Denton County is a busy county, even though most of its activity is in the lower half of its borders. The upper portion is devoted to the oilfield. Driving through its southern section, you can witness the beauty of its redbud trees or drive along a lakeside before heading to the city of Denton to catch a jazz band. The thump of the band is not the only beat you need to care for. Your heart and health should also be a concern. We at CoverMile are here to help you find the best health insurance in Denton County at a price you can afford. Contact us today, and that is something we can all raise a mug to.
CoverMile helps individuals and families find the best health insurance coverage at the lowest prices in Denton County, TX. Plans exist for as low as $0 per month with subsidies. Let us show you how.
2023 Health Insurance Facts in Denton County, Texas
Texas saw 2.4 million residents enroll in the Affordable Care Act in 2023. Florida was the only state to have a higher enrollment. Texas also ranked highest with the country’s uninsured rate at 22.1 percent. The Lone Star State has held that position since the exchange system’s implementation.
Here are additional facts about health insurance in Texas.
- According to a U.S. Census estimate, Denton County’s population is just shy of 1 million residents. Of that total, 12.1 percent are uninsured.
- By gender, of those insured, 50.9 percent are female, and 49.1 percent are male.
- Eighty-seven percent of consumers have access to three or more insurers in 2023. In 2024, through the ACA, Denton County has access to six insurance providers.
- 89.1 percent of Denton County has health insurance. Sixty-three percent obtain it with their employer, while 11.6 percent have it through non-group plans. 7.87 percent are on Medicare, 5.55 percent have insurance through Medicaid, and 1.05 percent have insurance through the V.A. or military.
- Fifty-nine percent of consumers have access to a plan from a national insurer; companies like Blue Cross Blue Shield of Texas and UnitedHealthcare are available to more than just a local area.
- According to Niche, Denton County is the sixth Healthiest County in Texas for 2023. It was also voted as one of the best counties to live in for families and young professionals.
- The average cost for a Silver health insurance plan in Texas is $475
- If you miss the annual Open Enrollment period, check if you qualify for Short Term Health Insurance. In Denton County, UnitedHealthcare offers this benefit to residents.
Here are a few fun facts about Denton County itself:
- Denton County was named after John B Denton, a lawyer, minister, and military captain advancing against the Indians. His most famous battle was the Battle of Village Creek. Sent to scout by General Edward Tarrant, Denton was wounded by Indians hiding in the thickets of one village. Their company chose to retreat. His injury led to his death.
- Denton County has a brewery. The Denton County Brewing Co. From ciders to ales to IPAs, there is a craft for all palates.
- Denton County is the seventh most populated county in Texas, even though most of the county is oilfield land. Denton County is part of the Barnett Shale. Between 1995 and 2007, the number of wells increased from 156 to 1820. Today, there are permits for 3,629 wells within the county.
- Highways I35E coming from Dallas and I35W coming from Ft Worth reconverge in Denton and head north, eventually into Oklahoma City.
- Denton, the city in the county of Denton, is the Redbud Capital of Texas. It holds an annual Redbud Festival in April of each year when the trees hit their peak bloom.
- Denton County has three major lakes. These are Grapevine Lake, Lewisville Lake, and most of Lake Ray Ellison. Lewisville Lake was created by damming up the Elm Fork of the Trinity River.
- Denton County has an annual art and jazz festival in October. This event highlights local, statewide, and regional artists. It is a free event and one of the largest tourist attractions in North Texas.
- Denton County has five ghost towns. Among these are Pinckneyville, Stony, and Elizabethtown, a town with an interesting nickname, “Bug Town.” This came from a freak infestation of a church service.
Do I Need Health Insurance in Denton County, TX?
Heading into the 2024 Open Enrollment period, only five states still maintain health insurance stipulations. While Texas residents aren’t required to have health insurance to see a doctor or visit a healthcare facility, when you don’t have health insurance, you will face issues you may not consider.
- Healthcare costs.Members of a retail store receive a discount when they present their membership card at the register. Health insurance is somewhat the same. Insurance companies contract with medical facilities to provide care at a negotiated rate. If you choose not to carry health insurance, you will pay full price.
- Healthcare networks.Networks are an insurance company’s list of doctors, specialists, and medical facilities that provide medical care. These can help ease the concern of searching on your own. Especially since seeking advanced medical care may burden an already stressful situation.
- Healthcare maintenance.Under the Affordable Care Act, free preventive care services such as immunizations and well-checkups are mandated. When you don’t have health insurance, you need to pay for these services on your own.
What are My Health Insurance Options in Denton County, Texas?
Individuals and families can buy health coverage through the ACA Marketplace in Denton County. You can also purchase directly from a health insurance company like Oscar Insurance. Each option has its benefits.
Affordable Care Act/Marketplace – The most common way individuals find health insurance is through the Marketplace. When shopping online, you are given a variety of private health insurance choices in Texas. You select the one that best suits your family’s situation. The Affordable Care Act website also informs you if you qualify for premium tax credits and subsidies like cost-sharing reductions.
