What is the Average Cost of Health Insurance in Texas?

No one wants to spend more money than they have to. This is especially true when it comes to health insurance. It is even more relevant when you are healthy, and you feel there is no need to have a health insurance policy. You are not ill, so why spend the money? However, one never knows when they will get sick, and even a simple trip to Urgent Care for a fever or bump on the head can become expensive rather quickly. Health insurance in Texas is crucial, and even more so if you have a family. We at CoverMile want to help you find the best health coverage at the best cost. Let’s show you how.

Is Health Insurance in Texas Mandatory?

There is no longer a federal penalty for not carrying health insurance. However, four states and DC carry their own penalties. Don’t worry; Texas is not among them. You cannot be penalized for not carrying health insurance. However, when you do not have health insurance, you will pay more for your health care when you visit a doctor or medical facility. It is to your benefit to contact an insurance expert at CoverMile. We can assist you with finding the best insurance policy that will fit your needs and not break the bank.

What Does Health Insurance in Texas Cover?

When you have Affordable Care Act health insurance, you are covered for all preexisting conditions. It doesn’t matter if you have stubbed your toe, logged into the website, purchased your policy that day, then went to see a doctor, or if you have a chronic condition, you are covered from the day you signed up. There are no waiting periods, and there is no reduced coverage for any condition you may have.

Under the law, the Affordable Care Act mandates these 10 Essential Benefits that every health insurance company must include on every policy.

  • Outpatient healthcare
  • Emergency Services
  • Hospitalization
  • Pregnancy, maternity, and newborn services
  • Mental health and substance abuse disorder services
  • Prescriptions Drugs
  • Rehab and habilitative services
  • Laboratory services
  • Preventive and wellness services
  • Pediatric, involving oral and vision care

How Much Does Health Insurance in Texas Cost?

The average cost of a Silver health insurance plan in Texas is $475. This can differ depending on numerous factors—the plan you select is one of them. A Gold metal plan will cost more than a Bronze metal plan because of the higher coverage levels. However, due to new ACA regulations, you may find some Gold plans less expensive than Silver plans in some cases. Contact CoverMile for more information.

Overall, the cost of your health insurance plan in Texas will be determined by

1.     The insurance company you select.

It’s no secret that insurance can be expensive. As you read above, the average cost of a plan is $475, that doesn’t mean everyone’s base cost goes by that figure. That number takes every insurance company’s premium and meshes them together. Not every company and not every plan are created equal. Shopping around is crucial. This is why you have help like us at CoverMile. We can assist you in understanding what each health insurance company offers, how their policies match up, and their costs so you can make an educated decision.

  • Where you live.

Location. Location. Location. Your city and even your zip code can mean the difference to your insurance premium. If you plan on moving, it is important to notify your insurance company that you are. It can help you possibly lower your rates. It is also a trigger for a Special Enrollment Period, so you are able to make changes to your policy if you need to.

3.      Your deductible and coinsurance.

Your policy’s cost can rise and lower depending on how much you are willing to pay out of pocket for your health care. This comes in the form of deductibles and coinsurance.

  • Deductibles – The amount you pay before the insurance begins to pay its portion. This is usually expressed as a fractioned dollar amount: 7500/15000. The first amount is your individual deductible; the second is your family.
  • Coinsurance – This is usually a percentage. 50/50, 60/40, and 70/30 are common coinsurance amounts. You pay the smaller portion until you reach your out-of-pocket maximum.

Deductibles will vary by policy, and they affect your premium. If you have questions about premiums, click the links above or contact us at CoverMile, we would be happy to help you select the right policy for you and your family.

  • Who is on your policy.

The more individuals on your policy, the higher your premium will be. Adding a spouse and children increases what you will pay. However, when you add children, it can decrease your premium, especially if you are on the Silver metal plan and you qualify for tax subsidies and Cost Sharing Reductions.

  • What type of policy you select.

The biggest difference in your premium cost will occur when you switch metal levels. If you choose a gold policy over a silver metal plan, you will see a cost increase, as you could see a decrease when you select a Bronze metal plan over a Silver plan. As we mentioned a moment ago, when you qualify for the premium tax credit, you can save on your insurance costs.

  • Bronze Metal – These plans are usually the lowest cost. This tier is best for young individuals, single, and those just starting out who are healthy and only visit the doctor for their annual physical or when they are sick.
  • Silver Metal – The next step up, both coverage and premium wise. This one is for those with additional responsibilities like a family. A Silver metal plan is a better option because you have the availability of the premium tax credit and cost sharing reductions.
  • Gold Metal – The top tier would benefit those who visit the doctor regularly. Those with chronic conditions. You may even look at companies like Oscar Health Insurance that has plans designed for those with Diabetes. Gold plans generally have the highest premium, but the greatest coverage.

In some cases, a Gold tiered plan can cost less than a Silver plan due to premium subsidies. If you have questions about policy selection or health insurance in Texas, contact CoverMile we can assist you with finding the right insurance for you and your family.

  • If you are a smoker

True, we said that your health cannot affect your insurance rate. However, this is one factor that will increase how much you pay for your health insurance. And lying on your application will only cause issues should you develop a condition that traces back to smoking. It is easier to pay a smoker’s rate than to be discovered and have your policy charged retroactively from the beginning of the policy. Either way, you will have to pay the rate.

All these factors weigh into how much you will pay for your health insurance in Texas. Each carrier experiences increases and decreases in what they will charge consumers. For 2024, Blue Cross Blue Shield of Texas experienced a .24 percent decrease over their 2023 rates. Oscar insurance was among those with a rate increase; however it was on the low end of those with increase, their increase was three percent.


It doesn’t take much for a health insurance bill to rise. Individuals need health insurance to help alleviate the high cost of doctor visits, medication when they need it, and the occasional ER trip. You never know when the unexpected should occur. The cost of health insurance is worth the inconvenience versus the huge medical bill if you choose to go without it. Let us help you by finding affordable health insurance today.

You can contact CoverMile for more information whether you live in Dallas, El Paso, Houston, Laredo, or Austin. We instantly compare the costs with hundreds of carriers, finding the best one to fit your family situation. Contact CoverMile today.