While the first thing many may think of when they hear the word sterling is silver, it isn’t the type of sterling we are referring to. However, we will discuss silver later in our review. Stay tuned. As for the Sterling we are talking about, it is the western county just about to the panhandle. The namesake was a passer-through who was the first to stay; they named the place after him. Maybe you are passing through health insurance companies and don’t know where to hang your hat. We at CoverMile want to help you find the best plan for you and your family, and no fence-cutting will be involved.
We at CoverMile are here to match you with the best health insurance plans in Sterling County at the lowest prices. Coverage exists for as low as $0 per month with subsidies. Read on, and we will show you how.
2023 Health Insurance Facts in Sterling County, Texas
With 2.4 million individuals for 2023, Texas has one of the country’s highest exchange enrollments. Only Florida has seen more people enroll. The Lone Star State also has the highest uninsured rate at 22.1 percent. It has held this position since the exchange system began in 2019.
Here are additional facts about health insurance in Texas.
- According to a US Census estimate, Sterling County has a population of 1417 residents. Of that total, 21.5 percent are uninsured.
- By gender, of those insured, 58.1 percent were women, and 41.9 percent were men.
- Eighty-seven percent of consumers have access to three or more insurers in 2023. Through the ACA, Sterling County has access to two insurance providers.
- Fifty-nine percent of consumers have access to a plan from a national insurer; companies like Blue Cross Blue Shield of Texas are available to more than just a local area.
- 64.8 percent of Sterling County has health coverage. 35.8 percent obtain it with their employer, while 9.6 percent have it through non-group plans. 8.8 percent have Medicare insurance, 10.7 percent have insurance through Medicaid, and none obtain health care through the VA or the military.
- According to the US Census Bureau, about 12.4 percent of Texans are disabled. In Sterling County, the number is 7.1 percent.
- The average cost of a Silver health insurance plan in Texas is $454
Here are a few fun facts about the square County itself:
- Sterling County was named after W.S. Sterling. He was one of the first early settlers in the area. He was known as a buffalo hunter and Indian fighter.
- In the fall of 1883, a conflict known as the Fence Cutting Wars began. It was ignited by those who did not own land and desired free range. The three primary groups called themselves Owls, Javelinas, and Blue Devils.
- Sterling City has been called “Windmill City” and was noted for its windmills, which at one time numbered 150.
- Camp Elizabeth was used in the 1870s as officer’s quarters, rock corrals for horses, and tents for enlisted men.
- The North Concho River flows through the middle of the county, from the Camp Elizabeth Historical Marker down to the 87 and 138 interchanges to the W H Reed Reservoir. It continues into Tom Green County to San Angelo.
- Sterling County only has one incorporated city, Sterling City.
- However, Stonewall County has three ghost towns: Broome, Cummins, and Monte Valley.
Do I Need Health Insurance in Sterling County, TX?
It is no longer a federal mandate to have health insurance. Only six states still require individuals to carry health insurance. Yet, if you choose to remain uninsured in Sterling County, it can open the door to many issues you may not realize.
- Healthcare costs.When you don’t have health insurance, you pay full price for medical care. Think of health insurance as having a membership to your favorite chain store. When the cashier swipes your card, you receive a discount. Health insurance is the same. Insurance companies contract with medical facilities to provide care to individuals at a negotiated rate.
- Healthcare networks.Your doctor may suggest seeing a specialist after visiting them to have further testing done. When you have insurance, you have a network of doctors and facilities to ease the concern of searching on your own. Especially since seeking advanced medical care may burden an already stressful situation.
- Healthcare maintenance.Due to Affordable Care Act mandates, health insurance provides free preventive care such as immunizations. You must pay for these services out of pocket when you do not have health insurance.
What are My Health Insurance Options in Sterling County, Texas?
Individuals and families who need health care have several options in Sterling County. You can find a plan through the ACA Marketplace or purchase directly from the health insurance company.
Affordable Care Act/Marketplace – When you purchase your plan through the Marketplace, you can search based on your area, family size, and annual income. This information lets you determine if you qualify for premium tax credits and subsidies like cost-sharing reductions.
Direct Purchase – Before searching for a direct purchase from a health insurance provider, ensure you do not qualify for ACA tax credits and subsidies. You can save money if eligible. If not, continue with your direct purchase from a health insurance provider. In some cases, like with Blue Cross Blue Shield of Texas, you may have additional plan options only available on the insurance company’s website.
Short-term Health Insurance – Short-term Health Insurance can assist those seeking insurance, but: it may be too early in the year for Open Enrollment, you’ve just started a job and an employer’s benefits package has a waiting period, or you are waiting for Medicare benefits to begin. Short-term Health Insurance covers an initial period of 364 days and can be renewed for an additional 24 months. Keep in mind Short-term Health Insurance has limits. It does not cover preexisting conditions, maternity care, or prescription medication.
Types of Insurance – HMOs, EPOs, and PPOs are the most common health insurance network types. Some insurance companies, like Ambetter, offer multiple network options through the Marketplace or a direct purchase. When you enroll, double-check that your primary doctor is on their list of covered providers. If they are not, you can incur out-of-network fees. Or, as with EPO networks, you may not have coverage at all.
Top Rated Health Insurance Companies in Sterling County, TX
What a customer is willing to pay for their health insurance over time is one of the main details rating companies evaluate. Health insurance shoppers then use reviews to consider which insurance companies are best and purchase based on their research.
To address this concern, we’ve rated the top companies available in Sterling County based on their 2023 rates compared to their 2022 rates.
