How Much Can I Expect to Pay for Health Insurance as a Single Mom in Texas with a Low Income?

As a parent, there is nothing more important than the well-being of your little ones. Whether they are infants or getting ready to walk the stage in a cap and gown, you understand their health is one of the most important boxes on your checklist. A recent Current Population Survey revealed that there are currently 9.8 million single-parent households in the U.S. Of those, 7.3 million of them are led by a single mother.

Being a parent on your own, you may be asking questions about where you can obtain health insurance. At CoverMile we understand the pressure you are under and are here to help sort out the confusion. We want you to know there is Texas health insurance for low-income single moms. We plan to guide you through what is available and help you make the best decision for you and your family.

Is There Health Insurance for a Single Parent in Texas?

Anytime there is a change in the family dynamic, there can be confusion about what is next and what will it mean to your finances, insurance can be one of those things. Here are a few of the options that can be available to you:

Employer-Sponsored

One of the first places you will want to check is if you qualify for health insurance through your employer. This helps for several reasons. One is that costs are often lower because your employer will bear part of the burden. Another is your premiums will be deducted from your paycheck, pretax. If you have a job that offers benefits, ask your human resource director what options may be available to you.

Private Health Insurance

This is insurance through the Marketplace and the most likely place you will find coverage. The Affordable Care Act outlines Texas health insurance for low-income individuals providing subsidies that will often allow you to pay as little as $0 in premiums. A single mom with a low income in Texas can easily qualify for subsidies as well as cost savings reductions when applying for a Silver metal plan.

Medicaid and CHIP

Medicaid is a government health insurance program that provides a single mom with a low income and her family who qualify for health insurance. This insurance is based on the Federal Poverty Level and the stipulations outlined by Texas, based on family size and income level. You may be able to obtain health insurance along with your child if you meet income requirements. A pregnant woman can also receive coverage during her pregnancy and up to 12 months post-partum.

In Texas, Medicaid is usually called the STAR (State of Texas Access Reform) Program. To help clear up confusion, there are divisions of STAR aside from the traditional Medicaid version: STAR Kids is for those with disabilities, STAR+PLUS is for adults 65 and older, and STAR Health is for children in the foster care system.

Children Health Insurance Program Family (CHIP) is a program designed for those who do not qualify for Medicaid due to income, but still need the protection of health coverage. It will cover the child and mom during the pregnancy and for up to two post-partum visits.

Both Medicaid and CHIP cover the same services. These can be:

You must also live within CHIP’s coverage area. For instance, while BCBS of Texas is offered statewide, the CHIP program is only available in eight counties around the Austin area.

Which Health Insurance Companies Cover a Single Mom in Texas?

We have researched the top Texas health insurance companies that provide coverage for low-income single moms in Texas. You will see plans on both the Silver as well as Gold metal tiers. With the cost of health insurance and how ACA subsidies work, you will often find Gold plans equal to or more affordable than Silver plans.

Below we have selected the best plans from each company based on cost and coverage. Each company has additional plans, and you can visit each company’s highlighted link to view additional information and plans they have available.

Blue Cross Blue Shield

The major benefit of BCBS of Texas is that they are available statewide. They offer low premiums, low deductibles, and a low cost to visit a Primary Care Physician.   

	My Blue Health Silver – 807	My Blue Health Gold – 403	My Blue Health Gold – 808	My Blue Health Silver -405
Deducible	$0/$0	$1000/$2000	$1500/$3000	$0/$0
Coinsurance	25%	30%	25%	30%
Out-of-Pocket Max	$1800/$3000	$9450/$18,500	$8700/$17,400	$1000/$2000
Primary Care Visit	$0 copay	$0 copay Select PCP | $20 copay all others	$30 copay	$0 for PCP – $5 all others
Specialist Visit	$10	30% coinsurance	$60	40%
Emergency Room	25% coinsurance	$950/visit plus 30% coinsurance	25% coinsurance	$500/visit plus 30% coinsurance
Urgent Care	$5 copay	$30 copay	$45 copay	$10 copay
Inpatient Hospital	25% coinsurance	$850/visit plus 30% coinsurance	25% coinsurance	$250/visit plus 30% coinsurance
Outpatient Hospital	25% coinsurance	40%	25% coinsurance	$100/visit plus 30% coinsurance
Prescription (Pharmacy)	$0/$15/$15/ $50/$50/ $150**	$5/$10/$15/$25/ 30%/35%/35%/ 40%/45%/50%**	$15/$15/$30/ $30/$60/$60 $250**	$5/$10/$15/$25 /30%/35%/35%/ 40%/45%/50%**
Children’s Dental/Vision*	No/Yes	No/Yes	No/Yes	No/Yes

*See plan details for limitations.

