The Five Best Health Insurance Companies in Texas for 2024

When shopping for health insurance, you want your choices to be from only the best of the best. You desire to find an insurance company that will not leave you and your family hanging when you need coverage for a doctor’s office check-up, an emergency room visit, and everything in between. This is the goal of our compilation, to do the hard work for you. Our researchers have narrowed it down to the top five health insurance companies in Texas that will offer you plans with the best coverage at prices you can afford. By the end of this review, you should have the information you need to make an informed decision as to your next health insurance provider.

The Affordable Care Act Health Insurance in Texas

To save time and space, let’s begin with what each of our choices has in common. All our top five health insurance in Texas choices offer the 10 Essential Health benefits. These include:

  • Outpatient healthcare
  • Emergency services
  • Hospitalization
  • 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

Remember, to be regarded as an Affordable Care Act policy, a Texas health insurance provider must offer these services as part of their basic health plan. This cannot be an added service or included at a premium. 

Top Five Health Insurance Companies in Texas for 2024 

These are the top five health insurance companies in Texas based on what they offer customers, their cost, and their rating. They are not written in any particular order. .

Best Plan Summary

  • Best Network Coverage: Blue Cross Blue Shield
  • Most Affordable: Aetna
  • Best Value with Lower Deductibles: Oscar
The Five Best Health Insurance Companies in Texas for 2024

Blue Cross Blue Shield 

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One of the primary benefits of Blue Cross Blue Shield of Texas (BCBSTX) is that they are available statewide. Out of all the insurance companies in our review, they are the most available option.  

Pros

  • Has some plans that offer $0 co-pays to see primary care physicians in network 
  • Has the most extensive coverage of any carrier in Texas 
  • Every County in Texas has in-network coverage 
  • Also offers dental and vision 

Cons

  • Low customer satisfaction index rating 

Why We Chose It

BCBSTX has a variety of plans that allow you to select the policy you need if you require coverage for just you or if you plan to insure a family. They also allow you to adjust your plan by how much you can afford. They break plans down by medal levels—the lowest, bronze, allowing a more affordable premium, up to the highest medal, gold, for the more costly premium. The only difference will be the co-insurance paid by the insured.  

When you turn 65 (three months before, the month of, and three months after), you are able to sign up for Medicare. With BCBSTX, you can elect to sign up for Medicare Advantage. This is a Medicare all-in-one plan. This gives you your Part A (Hospital Insurance), Part B (Medical Insurance), and Part D (Prescription Coverage). With Blue Cross Blue Shield, they offer dental, vision, and hearing as part of the package. And if you do not have Medicare Advantage, you can look into Medigap plans that assist with Original Medicare co-insurance, copayments, and deductibles.  

Another reason to choose Blue Cross Blue Shield of Texas is their ancillary products. They offer members short-term disability and critical illness benefits, accident indemnity plans, and accidental death and dismemberment benefits. These are payouts for incident benefits. 

United Healthcare

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United Healthcare is also available statewide. They have many bells and whistles. For instance, like BCBSTX, they offer Medicare Medigap plans that assist policyholders with co-insurance, co-pays, and deductibles. Some of the others do not provide ancillary products. 

Pros

  • Offers plans with unlimited $0 app-based care
  • Offers plans that charge only $3 for generic drugs retail 
  • Large Network  
  • Great customer service reviews 
  • Dental and Vision offered  
  • Medicare Advantage offered 

Cons

  • Lowest Customer Satisfaction Index Rating according to JD Power Health Plan Study
  • While available in TX, they are limited to 22 states throughout the US for ACA coverage. 

Why We Chose It

United Healthcare offers both HMO and EPO plans. In addition, they offer short-term health plans that provide temporary insurance while you are waiting for an employer’s plan to begin, waiting for ACA Open Enrollment, or your Medicare enrollment period is coming up. Short-term health insurance covers for one year. However, pre-existing conditions can be excluded, or your application to be denied. UnitedHealthcare also has a three-year option to sign up for called TriTerm Medical Insurance. It covers for preventive care, doctor’s office visits, and prescriptions. Its acceptance is more lenient. However, for the first year, any pre-existing conditions will be excluded.  

