bill or service, how is it handled?

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