What are the Best Health Insurance Companies in Texas for 2024
When you’re looking for health insurance, you want the best health insurance company that will provide the best coverage with the lowest premiums. In Texas, where you live will determine which health insurance provider you are eligible for. This can become complicated the further away you get from a major city and the smaller the insurance company’s name becomes. The big names like Blue Cross Blue Shield of Texas and UnitedHealthcare, while available throughout Texas, may not always be the best option for you and your family. This is why we at CoverMile have compiled ten of the best health insurance companies in Texas that will provide you and your family health insurance and meet the Affordable Care Act standards.
Blue Cross Blue Shield of Texas
Blue Cross Blue Shield of Texas is available statewide. They offer health insurance plans across all three metal tiers that adhere to Affordable Care Act standards. When you qualify, you can use premium tax credits toward your policy in addition to cost-sharing reductions. They have deductibles between $0 and $9450, depending on the plan you select.
BCBS of TX is known for being available everywhere. However, being an HMO, you are required to remain within your physician network or pay out-of-network fees. If you are experiencing an emergency, this out-of-network stipulation does not apply when you contact Blue Cross Blue Shield of Texas about your situation.
For 2024, they experienced a .24 percent rate decrease, which lends to their attraction for those on a budget. They offer a 24-hour nurse line and MDLIVE, where one can talk to a doctor virtually. Other benefits are Blue365, a discount program for health, fitness, and vision/hearing services.
| Silver | Blue Advantage Plus – 202 | Blue Advantage Plus HMO – 705 | Blue Advantage HMO – 205 | My Blue Health – 405 |
| Deducible | $1500/$3000 | $5900/$11,800 | $1950/$3900 | $2250/$4500 |
| Coinsurance | 50% | 40% | 50% | 40% |
| 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 Visit | 50% | $80 copay | 50% | 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%* |
*Prescriptions are Preferred and Non-Preferred Generic/Preferred and Non-Preferred Brand/Preferred and Non-Preferred Specialty
UnitedHealthcare
UnitedHealthcare has grown over the last year. After being one of the companies with the fewest covered counties in Texas, for 2024, UnitedHealthcare is now one of the largest behind Blue Cross Blue Shield of Texas, now covering 206 of 254 counties. They have deductibles between $0 and $8250, depending on the plan you select.
UnitedHealthcare has a unique way of how it breaks up its plans. Subscribers can choose between four different plan levels, all with various advantages. The differences begin with their deductible. Then, you will see plans like the Value and Advantage that have better PCP visit coverage. Other items to note are prescription coverage with a $0-$3 copay for generics on some plans.
UHC has options on its Bronze level that allow your HDHP to be connected with a Health Savings Account (HSA). These are savings accounts you can use toward health-related expenses like copays and prescriptions.
You will see a plus sign attached to the Advantage plan; this is also available on the Gold plan. This plus means the addition of Adult Dental and Vision. Not many insurance companies have Vision or Dental Insurance, much less have it as an add-on to their policies. It is usually a separate policy.
UnitedHealthcare is also the only company that offers Short Term Insurance should you need a health insurance option until Open Enrollment.
| Silver | UHC Silver Standard | UHC Silver Virtual First | UHC Silver Value | UHC Silver Advantage+ |
| Deducible | $5900/$9,100 | $3800/$7600 | $3250/$6500 | $2500/$5000 |
| Coinsurance | 40% | 40% | 30% | 30% |
| Out-of-Pocket Max | $9100/$18,200 | $9100/$18,200 | $9450/$18,900 | $9450/$18,900 |
| Primary Care Visit | $40 | $100 copay | $0 | $0 |
| Specialist Visit | $80 | $100 copay | 50% coinsurance | $100 copay |
| Virtual Visits | $0 | $0 | $0 | $0 |
| Emergency Room | 40% | 40% | 50% | $1000 copay |
| Urgent Care | $60 | $100 copay | $75 copay | $100 |
| Inpatient Hospital | 40% | 40% | 50% | 30% |
| Outpatient Hospital | 40% | 40% | 50% | $750 copay per day |
| Prescription (Pharmacy) | $20/$40/$80 $350/ N/A | $0/$3/$30/$100// 40%/50%* | $0/$3/$30/$100/ 45%/50%* | $0/$3/$30/$85/ 40%/50%* |
*Prescriptions are Tiered 1 through 6. 1 being low-cost, Generic; 5 being Brand and higher cost.