Ancillary insurance products include: Dental and vision benefits; accident insurance; critical illness insurance should you be diagnosed with a covered illness or injury, your policy would payout the stipulated amount; and hospital insurance which will pay a benefit depending on the medical service provided. This can include lab work and x-rays, ambulance and ER visits, and ICU confinement. In addition, UnitedHealthcare also offers hospital indemnity plans, which are supplemental plans that pay cash benefits for services. They carry the same $0 virtual doctor visit benefit the standard health insurance covers.  

United Healthcare also offers health plans targeted for small businesses, the self-employed, and students. In addition, they provide for those in the final season of life, Medicare. For those looking for the all-in-one plan of Part A and Part B with the prescription coverage of Part D, a Medicare Advantage plan can be a coverage to look at. Advantage plans come with added benefits such as vision, dental, and hearing.  

Oscar 

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Oscar has been making changes to the insurance types it offers. It has grown as a health insurance company in Texas in 2023. While this has little effect on the individual market, it will impact those who run small businesses or want a Medicare policy. For those shopping for a health insurance policy, the company’s growth proves people are looking to Oscar for their health insurance needs.   

Pros

  • Offers plans with $0 Virtual Care  
  • Offers Plans with $3 Preferred Generic Drugs 
  • Overall, has lower rates than the general market 
  • Lots of doctors now accept Oscar as they are now a well-known carrier 

Cons

  • Out-of-network coverage is limited to emergencies only. 
  • Only available to five geographical areas.

Why We Chose It

The first thing you need to understand about Oscar is that in Texas, they are offered as an EPO and not an HMO or a PPO. Okay, sorry, yes, bombarding you with a bunch of alphabet soup. The primary differences lie in the type of network you can access to doctors and facilities like hospitals and urgent care—each of these contracts that provide better rates, thus the terms, in-network or out-of-network. EPOs only contract with certain doctors and facilities. So, if you do not visit one of their listed providers, you will not have insurance coverage. However, if you face an emergency situation, this will supersede this rule, and you will be treated and receive full coverage.  

One of the perks of Oscar is their virtual visit. In many cases, when you are sick, it seems it happens at the most inopportune times, when the doctor is closed, after hours for an Urgent Care facility, or there is no appointment available. And to go to an Emergency Room for a cold would be too expensive. Oscar has a benefit called Virtual Visit which allows you to have a doctor visit through a video meeting. The best of this is that the visit is free.   

Prescriptions are also a big concern for many Texas health insurance shoppers. Oscar provides $3 prescriptions in some markets, and some plans carry no cost. Another benefit is that you do not require a referral from your primary care physician to see a specialist as would with an HMO.  

They do have Small Business options, however, not in the state of Texas. And Oscar had once offered Medicare Advantage. However, for 2023 they will no longer offer Medicare Advantage to its customers in Texas. 

Ambetter

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Some health insurance companies work with you to provide coverage and reward you for having healthy lifestyles. Ambetter health insurance has created a program for those who desire both benefits. 

Pros

  • One of the only carriers to offer plans that combine dental and vision 
  • Has some plans that offer $0 co-pays to see primary care physicians in network
  • 24/7 Telehealth with a $0 co-pay 
  • Adult Vision and Dental Available 

Cons

  • Out-of-network coverage is limited to emergencies only.  
  • Higher co-pay for prescription drugs.

Why We Chose It

Ambetter, like Oscar, offers an EPO; this means that if you are trying to use an out-of-network doctor or traveling out of state, you will not have coverage under your health plan. They have an HMO option as well. Both levels offer a variety of Silver and Gold Affordable Care Act plans with a wide range of deductible options, including zero-dollar and HSA plans for those who like to have a savings account option with their health insurance.  

