When one is self-employed, it can be difficult to accomplish all the things you must do during the day. The last thing you want to do is sift through the myriad of health insurance sites to try and determine which health insurance in Texas would fit your family and your insurance situation. That is the purpose of this brief review. We aim to give you the best of the best to assist you in deciding, whether it be for the best coverage, insurance plan affordability, or simply the best value.
The Affordable Care Act Health Insurance in Texas
Before we begin, it is worth noting that each of these plans are part of the Affordable Care Act. You will receive coverage for the 10 Essential Health benefits. These include:
- Outpatient healthcare
- Emergency services
- Pregnancy, maternity, and newborn care
- Mental health and substance abuse disorder services
- Prescription drugs
- Rehab and habilitative services
- Laboratory services
- Preventative and wellness services
- Pediatric, including oral and vision care
Our Review of the Best Health Insurance in Texas
We have done some of the shopping for you. We have scoured the internet and looked through the top three concerns of health insurance shoppers: coverage, affordability, and overall value. We have narrowed it down to these three health insurance companies and will explain why we have chosen them in their particular category.
Blue Cross Blue Shield – Our choice for the best network coverage.
Blue Cross Blue Shield is probably the most popular health insurance carrier in Texas. They offer in-network coverage in every county in Texas. In fact, the majority of doctors in Texas accept Blue Cross Blue Shield of Texas (BCBSTX) as a form of insurance. From El Paso to Beaumont and Amarillo to McAllen, self-employed Texans have the coverage they need for the medical emergencies they encounter.
What coverage does BCBS of Texas offer?
- The ACA Ten Essential Benefits
- Individual and Family Health Insurance – BCBSTX has a variety of plans that allow you to select the coverage you need if you require coverage for just you or if you plan to cover a family. They also allow you to adjust your plan by how much you can afford. They break it down into medal levels—the lowest allowing for a more affordable premium, up to the highest medal for the more costly premium. The only difference will be the co-insurance paid by the insured.
- Medicare – When one turns 65 years old, they qualify for Medicare. One benefit of BCBS is that they offer dental, vision, and hearing that Medicare alone does not provide. It is offered through Medicare Advantage. They also offer Medigap plans that are designed to share the costs of Medicare, helping with coinsurance, copayments, and deductibles.
- Medicaid – For those who qualify for Medicaid, BCBCTX offers a STAR health plan.
- Dental and Vision – Blue Cross Blue Shield also has dental and vision benefits.
- Other Insurance Products
- Life Insurance
- Short-Term Disability
- Critical Illness
Aetna – Our choice with the most affordable plans.
Aetna entered the Texas market for open enrollment in 2022. They are consistently one of the cheapest health insurance carriers in the Texas market. They sell health insurance within the Affordable Care Act marketplace. They are limited in their health insurance in Texas, only offering coverage to 32 of the 254 counties. However, to those for whom coverage is available, they are known as the health insurance company with the most affordable rates.
What affordability does Aetna offer?
Aetna is a 10 Essential Benefits Obamacare plan. It offers recipients zero-dollar preventative care, virtual care (Telemed), and zero-dollar MinuteClinic©. Both of which are available on all its plans. Self-employed Texans can take advantage of this benefit in whichever tier they elect.
Aetna also provides health care benefits through Medicaid, Medicare, and plans for employers, students, and dental plans.
- The ACA Ten Essential Benefits
- Medicare – offers Medicare Advantage as well as Part D prescription plans.
- Medicaid – Offers plans as part of the STAR and CHIP program. Those who qualify are those who have limited income, are pregnant or have newborns or receive cash assistance.
- Dental – Aetna offers dental insurance as an add-on or a stand-alone policy. They also offer a dental saving program that would also be independent of insurance purchase.
- Student Health Plans – plans designed for students who live away from home. They carry the same benefits as they would as living at home.
- Small Business Health Insurance – These plans provide employees the ability to obtain ACA-approved health coverage through payroll deduction.
Oscar – Best Value Plans with lower deductibles
Oscar’s coverage area is limited to five Texas geographical areas: San Antonio, Austin, Dallas, Houston, and El Paso and their surrounding areas. However, when you live within their coverage area, you have access to Oscar’s best-value plans and lower deductibles on most of their individual and family plans.
What value does Oscar offer?
Oscar too is available as an ACA plan and covers the 10 Essential Health Benefits. While most plans can be purchased through the Marketplace, its highest tier, Gold classic standard, is only available for purchase through its website
Oscar offers health care benefits through Medicare and assists small businesses in providing their employees with obtaining health insurance.
One benefit that sets Oscar apart is virtual visits with a doctor with a zero-dollar co-pay. This allows patients to see a doctor from the comfort of their home and not have to make the trek into a doctor office if they are not well. They save the money of a co-pay of a doctor office, urgent care, or emergency room. This benefit extends to all plan types.
Benefits Oscar extends to subscribers:
- The ACA Ten Essential Benefits
- Tele-med – A virtual phone call with your doctor. Think Zoom or Skype, where you can talk to your doctor live. These are part of your insurance plan and have a zero-dollar co-pay.
- Medicare – Medicare Advantage, which includes Part A, Part B, and Part D, your prescriptions portion. Advantage also includes benefits like dental, vision, and hearing.
- Small Business Health Insurance – Cigna + Oscar is a partnership that brings small business owners the ability to offer their employees ACA-approved health insurance and allows it through payroll deductions.
The Sum of It All
Health insurance should be affordable to all, and shopping for it should not be a chore. With the above information, you now have what you need to make an informed decision as to the best health insurance for you and your Texas family, whether you live in Austin, Dallas, or San Antonio. We at Cover Mile aim to make your insurance purchase experience as comfortable as possible. Our informed agents are ready to assist you in purchasing your policy. Contact us today!!