Cigna
Cigna is another multifaceted insurance company that offers health, dental, and even supplemental insurance. The one negative they have is they are only available in eleven counties that cover cities like Dallas and Ft. Worth and their surrounding areas, Lubbock and El Paso. While they are limited, if you live in these areas, you have access to a wide range of insurance products all under one roof. Cigna does have Out of Territory coverage in areas of Austin, Houston, and San Antonio. These function just as if they were your service area. You have coverage.
You can see their plans are listed primarily by their deductible level. They have over 20 plan options, including those with cost-sharing benefits. You can also enroll in Cigna Rewards, a discount program to earn points and up to $350 cash to spend on health-related items. They have deductibles between $0 and $9450, depending on the plan you select.
Cigna is another health insurance company that offers plans designated to Native American and Alaskan Native residents. These plans generally offer a zero-dollar deductible, but other benefits may apply depending on the plan you select.
Cigna is another company that has its own Dental insurance company. You can add it to your policy. They offer three different coverage levels: a low and high-deductible plan, as well as a bundled plan with vision insurance.
| Silver – Connect | Cigna Connect Silver-4 -725 | Cigna Connect 3000 | Cigna Connect 5000 | Cigna CMS Standard Silver -2 |
| Deducible | $725/$1450 | $3000/$6000 | $5000/$10,000 | $5700/$11,400 |
| Coinsurance | 0% | 50% | 40% | 40% |
| Out-of-Pocket Max | $725/$1450 | $9400/$18,900 | $9100/$18,200 | $7200/$14,400 |
| Primary Care Visit | $10 copay | $0 copay | $15 copay | $40 |
| Specialist Visit | $20 | $95 copay | $70 copay | $80 |
| Virtual Visit | $0 copay | $0 copay | $0 copay | $60 copay |
| Emergency Room | 0% | $1,450 copay | 40% | 40% coinsurance |
| Urgent Care | $25 copay | $45 copay | $55 copay | $30 |
| Inpatient Hospital | 0% coinsurance | 50% coinsurance | 40% | 40% coinsurance |
| Outpatient Hospital | 0% coinsurance | 50% coinsurance | 40% | 40% coinsurance |
| Prescription (Pharmacy) | $3/$9/0%/0%/ 0% | $3/$40/$100/ 50%/50%* | $3/$40/$100/ 50%/50%* | $20/$40/$80/$350* |
*Prescriptions are Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, and Specialty.
Baylor Scott and White
Due to Baylor Scott and White’s limited coverage options on their Silver-tier, we chose to list a Bronze and Gold plan alongside two of their three Silver tier plan options. (NOTE: They do have Cost-Sharing Reduction plans available.) In many cases, due to the Marketplace’s increase in costs for the Silver plan tier, Gold tier plans can sometimes be comparable in premium. This is why it is best to shop around when looking for the best health plans in Texas.
Baylor Scott and White offers both an HMO and EPO option, depending on which county you live in. Their EPO option is available in all but six of the 171 counties they service. For example, the Vital Bronze 007 plan below is the dual plan that services both HMO/EPO policyholders. As a whole, BSW has deductibles between $0 and $9450, depending on the plan you select.
In addition, Baylor Scott and White services Medicare Advantage and STAR Medicaid. They have specific plans tailored for each category. You can also talk to a doctor through myBSWHealth mobile app 24/7.
