Health Insurance Plans in Fort Bend County, Texas, 2024

Fort Bend County is another example of where the county’s most popular city is not its county seat. Richmond is less popular than Sugar Land. Perhaps this could be due to the rise in fame of the country band or to the Brazos flowing through Sugar Land Memorial Park. It is by far the largest in population. With so many residents living in such a small area, you need to be sure to care for your health. We at CoverMile are here to help you find the best health insurance in Fort Bend County at a price you can afford. Contact us today.

CoverMile helps individuals and families find the best health insurance coverage at the lowest prices in Fort Bend County, TX. Plans exist for as low as $0 per month with subsidies. Let us show you how.

2024 Health Insurance Facts in Fort Bend County, Texas

For 2023, Texas had 2.4 million residents enroll in the Affordable Care Act. Florida was the only state that had greater numbers. 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, Fort Bend County’s population is just shy of 890 thousand residents. Of that total, 13.7 percent are uninsured.
• By gender, of those insured, 50.7 percent are female, and 49.3 percent are male.
• Eighty-seven percent of consumers have access to three or more insurers in 2023. In 2024, through the ACA, Fort Bend County has access to seven insurance providers.
• 87.8 percent of Ft. Bend County has health insurance. Fifty-eight percent obtain it with their employer, while 11.9 percent have it through non-group plans. 8.1 percent are on Medicare, 8.82 percent have insurance through Medicaid, and less than one 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, Fort Bend County is the third Healthiest County in Texas for 2023. Ranked number one as the most diverse county, it was also voted as one of the best counties to live in for families.
• 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 Fort Bend County, UnitedHealthcare offers this benefit to residents.

Here are a few fun facts about Fort Bend County itself:

• Fort Bend County was named after the location where a blockhouse was built by settlers. They believed they were on the Colorado River but later found they were at the bend of the Brazos. They named the location ‘The Fort on the Bend,’ which later became Fort Bend.

• Brazos Bend State Park has 37 miles of fishing, camping, and exploring. It also includes George Observatory and a day park that surrounds the “U” shaped Hale Lake.
• While the city of Houston is in Harris County, parts of the city do lie within Fort Bend County: Near Missouri City, Sugarland, and a portion around Buffalo Bayou.
• The Brazos River diagonally zig zags through the county, then rides the east lower border. There are also several lakes; the largest is Smithers Lake. Others are Worthington Lake, 40-acre Lake, and Elm Lake, which are part of Brazo’s Bend State Park.

• Fort Bend County has an annual County Fair in Rosenberg in September. This event celebrates local ranching, rodeo, and music. This is a week-long, and then some, event and one of the largest county fairs in the state.
• Fort Bend County has three ghost towns. Among these are Duke, Juliff, and Diddy Wa Diddy, another name for Juliff, but thought to be mythical where food is in abundance and you don’t have to work.
• In 2017, Hurricane Harvey caused damage in Fort Bend County. It forced the evacuation of over 200,000 people and 10,000 rescues.
• Sugarland is a city in Fort Bend County. The country band Sugarland gets its name from the town. Kristin Hall, an original band member, named the band after the city. While none of the band members are from there, she thought it sounded like it would be a cool place to be from.

Do I Need Health Insurance in Fort Bend County, TX?

For the 2024 Open Enrollment, only five states still maintain health insurance standards. Texas residents aren’t required to have health insurance to see a doctor or visit a health care facility. However, when you don’t have health insurance, you will face issues you may not consider.

1. Healthcare costs.When a member presents a membership card at a big box store, they receive a discount for the items they purchase. 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.
2. Healthcare networks.Insurance companies have lists of doctors, specialists, and medical facilities that provide medical care. These are known as networks. Networks can help ease the concern of searching on your own. Especially since seeking advanced medical care may burden an already stressful situation.
3. 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 Fort Bend County, Texas?

In Fort Bend County, Individuals and families can purchase health coverage through the ACA Marketplace. You can also buy directly from a health insurance company like Oscar Insurance. Each option has its benefits.

Affordable Care Act/Marketplace – The most common method for individuals to obtain health insurance is through the ACA Marketplace. When shopping online, you’re given a selection of private health insurance companies in Texas. You choose 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 shopping an insurance company for a Direct Purchase, it is important to understand you will not have access to ACA subsidies. If you believe you may qualify, apply through the Marketplace website. Also, plans available and insurance rates may vary when making a direct purchase through an insurance company.

Short-term Health Insurance – When you only need health insurance temporarily, short-term insurance may be an option for you. You can apply when it’s too soon for Open Enrollment and you don’t qualify for a Special Enrollment period, you are still within a 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. Short-term health insurance does have 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 only allow you to see doctors and use facilities within their network. PPOs are the most lenient on which medical professionals 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 Fort Bend 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 Fort Bend 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 but includes Adult Dental and Vision options 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 – Last year,BCBS of Texas had a three percent increase. For 2024, they have a slight decrease. 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. This year, they have an increase, but not 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 performance. 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 Fort Bend County, TX*

Below, we’ve selected each company’s best health insurance plans for Fort Bend County, TX. They are in order to 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	Complete VALUE Silver HMO	40%	$5000/ $10000	$7500/ $15100	$20/$50	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
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
BCBS of Texas	MyBlue Health Silver 705 HMO	40%	$5700/ $11400	$7200/ $14400	$40/$80	Fee Applies	Dental/ Vision as separate policies

*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 Fort Bend County, TX?

The enrollment process does not change much whether you live in Dallas, El Paso, Corpus Christi, or Fort Bend Counties. Each county must follow Affordable Care Act standards.

When – Open Enrollment for the Affordable Care Act begins on November 1^st  and continues through January 15^th. If you enroll by December 31^st, your health insurance begins on January 1^st. If you wait until January 15^th to enroll late, your start date will be February 1^st.

One can enroll anytime outside of Open Enrollment if they qualify for a Special Enrollment Period (SEP). You are eligible 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.
• In your residence. – If you move and you switch zip codes, this may trigger an insurance rate adjustment.
• 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 Affordable Care Act website. When you visit the Marketplace, 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 Fort Bend 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 Fort Bend County, TX?

One primary concern is if your doctor will be within 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.

Blue Cross Blue Shield of TX

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.

Oscar

Once you select your plan, you can find Primary Care Providers (PCPs), hospitals, pharmacies, and urgent care centers in your area.

Ambetter

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.

UnitedHealthcare

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.

Aetna

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.