- Blue Cross Blue Shield of Texas – 3.42% rate increase – Although BCBS of Texas had an increase in 2023, they’ve proven to be a strong and reliable insurance provider through the years. They have more plans available than other insurers; they also cover the entire state of Texas.
- · Ambetter – 10.7% rate increase – Ambetter offers Adult Dental and Vision options with some of their EPO network plans. Most insurance companies only provide the Children’s dental mandated by the ACA 10 Essential benefits. The one thing Ambetter lacks, however, is they do not offer a Bronze metal plan.
Top Six Health Insurance Plans for Sterling County, TX
Below, we’ve selected the best Silver metal policies for Sterling County, TX, from each of the above companies. They are in order, reflecting a standard policy’s premium without Cost Sharing reductions.
|Insurance company||Insurance Plan||Co-insurance||Deductible||Out-of-Pocket Max||Copay PCP/ Specialist||$0 Virtual Care PCP||Adult Dental/ Vision|
|Ambetter||Complete Silver EPO||40%||$5000/ $10000||$7250/ $14500||$20/$50||Yes||No|
|Ambetter||Focused Silver +Vision +Adult Dental EPO||50%||$5100 /$10200||$6300 /12600||$35/$85||Yes||Yes|
|BCBS of Texas||Blue Advantage Silver 205 HMO||50%||$1500/ $4500||$7250/ $14500||$15/50%||Fee Applies||Dental/ Vision as separate policies|
|Ambetter||Focused Silver +Vision +Adult Dental EPO||40%||$5000/ $10000||$7250/ $145000||$20/$50||Yes||Yes|
|BCBS of Texas||Blue Advantage Silver 705 HMO||40%||$5700/ $11400||$7200/ $14400||$30/$60||Fee Applies||Dental/Vision as separate policies|
|BCBS of Texas||Blue Advantage Plus Silver202||50%||$1500/ $4250||$7250/ $14,500||$20/50%||Fee Applies||Dental/Vision as separate policies|
How to Enroll in Health Insurance in Sterling County, TX?
There isn’t much difference to the enrollment process whether you live in Orange, Sterling, Corpus Christi, or Dallas County. Each must adhere to Affordable Care Act standards.
When – The Affordable Care Act Open Enrollment period is from November 1st through December 31st. Your health insurance will begin on January 1st. You can also sign up until January 15th, but your start date will be February 1st.
The ACA also has Special Enrollment Periods (SEP) where one can enroll anytime during the year. You qualify for a SEP when:
- There is a change in your household. – This includes getting married or divorced; a birth or adoption in your family; or a death in the family.
- You have a change in your residence. – If you move and switch zip codes; this may require an insurance rate adjustment.
- You have a change to your health coverage. – When you lose health coverage provided through an employer or alternative source, you can apply for ACA health insurance.
How – The easiest way to apply for Texas health insurance is through the ACA Marketplace. As you fill out your application, the website guides you through selecting your plan, and you will be able to see if you qualify for tax subsidies.
If you have any questions when shopping for health insurance in Sterling County, TX, contact CoverMile. We can help you find the best coverage that will fit your family’s current situation.
How to Find Doctors Near Me in Sterling County, TX?
One concern insurance shoppers have is whether they will be able to keep their current doctor or if they will have to find someone new. You can find this information by visiting the insurer’s website and searching for your doctor’s or the facility’s name. This search will tell you if they are in-network or out-of-network.
The links below take you to each provider’s directory. You can see if your doctor or the facility you visit is covered. You can search by location, doctor’s name, and facility type. Each website is different, and some offer more information than others.
After entering your location, you can search Medical Care, Urgent Care, Behavior Health, and Cost Estimates. You can also search for pharmacy information, as well as for dental and Vision care.
Enter your plan information and location, and you can find doctors and facilities in your area. You are also allowed to connect with Telehealth or talk with a nurse directly.
Frequently Asked Questions
Is health insurance in Sterling County, TX expensive?
The cost of health insurance in Texas depends on many factors. The average health insurance plan in Texas is $454. However, insurance can increase depending on the insured’s gender, age, and whether or not they smoke. Other factors contributing to cost are family size, where you live, and tobacco use. Premiums can be lowered based on qualifying for tax credits and subsidies.
Can I talk to a doctor after hours in Sterling County, TX?
Both Blue Cross Blue Shield of Texas and Ambetter offer after-hours services for their subscribers. Services 24/7. All you need is a phone or computer. These services usually ask a few medical questions and connect you with a medical professional. BCBS of Texas requires a small copay. Ambetter Telehealth services have a $0 copay on all their plans.
Can I sign up for Oscar Insurance in Sterling County, TX?
Blue Cross Blue Shield of Texas and Ambetter health insurance plans offered to Sterling County residents. However, Oscar Insurance is unavailable through the ACA Marketplace or sold on the open market through the company’s website.
Can I use my Sterling County, TX, health insurance when I travel?
Most insurance companies have a network of doctors and facilities you must use or either pay an out-of-network rate or not have coverage. Ambetter is an EPO and is stricter regarding out-of-network coverage. However, you have coverage if you travel out of state or country and experience a medical emergency.
Am I able to get Dental or Vision Insurance in Sterling County, TX?
Children’s Dental and Vision services are part of the mandated ACA 10 Essential Benefits but are limited. However, adults are not included. Ambetter offers Adult Dental and Vision on select plans. Blue Cross Blue Shield of Texas offers Dental and Vision benefits that include children and adults, but they are sold separately from their health insurance plans. Visit their website for more information.