| Silver | BSW Vital Bronze HMO 007 | BSW Prime Silver HMO – 008 | BSW Prime Silver HMO – 005 | BSW Elite Gold HMO – 004 |
| Deducible | $7500/$15,000 | $5900/$11,800 | $1200/$2400 | $1100/$2200 |
| Coinsurance | 50% | 40% | 0% | 25% |
| Out-of-Pocket Max | $9400/$18,800 | $9450/$18,900 | $9450/$18,900 | $9450/$18,900 |
| Primary Care Visit | $50 copay adult/ $0 pediatric copay | $0 for first 2 visits/ $25 Adult copay/ $0 Pediatric | $0 for first visit/ $45 Adult copay/ $0 Pediatric | $0 for first 2 visits/ $40 Adult copay/ $0 Pediatric |
| Specialist Visit | $0 | $35 copay | $85 copay | $65 copay |
| Emergency Room | $100 copay | 50% | $750 | $750 copay |
| Urgent Care | 50% | $35 copay | $85 copay | $60 copay |
| Telehealth Visit | $75 copay | $0 | $0 | $0 |
| Inpatient Hospital | 50% | 50% | $2000 | $1500 copay |
| Outpatient Hospital | 50% | 50% | $1000 | $300 copay |
| Prescription (Pharmacy) | $25/$50/$100/ $500* | $15/$90/$140/ $500* | $20/$100/$140/ $500* | $15/$55/$150/ $500* |
*Prescriptions are Generic, Preferred, Non-Preferred Brand. and Specialty
Aetna
Aetna is limited to 41 of the 254 Texas counties. And new for 2024, they no longer offer a Bronze metal tier in the state. They offer six silver and four gold metal plans along with over a dozen options for those who qualify for cost-sharing reductions due to their income level and family status. They have deductibles between $0 and $8390, depending on the plan you select.
Some of Aetna’s benefits are that they extend a health allowance of $100 for members to use toward CVS Health brand products as well as Zero-dollar 24/7 virtual and walk-in clinics in locations across Texas. Aetna is also one of the few who offer a plan schedule for American Indians and Alaskan Natives.
Aetna is one of the insurance companies that have their own dental network; however, to purchase it as part of your health insurance plan, you will need to purchase your policy off-market. This doesn’t mean you will not be adhering to ACA standards; it just means you will be purchasing your policy directly from Aetna as opposed to through the Marketplace.
Ascension – US Health and Life
Ascension is available only in a small part of Texas—namely, the eighteen counties surrounding the Austin area. On-exchange plans are found in Bastrop, Burnett, Caldwell, Hays, McLennan and Travis, Austins home, and Williamson Counties. In other counties, one can only find off-exchange health insurance plans. They have deductibles between $0 and $9450, depending on the plan you select.
For those for whom Affordable Care Act health insurance is available, one can find three Bronze tier plans, three basic Silver plans, as well as a larger variety of Cost-Sharing Reduction plans available. On their Gold tier, Ascension offers only one plan for the 2024 plan year. Other plan offerings include American Indian and Alaskan Native coverage.
Like other health insurance companies, Ascension, formerly US Health and Life, offers prescription coverage and mail order pharmacy. They do not offer dental for adults or children other than the children’s ACA Essential benefit. They have vision coverage for children. It depends on your metal tier with how it pays.
Ascension also offers various discount programs. One of these is called True Hearing, which is a discount on hearing devices, and another is savings on gym memberships.
The biggest difference with Ascension is that they are an EPO. This means that even though you do not need a referral to see a specialist, you do need to remain within your physician network. Failure to do so will result in your visit not being covered. The only caveat would be a medical emergency. It is important to notify Ascencion as soon as you experience an emergency.
Ambetter
Ambetter ranks a bit lower on our scale, first because they do not offer a Bronze metal tier level in 2024. While many go straight for a Silver plan due to their cost-sharing benefits, Bronze plans are great for those who are healthy and want low-cost health insurance without all the bells and whistles. They have deductibles between $0 and $6300, depending on the plan you select.
Ambetter Silver metal tier has several options to select from, especially for those who qualify for Cost-Sharing Reductions. If you live within certain counties, they have an additional network called the Value Network. It offers the coverage as their Virtual Access, only their plan names are different. You also have Gold metal plan options available; you can read more about Ambetter here.
Ambetter is both an HMO and an EPO. As a reminder, the difference between the two is that HMOs allow you to go out of network with permission, EPOs do not. Also, you do not need a referral to see a specialist within an EPO; with an HMO, you do.