Direct Purchase – When selecting an insurance policy for Direct Purchase, it is important to understand you will not have access to ACA subsidies. If you think you may qualify, apply on the Marketplace. Also, insurance rates and plans available may vary when making a direct purchase through an insurance company.
Short-term Health Insurance – Short-term insurance is an option when you need temporary health insurance. You can have insurance when it is early in the year and too soon for Open Enrollment and you don’t qualify for a Special Enrollment period, you are still within your probationary period of your employer’s benefit package, or you are nearing Medicare eligibility. Short-term insurance covers an initial period of 364 days and can be renewed for an additional 24 months. Understand Short-term health insurance has limitations. It doesn’t cover preexisting conditions, maternity care, or prescription medication.
Types of Insurance – Health insurance has three primary network types: HMOs, EPOs, and PPOs. The difference is the network structure. EPOs are the strictest. PPOs are the most lenient on which doctors you can see and when. BCBS of Texas, Aetna, and UnitedHealthcare are HMOs. Ambetter and Oscar are EPOs. When shopping for a plan, watch for out-of-network fees and restrictions. The doctors or specialists you use may not be within all plan networks.
Top Five Health Insurance Companies in Denton County, TX*
What a customer is willing to pay for their policy over time is one of the main details top insurance ratings evaluate. Health insurance shoppers then use reviews to consider which insurance companies are best and purchase based on this research.
To address this concern, we’ve rated the top companies available in Denton County based on their 2024 rates compared to their 2023 rates.
- Aetna – 14.94 % rate increase – Last year, Aetna had a significant decrease. This year, they top the list of insurance companies with an increase. Aetna is known for their $0 preventive care, 24/7 $0 Virtual Care, and in-network, $0 walk-in clinics available seven days a week.
- Ambetter – 4.39% rate increase. – Ambetter doesn’t offer a Bronze Metal tier. However, they offer an Adult Dental and Vision option that is included with some EPO network plans. Other insurance companies only provide the ACA 10 Essential Benefits mandated Children’s Dental and Vision.
- Blue Cross Blue Shield of Texas – 0.24% rate decrease – BCBS of Texas had a three percent increase last year. For 2024, a decrease is a welcome sight. They have more plan options available than most insurers. They are also one of the few companies that is available nationwide.
- Oscar – 3.39% rate increase. – In 2023, Oscar had a double-digit increase. In 2024, they will have an increase, but it will not be as bad. Oscar Insurance offers benefits few match. First is a $3 copay for prescriptions on some plans. Second, they offer $0 Virtual Specialist Visits. Most companies only include Virtual Visits for a Primary Care Physician.
- UnitedHealthcare – 13.46 % rate increase. – This year, UnitedHealthcare duplicates last year’s rare increase. While UnitedHealthcare had the second largest premium increase of those surveyed, they offer a benefit other companies on our list don’t—short-term insurance. If you are without insurance, it’s between Open Enrollment, and you don’t qualify for a Special Enrollment Period, UnitedHealthcare may be your only option.
Top Ten Health Insurance Plans for Denton County, TX*
Below, we’ve selected each company’s best health insurance plans for Denton County, TX. They are in order as they reflect the cost of a standard Silver policy without Cost Saving reductions.
Insurance company | Insurance Plan | Co-insurance | Deductible | Out-of-Pocket Max | Copay PCP/ Specialist | $0 Virtual Care PCP | Adult Dental/ Vision |
Ambetter | Focused VALUE Silver HMO | 50% | $5100/ $10200 | $6700/ $13400 | $35/$85 | Yes | Dental is reimbursement |
Aetna | Aetna Silver S HMO | 40% | $5700/ $11400 | $7200/ $14400 | $40/ $80 | Yes | Dental/ Vision as separate policy |
Aetna | Aetna Silver 1 HMO | 40% | $4250/ $8500 | $7325/ $14650 | $20/$40 | Yes | Dental/ Vision as separate policy |
Oscar | Silver Classic Standard EPO | 40% | $5700/ $11400 | $7200/ $14400 | $40/$80 | Yes | No |
United Healthcare | Silver-E Virtual First HMO | 35% | $3200/ $6400 | $7250/ $14500 | $0/$100 | Yes | Dental/ Vision as separate policies |
BCBS of Texas | MyBlue Health Silver 807 HMO | 40% | $5700/ $11400 | $7200/ $14400 | $40/$80 | Fee Applies | Dental/ Vision as separate policies |
Oscar | Simple PCP Saver EPO | 40% | $4750/ $9500 | $7200/$14400 | $20/$80 | Yes | No |
United Healthcare | UHC Silver-E Advantage+ HMO | 30% | $2500 $5000 | $7100/ $14300 | $0/$100 | Yes | Yes |
BCBS Of Texas | Blue Advantage Silver 801 HMO | 40% | $2500/ $5000 | $7550/ $15100 | $45/$80 | Fee Applies | Dental/ Vision as separate policies |
Ambetter | Complete EPO Silver+ Vison+ Adult Dental | 40% | $5000/ $10000 | $7500/ $10000 | $20/$50 | Cost sharing applies | Yes |
*In our review, we have listed seven health insurance companies. Other insurance providers may be available.
