How Much is COBRA Insurance in Texas?

COBRA Health Insurance

When you leave a job that has provided health coverage, you have options. You can see if you qualify for an Affordable Care Act Special Enrollment Period and apply. You can also go without coverage until your new job’s probationary period has expired and apply for benefits, or you can accept the option of continuing your employer’s insurance plan through COBRA. But what does this mean? At CoverMile our job is to help you sort through the confusion. We intend to explain COBRA and see if it is the best option for you and your family.

What is COBRA Insurance?

COBRA is the Consolidated Omnibus Budget Reconciliation Act. Doesn’t sound much like insurance, does it? I can assure you it does have much to do with our topic. This reptilian topic name is about giving workers and families the right to choose to keep their health benefits when they leave their place of employment. This can be through quitting or a reduction of hours. However, if you were fired, then you may be out of luck. There are benefits and drawbacks to selecting COBRA. One, you can keep your health benefits. Two, you can see the same doctors. The downfall, you now assume the full cost of the insurance plan. This would mean the portion your employer paid.

How Does COBRA Insurance Work?

There are a few reasons one would receive the option for COBRA. These are:

  • You leave your job by resigning.
  • You are being let go from your job, other than “gross misconduct.”
  • Your hours are being reduced, which takes you below the qualifying for benefits threshold.

If you are the spouse of the employee, you are given the same insurance rights. You can receive COBRA as well. In addition to the above reasons, you have these:

  • The employee becomes eligible for Medicare.
  • You become divorced or legally separated from the employee.
  • The employee passes away.

COBRA insurance is the same insurance plan you had when you were employed. The difference now is that you are paying the entire bill versus your employer paying a portion of it. You still have the same deductibles, copays, and out-of-pocket maximums. Also, when you assume paying on your own, you are picking up where you left off, it does not start over, this is one of the main benefits of selecting COBRA insurance.

How Much Will I Pay for COBRA Insurance?

As we have discussed, when you begin to pay for COBRA Insurance in Texas you are assuming your employer’s full insurance cost; your portion and the portion your employer was paying are now your responsibility, plus an additional two percent. This additional amount is an administrative fee that allows you to keep the coverage.

A 2023 KFF study reveals an average of how much this breaks down can be:

Annual CoverageSingle CoverageFamily Coverage  
Plan TypeEmployerEmployeeTotalEmployerEmployeeTotal
ALL Plans$7034$1401$8435$17,393$6575$23,968

As you can see, an employer pays quite a large sum of an employee’s benefits. Most employees never realize how much of the bill an employer fronts for each employee just to enjoy the luxury of health insurance. This is one reason many skip the option of continuing their COBRA option. Paying $1979 per month for an HMO family coverage plan may be a bit out of budget, especially when you are out of your job.

COBRA and the Affordable Care Act

When you leave a job, you are given the option to continue your employer’s health coverage. Leaving a job triggers a Special Enrollment Period for the Affordable Care Act. If you find that COBRA health insurance is too expensive, you can search the Marketplace and shop for a health insurance plan from health providers such as Blue Cross Blue Shield of Texas and UnitedHealthcare.

Below we have listed Silver metal insurance plans from a few providers. You can find more through the link provided.

Blue Cross Blue Shield of Texas

BCBS of Texas is the largest insurance provider. They are available statewide. While they may not always be the most affordable or offer the best coverage, they are a good option for one seeking an alternative to COBRA insurance in Texas.

SilverBlue Advantage Plus – 202Blue Advantage Plus HMO – 705Blue Advantage HMO – 205My Blue
Health – 405
Out-of-Pocket Max$9450/$18,900$9100/$18,200$9450/$18,900$9450/$18,900
Primary Care Visit$25 copay$40 copay$15 copay$0 for PCP – $30 all others
Specialist Visit50%$80 copay50% 40%
Emergency Room$950/occurrence deductible, then 50%40%$950/occurrence deductible, then 50%$950/occurrence deductible plus 40%  
Urgent Care$40 copay$60 copay$25 copay$0 first two, then $30
Inpatient Hospital$850/occurrence deductible, then 50%40%$850/occurrence deductible, then 50%$850/occurrence deductible plus 40%  
Outpatient Hospital$600/occurrence deductible, then 50%40%$600/occurrence deductible, then 50%$600/occurrence deductible, then 40%  
Prescription (Pharmacy)$5/$15/$30%/35%/ 45%/50%*$20/$40/$80/ $350/40%/40%$5/$15/30%/35% 45%/50%*$5/$15/30%/35% 45%/50%*
Children’s Dental/Vision**No/YesNo/YesNo/YesNo/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.


UHC is another option for one seeking an alternative to the high cost of COBRA insurance. A few UHC includes are zero-dollar virtual visits, zero-dollar prescriptions for some medications, and dental screenings for children.