With Ambetter EPO plans, you have an Adult Dental and Vision option on some plans. This will not include children other than the routine care they receive from the ACA 10 Essential Benefits. They also offer medical plans you can pair with Health Savings Accounts (HSAs), and they have a Medicare Advantage plan known as Allwell.
Oscar
We mention Oscar here because they have limited availability. They do, however, have one of the lowest rate increases for 2024. If you live in one of the eleven counties they serve, you will have a deductible between $0 and $9450, depending on the plan you select.
Oscar insurance is an EPO, which means you can see any doctor you choose without having a referral from a Primary Care Physician (PCP), but you must remain within your network, or you will not have coverage. Oscar is also a dual network provider: Oscar Choice Network and Oscar Select, depending on the area you live in. Visit our Oscar review for more information.
Oscar divides their plans within each metal tier into what they call ‘suites.’ Simple is the least expensive. Elite is the most comprehensive. Their Classic is the mid-range premium plan and the most popular. They offer five Bronze metal plans, six Silver plans (fifteen for those who qualify for CSRs), and three Gold plans. They do not provide a stand-alone dental or vision, only the ACA mandated Children’s coverage.
Virtual Urgent Care is available on all plans, as well as a mail-order pharmacy. They even have a price tool for you to know your prescription cost before you purchase it.
Under their Cost-Savings Reduction plans, Oscar has plans designed for those with Diabetes. They are the same as the standard plans but offer $0 PCP visits, diabetic labs, and insulin for no more than $100 per month.
Molina
Molina Health Insurance covers fourteen counties that surround major Texas cities, such as El Paso, Dallas, Houston, San Antonio, and Laredo. They offer four levels of Silver coverage, four steps within each of those levels. Individual Deductibles are from zero dollars up to $7000. Your copays to see a doctor will vary depending on the plan you have. The average is about $30. They also have a $2-$10 cost on many generic prescriptions.
Like some other health insurance companies on our list, they have chosen not to provide shoppers with a Bronze metal option. They do offer two Gold metal plans. Also, like a handful of companies, Molina offers Adult Vision services as an added feature on select plans.
One shared benefit most companies offer is virtual care through Teladoc. Molina offers this 24/7 benefit at no cost online, through a mobile app, or a traditional phone call. They also have a Nurse Advice Line for answers to common medical questions. This, too, is available 24/7. You have access to all of this through their mobile app.
Health perks Monina offers are through their My Molina Portal. One can earn a gift card by answering health questions and completing an annual physical. Other features include their My Health Perks program.
Sendero
Sendero Health is limited to Bastrop, Burnet, Caldwell, Fayette, Hays, Lee, Williamson, and Travis County, the home of the state’s capital, Austin. Within their coverage area, they offer health insurance recipients all three metal levels of coverage, both on and off-exchange. Sendero also offers one Platinum metal plan. Their deductibles range from $0 up to $9450, depending on your plan selection.
Sendero plans benefit from premium tax benefits as well as four different Silver tiers that benefit from cost-saving reductions. All coverage levels, but the Platinum tier, have an American Indian and Alaskan Native plan. There are two plan levels: Zero Cost and Limited Cost Sharing.
If you need to talk to a doctor and can’t wait for an appointment, you can Instant Message or Video Chat 24/7/365 on their eHealth Account platform. They also help you keep track of your personal health history through a Personal Health Record through WebMD. You can create your own record and keep track of your immunizations, lab results, and more.
Sendero is one of the few companies that offers children’s dental. You can receive both children’s dental and vision care when you purchase Sendero health insurance. However, this dental is for children only and for checkups alone and not for any type of major procedures.
Signing Up for Health Insurance in Texas
As you can see, each health insurance provider in Texas has its similarities as well as its differences. Within each of the providers listed, we have a comprehensive review of the company as well as our thoughts on how they stack up against the competition. You can also visit your specific county page for a better idea of which company serves your area and which plans are available to you, as cost and availability can change depending on where you live.
As always, if you have any questions, you can contact us at CoverMile. We are happy to assist you with finding the right policy for you and your family and signing up for Affordable Care Health insurance.