** No charge for the first two sick visits, $25 copayment per visit for subsequent visits in that plan year; deductible does not apply.
How to Enroll in Health Insurance in Denton County, TX?
The enrollment process does not change much whether you live in Denton, El Paso, Corpus Christi, or Orange Counties. Each county must follow Affordable Care Act standards.
When – Each year, Open Enrollment for the Affordable Care Act begins on November 1st and continues through January 15th. If you enroll by December 31st, your health insurance starts on January 1st. If you wait until January 15th to enroll late, your start date will be February 1st.
The Affordable Care Act also allows a Special Enrollment Period (SEP) where one can enroll anytime during the year. You qualify for a SEP when:
- There is a change in your household. – This can include a change in marital status, having a birth or adoption, or there is a death in the family.
- You have a change in your residence. – If you move and you switch zip codes, this may require an insurance rate adjustment.
- You have a change to your health coverage. – When you or your spouse lose employer-sponsored health coverage or a plan from an alternative source, you can apply for health insurance.
How – The easiest way to apply is on the Marketplace website. When you visit the site, you are guided through entering your personal information. It is quick and easy, and you will know your status as soon as you complete your application. You will also know if you qualify for tax subsidies and how they will apply toward your policy’s cost.
If you have any questions about health insurance in Denton County, TX, contact CoverMile. We can help you find the best coverage that fits your current situation and guide you through the application process.
How to Find Doctors Near Me in Denton County, TX?
One primary concern is whether your doctor will be on your insurance company’s network. You can find out by visiting the insurance company’s website and searching for your doctor or the facility’s name to see if they are in-network or out-of-network.
The links below will take you to each provider’s website and directory. 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.
Once you select your plan, you can find Primary Care Providers (PCPs), hospitals, pharmacies, and urgent care centers in your area.
Enter your plan information and location, and you can find doctors and facilities in your area. You are also given the option to connect with Telehealth or to talk with a nurse directly.
Begin by selecting the type of provider you are searching for, then your plan type, and finally, the plan you are on. Then, you can search by doctor, facility, specialty, or condition. You can also view a cost estimate.
After providing your zip code and the search parameters, select your health plan. Then, you can search for doctors, facilities, and pharmacies in your selected area.
Frequently Asked Questions
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How much is health insurance in Denton County, TX?
For 2024, the average cost for a health insurance policy in Texas is $475. Your cost will depend on factors such as age, family size, and the plan you select. Other considerations that can impact your premium are where you live and tobacco usage. You can save on your premium if you qualify for tax credits and subsidies.
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Can I sign up for Oscar Insurance in Denton County, TX?
Yes, Oscar Insurance is available in Denton County. You can apply through the Marketplace or visit Oscar Insurance’s website and purchase one of their off-marketplace plans. You can also contact CoverMile, and we can assist you with applying for coverage. Oscar Insurance is known for their $3 prescriptions on some plans and Virtual Urgent Care.
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Is there a penalty for not having health insurance in Denton County, TX?
The federal mandate for health insurance ended in 2018. In Texas, there is no longer any local tax penalty for not having health insurance either. You can enroll during Open Enrollment from November 1 through January 15th. However, if you choose to remain uninsured, you will pay more for routine health care such as immunizations and well-checkups.
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How do I see a doctor without health insurance in Denton County, TX?
If you don’t have health insurance in Denton County, it may be difficult to see a regular doctor. Most require you to have medical insurance or provide the ability to pay. If you are cash-paying, it’s best to go to a Walk-in Clinic, an Urgent Care facility, or an Emergency Room. Keep in mind that without insurance, the cost of services is different and will be more costly. Some may ask you to pay at the time of service.
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What happens if I miss the ACA Open Enrollment period in Denton County, TX?
The Affordable Care Act Open Enrollment begins on November 1st and continues through January 15th of each year. If you miss the Jan 15th deadline, you will need to have a qualifying event to enroll in a Marketplace insurance plan. A Special Enrollment Period can include getting married, recently losing a job that provided benefits, or your family adding a child through birth or adoption.
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Does Denton County, TX, have healthcare for low income?
All Marketplace health insurance plans can be subsidized through tax credits or cost-sharing reductions. Tax credits are based on your current year’s expected income and life situation. They help with your premium each month. There is a second form of savings, cost-sharing reductions (CSR). This form of savings can help you with other expenses, such as your deductible, copayments, and coinsurance. Understand that to receive the CSR benefit, you must apply for a Silver Metal plan level.
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Can I be rejected from Obamacare due to pre-existing conditions in Denton County, TX?
One benefit of Affordable Care Act insurance, or Obamacare, is that you cannot be denied coverage due to a pre-existing condition. Nor can an insurance company limit your coverage in any way. You have full benefits from the day you sign up. There is no waiting period.
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Am I able to get Dental or Vision Insurance in Denton County, TX?
Children’s Dental and Vision is available on all health insurance plans due to the ACA 10 Essential Benefits, but are limited. These plans exclude adults. Ambetter offers Adult Dental and Vision on select plans. Our review above includes one of them. Most other companies offer them, like Blue Cross Blue Shield, but it would be sold separately from its health insurance plan. Visit their website for more information.