SilverUHC Silver Virtual FirstUHC Silver StandardUHC Silver ValueUHC Silver Advantage+
Out-of-Pocket Max$9100/$18,200$9100/$18,200$9450/$18,900$9450/$18,900
Primary Care Visit$100 copay$40$0$0
Specialist Visit$100 copay$8050% coinsurance$100 copay
Virtual Visits$0$0$0$0
Emergency Room40%40%50%$1000 copay
Urgent Care$100 copay$60$75 copay$100
Inpatient Hospital40%40%50%30%
Outpatient Hospital40%40%50%$750 copay per day
Prescription (Pharmacy)$0/$3/$30/$100// 40%/50%*$20/$40/$80 $350/ N/A$0/$3/$30/$100/ 45%/50%*$0/$3/$30/$85/ 40%/50%*
Children’s Dental/ Vision**Yes/YesYes/YesYes/YesYes/Yes

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

**See plan details for limitations.

Baylor, Scott and White

While many may not have heard the name Baylor, Scott and White, they are growing, now offering health insurance plans in 171 of Texas’ 254 counties. They also offer a zero-dollar telehealth benefit and a lower deductible than most Silver Metal plans. Some of their health plans will include zero-dollar Primary Care Physician visits for up to two visits.

SilverBSW Prime Silver HMO – 003BSW Prime Silver HMO – 008BSW Prime Silver HMO – 005
Out-of-Pocket Max$9100/$18,200$9450/$18,900$9450/$18,900
Primary Care Visit$40 Adult copay/
$0 Pediatric
$0 for first 2 visits/ $25 Adult copay/ $0 Pediatric$0 for first visit/ $45 Adult copay/ $0 Pediatric
Specialist Visit$80 copay$35 copay$85 copay
Emergency Room40%50%$750
Urgent Care$60 copay$35 copay$85 copay
Telehealth Visit$0$0$0
Inpatient Hospital40%50%$2000
Outpatient Hospital40%50%$1000
Prescription (Pharmacy)$20/$40/$80/ $350*$15/$90/$140/ $500*$20/$100/$140/ $500*
Children’s Dental/Vision**No/YesNo/YesNo/Yes

*Prescriptions are Generic, Preferred, Non-Preferred Brand. and Specialty

**See plan details for limitations.

Should I Choose to Cancel COBRA Insurance in Texas?

Now the catch. If you do elect to sign up with a Marketplace health insurance plan instead of continuing your COBRA insurance in Texas, in most cases you will start over from scratch. This means that if you had previously met your deductible under your employer’s plan, it does not carry over to your new Blue Cross Blue Shield of Texas health insurance plan. This is one reason why many bite the bullet and pay the high monthly COBRA premium.

However, the Texas state constitution offers a conversion privilege. This allows those who are eligible to convert their group health plans to individual plans, even if they no longer qualify. This helps those with medical issues who don’t wish to start from scratch, you can maintain your current level of coverage deductibles, coinsurance, and out-of-pocket max you have already put into your current plan.

How Does COBRA Insurance Work with Medicare?

Having medical insurance such as Medicare, or nearing Medicare age, becomes a bit more tricky. Medicare has built-in timetables. Once eligible, you have eight months from the time you stop working, or no longer have a form of health coverage, to enroll in a Medicare Part B plan. Otherwise, you incur a penalty. This penalty will begin to add up the longer you go without a Part B portion, and you will pay this portion for as long as you have Part B. You cannot go back. So, while you consider COBRA insurance, if you leave a job and are given the option of COBRA insurance, that eight-month window, does not get reset if you choose the COBRA option because COBRA is not considered group health coverage. If you are of age, you need to choose your Medicare option or you will incur a penalty.

You can, however, choose to enroll in COBRA and Medicare simultaneously. Medicare will be your primary provider; COBRA will be your secondary insurance provider.


Sometimes COBRA is the right option for you and your family. At other times it is best to find another type of insurance, like through the Marketplace or apply for Medicare if you are of age. If you have questions, we are here to guide you. At CoverMile, we help individuals find the best health insurance to fit their situation. Contact us today.

Frequently Asked Questions

  1. Is COBRA Insurance expensive in Texas?

    Unfortunately, it is. Many do not realize how much employers pay for benefits. It can often be five times what an employee pays for their portion for single coverage, and triple for family coverage. When you leave your job, you will assume your portion plus your employer’s portion plus a two percent administration fee.

  2. Is there a time limit that I can keep COBRA insurance in Texas?

    It depends. You can only keep your COBRA health insurance for up to as long as 36 months. If you were terminated from your job for a reason other than misconduct or your hours are reduced, you can keep it for 18 months. If it is due to a disability, you can receive it for 29 months. If you become eligible for Medicare, you can receive it for 36 months. There are also events such as the death of an employee or divorce where the spouse can receive benefits, this will be up to 36 months.

  3. Who in my family can receive COBRA insurance?

    Your COBRA health insurance plan in Texas will continue as your plan did with the job it was connected to. Everyone will be entitled to benefits and no one will be excluded. You will also keep your current deductible and out-of-pocket levels and will not have to start over. Also, if you give birth to an additional child, they will automatically receive coverage.

  4. Can I make changes to my COBRA health insurance plan?

    No. You will receive the same health insurance plan you had with the job it was connected to. If you have lost a job that provided benefits you may qualify for a Special Enrollment Period for the Affordable Care Act, which would enable you to purchase a plan on the Marketplace when you are outside of Open Enrollment. Only then would you be able to make any changes, but you will be signing up for a new health insurance policy.

  5. What is Texas Mini COBRA Insurance?

    Texas Mini Cobra is a Texas continuation COBRA law for those seeking COBRA benefits. This type of benefit would allow you to continue COBRA insurance for up to nine months if you are not eligible for COBRA, and six months if you have used up your benefits.