Ambetter has a co-pay comparable to others on our list. They also have telehealth access 24/7 and a zero-dollar co-pay. However, the prescription cost is on the higher end of the scale. They do offer vision and dental benefits as add-ons to their plans.  

Ambetter has a smaller coverage area than our other options, and it is not available across every county in Texas. The closer you get to the panhandle, the scarcer you will find coverage. 

Mental health services are essential to maintain chronic conditions. Ambetter offers health management programs such as telephone support, behavioral health services, and other programs such as depression management and disease prevention. 

Aetna

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Having the smallest network of all our selections, they offer many options to visit a doctor away from the office from Urgent Care, MinuteClinics, and even, where available, home visits through DispatchHealth.

Pros

  • Consistently offers the lowest rates on the market 
  • Well-known for great customer service 
  • Offers plans that cover $0 walk-in clinics 
  • Telehealth 24/7 application 

Cons

  • They are not widely available 

Why We Chose It

While called Aetna Texas, they have a relatively small footprint within the state, primarily to the North-central portion and just a handful of counties near the Dallas area. They offer EPOs, PPOs, as well as HMOs. HMOs are essentially the middle ground of the above two concerning doctor’s office visits and out-of-network facilities. Under an EPO, you cannot use an out-of-network facility unless there is an emergency. You can with an HMO if it is deemed medically necessary and prior authorization. 

Anytime MD is a benefit that allows you to receive care 24/7 via phone call or video chat. This service is free to most health plans. If you need to see a doctor in person, MinuteClinic is an in-person med clinic that provides medical care and services to patients. These can include vaccines, tests and screenings, chronic condition management, injuries and pain, and prescription refills. They can also provide tests, screenings and physicals for health conditions or pre-job requirements. This seems to be their strong suit; they promote it heavily through their website. 

While small, they have a strong Excellent A+ rating by AM Best.  

The Best of the Best 

If you are looking for coverage options, Blue Cross Blue Shield is your best bet. They have your back from Dallas to Corpus Christi and El Paso to Houston. They even go beyond health coverage to include Medicare Advantage, which includes both Part A and B, as well as Part D prescription coverage or the alternative Medigap plans you can pair with your Original Medicare. 

Oscar had its benefits with the lower deductibles. So, if you are looking for insurance for value, then Oscar is worth looking at. Just remember that they are an EPO, and you must remain within their network. However, they are limited to five areas: El Paso, Dallas, San Antonio, Houston, and Austin.

Frequently Asked Questions

How Much is Health Insurance? 

Health insurance in Texas will depend on if you are enrolling as a single individual, are filing married, and if you include children. It can also depend on how much you make because if you are low-income, you may qualify for subsidies that can help you save on your health insurance premiums. 

When Can I Enroll in Health Insurance in Texas? 

Open Enrollment for the Affordable Care Act is from November 1 through December 31st of each year for insurance to begin on January 1st. You can still enroll until January 15th as a late enrollee, but your insurance will not start until February 1st.  

Can I Get Health Insurance if I Missed Open Enrollment? 

If you missed both the January 1st and the January 15th Open Enrollment deadlines, you would need to wait until the following November 1st Open Enrollment period for ACA. However, if you have a qualifying event, you will trigger a Special Event Open Enrollment period. These events include:

  • Getting married or divorced 
  • Having a baby or adoption 
  • Death of a covered family member 
  • Moved out of the zip code 
  • Loss of coverage through a sponsored health plan

How Can I Save Money on My Health Insurance in Texas? 

The best way to save money is to know your options. If you are low-income, you may qualify for the Premium Tax Credit. This will help reduce your monthly premium on your Affordable Care Act insurance Marketplace plan. It is based on your current year’s income estimate and household size. Another way is to keep your insurance plan up-to-date. If there are any changes in the middle of the year, like a covered family member moves out of your home and will no longer need coverage or you move, update your information. Your new status could see a lower rate. 

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