**RX: Generic, Brand preferred participating. Brand preferred non-participating, brand non-preferred participating, brand non-preferred non-participating, specialty.

Texas STAR Program

Texas single moms with a low income can qualify for the BCBSTX STAR Plan (State of Texas Access Reform). This health insurance program is available to those living in the Austin area and surrounding eight counties: Bastrop, Burnet, Caldwell, Fayette, Hays, Lee, Travis, and Williamson.

UnitedHealthcare

UnitedHealthcare is not far behind BCBS. They are offered in 209 of Texas’ 254 counties. They have a low deductible, but a higher out-of-pocket max. They offer zero-dollar copay for virtual visits should you need to see a doctor after business hours or if you are away on a vacation.

	UHC Gold Value	UHC Gold Virtual First	UHC Gold Standard	UHC Gold Advantage+
Deducible	$2000/$4000	$1000/$2000	$1500/$3000	$500/$1000
Coinsurance	20%	40%	20%	45%
Out-of-Pocket Max	$8500/$17,000	$8400/$16,800	$8700/$17,400	$7000/$14,000
Primary Care Visit	$0	$50 copay	$30 copay	$5
Specialist Visit	20% coinsurance	$100 copay	$60 copay	$75 copay
Virtual Visits	$0	$0	$0	$0
Emergency Room	20%	25%	25%	$500 copay
Urgent Care	$50 copay	$75 copay	$45 copay	$50 copay
Inpatient Hospital	20%	25%	25%	45%
Outpatient Hospital	20%	25%	25%	$300 copay
Prescription (Pharmacy)	$0/$1/$15/$60/ 40%/50%*	$0/$3/$30/ $60/40%/50%*	$0/$15/$30/$60/ $250/ N/A*	$0/$3/$30/$50/ 30%/40%*
Children’s Dental/ Vision*	Yes/Yes	Yes/Yes	Yes/Yes	Yes/Yes

*See plan details for limitations.

**RX: Preferred, Non-Preferred, Tiered 1-5

Texas STAR Program

Texas STAR with UHC is only available in 44 counties. Please visit their website for more information on if your county is listed. A few are Austin, Galveston, and Orange Counties.

Aetna

While Aetna has low premiums and deductibles, they have the highest out-of-pocket maximums. One benefit Aetna has built into every plan is a zero-dollar copay walk-in clinic and 24/7 virtual visits. This can be a great benefit for the busy single parent who needs to see a doctor on their schedule versus having to take a day off work and lose pay.

Silver	Aetna TX Gold 3: HMO	Aetna TX Gold S: HMO	Aetna Texas Gold 4: HMO	Aetna Texas Silver 5: HMO
Deducible	$795/$1590	$1500/$3000	$3500/$7000	$0/$0
Coinsurance	50%	25%	25%	50%
Out-of-Pocket Max	$9195/$18,390	$8700/$17,400	$9000/$18,000	$1275/$2550
Primary Care Visit	$15 copay	$30 copay	$0 copay	$0 copay
Walk in Clinic	$0	$0	$0	$0
Specialist Visit	$35 copay	$60 copay	$10 copay	$15 copay
24/7 Virtual Visit	$0	$0	$0	$0
Emergency Room	50%	25%	25%	50%
Urgent Care	$25 copay	$45 copay	$10 copay	$5
Inpatient Hospital	50%	25%	25%	50%
Outpatient Hospital	50%	25%	25%	50%
Prescription (Pharmacy)	$5/$15/$40/ 40%/50%**	$15/$30/$60/ $250**	$0/$20/30%/ 40%**	$0/10%/40%/ /50%**
Children’s Dental/Vision*	No/Yes	No/Yes	No/Yes	No/Yes

*See plan details for limitations.

**RX: Preferred Generic, Preferred Brand, Non-Preferred Generic/Brand, Specialty

Texas STAR Program

STAR Texas is available in Tarrant and Bexar Counties. If one has Diabetes, Dallas County can be included in the STAR Kids program.

How Much is Health Insurance for a Single Mom?

This is one benefit a single mom in Texas with a low income will not have to worry about. Most health insurance plans we have listed above are at zero cost when you qualify for premium tax credits. Your current income will determine which plans are available and how much you will ultimately pay for them.

Our research found the above low-cost plans, but there are most certainly more. Our scale is based on a single mom, 36 years old with two children (14 and 9) earning 25K per year. With the low-cost plans available through the Marketplace, you may not even need to apply for Texas Medicaid unless it would be your preference.

Summary

When you are looking for Texas health insurance for a low-income single mom, you can be inundated with life’s expenses from housing to feeding your family. One expense some feel they can often cut is health insurance. At CoverMile we desire to show you can have life’s necessities and include health coverage for you and your children. Contact one of our experts today to sign up.