If you live in King County, you aren’t living in the least populated county in Texas. Loving County has you beaten by about a hundred citizens. But you are still second, so you can place that runner-up trophy on the mantle. Large cities like Austin, or small towns like Guthrie need health insurance. This is where CoverMile enters the cattle pen. While living in such a small community, insurance may be confusing with which providers may be available to you. It doesn’t take a seared brand to recognize the difference.
CoverMile is here to help you find the best health insurance plans in Loving County, TX, at the lowest prices. You can find coverage for as low as $0 per month with subsidies. Read on, and we can show you how.
Health Insurance Facts for 2023 in King County, Texas
Health insurance in Texas is unique. While counties like King may be among the smallest in the state, Texas has one of the largest exchange enrollments in the nation, with 2.4 million for 2023. The only state that beats us is Florida. Texas also holds the highest uninsured rate in the country at 22.1 percent. We have held that position since the exchange system was implemented.
Here are additional facts about health insurance in Texas.
- According to a U.S. Census estimate, Loving County has a population of 233 residents. Of that total, 21.6 percent are uninsured.
- By gender, of those insured, 46.8 percent were men, and 53.2 percent were female.
- Currently, through the ACA, Eighty-seven percent of Texas insurance shoppers have access to three or more companies in 2023. This is unchanged from 2022. Loving County has access to three insurance providers.
- 76.3 percent of the King County population has health coverage. Most through an employer, 49.8 percent. This study shows that 10 % are on Medicaid, none are on VA or military plans, but 5.02% are on non-group plans, and 11.5% are on Medicare.
- Overall, Fifty-nine percent of national consumers have access to coverage from a national insurer; these include companies like Blue Cross Blue Shield of Texas, which is available in every state.
- The average cost of a Silver health insurance plan in Texas is $454
Here are a few fun facts about the tiny county itself:
- The county is named after William Philip King, who died in the Battle of the Alamo. He was a Private and the youngest to die in the battle. King was 14 years old.
- Guthrie is an unincorporated area; however, it is the County Seat.
- The Four Sixes (6666) Ranch is a ranch established by Samuel Burk Burnett in the early 1870s. They bred cattle and Durham bulls until oil was discovered on the land.
- The TV series Yellowstone had a spinoff series planned, The Yellowstone: 6666. This is the same ranch in our review here, probably with a bit of flare.
Do I Need Health Insurance in King County, TX?
In 2019, the federal mandate that individuals and families have health insurance was removed. Today, only a few states still have laws like this in place; Texas isn’t one of them. However, when you choose not to buy health insurance, even in a small county such as King, you may run across issues you may not have considered.
- Healthcare costs.When you do not have health insurance, you pay full price for your health care. Think of health insurance as having a membership to your favorite big box store. When you present your card at the register, you receive your discount. Health insurance is somewhat the same. Insurance companies contract with medical providers to provide care to individuals at a negotiated rate.
- Healthcare networks.When you receive treatment from your regular doctor or provider, you may require advanced medical care. Health insurance provides a connected list of doctors and facilities. This can help you locate a specialist fast, easing worries. Especially since looking for a specialist or care facility on your own may add burdens to an already stressful situation.
- Healthcare maintenance.Having health insurance provides you and those under your plan with preventive care services. These services are free due to the Affordable Care Act mandates. When you do not have health insurance, you must pay for these services out of pocket.
What are My Health Insurance Options in King County, Texas?
Individuals and families have options for healthcare in King County. One can purchase health insurance through the ACA Marketplace or directly from a health insurance company. Each option has its benefits.
Affordable Care Act/Marketplace – When signing up for Affordable Care Act insurance, you and your family can select from the best plans available. The Marketplace site will inform you if you qualify for premium tax credits and subsidies like cost-sharing reductions.
Direct Purchase – Before purchasing directly from an insurance company, it is always best to double-check if you qualify for tax credits and subsidies. If you don’t, you still have options with a direct purchase from a provider. In some cases, like with Blue Cross Blue Shield of Texas, you have additional plans that are not available on the Marketplace.
Types of Insurance – When shopping for an insurance plan, whether through the Marketplace or Direct Purchase, insurance companies may give you network options. The primary three are HMOs, EPOs, and PPOs. Each insurance company works with one or more of these network types. When you choose your plan, you can sometimes select your network type. However, when you find your plan, ensure that your doctor is within the plan’s network. If he is not, you can incur out-of-network fees.
Short-term Health Insurance – If you only need health insurance for a short period of time, Short-Term insurance may be an option for you. This insurance type is designed to bridge the gap from today until ACA Open Enrollment or your employer’s benefits package kicks in. 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 limits. It does not cover preexisting conditions, maternity care, or prescription medication.
Top Health Insurance Companies with the Highest Star Ratings in King County, TX
If you shop for health insurance in King County, you may wonder which insurance company is best for your family. You may have questions about premiums, how much they’ve charged in the past, and what your future costs may look like. To address this concern, we have rated the two companies available in King County based on their 2023 rates as compared to their 2022 rates.
- Baylor, Scott, and White– 1.7% increase – Although having a rise in 2023, Baylor, Scott, and White has one of the lowest price increases in the market. However, they do not have as wide of a coverage area as other insurance carriers. They provide insurance to major cities such as Austin, Dallas, and San Antonio and their surrounding areas.
- Blue Cross Blue Shield of Texas – 3.42% increase – Although BCBS of Texas has seen a rise this year, they have shown to be a strong and reliable insurance provider. They have more plans available than other insurers; this gives you and your family more options. They also provide coverage to the entire state of Texas.
Top Six Health Insurance Plans for King County, TX
Below, we have selected the best insurance policies for King County, TX, three from each of the two above companies. We’ve listed them in order of premium for a standard policy without Cost Sharing Reductions. This list includes Gold plans. However, be aware only Silver plans offer Cost Sharing Reductions.
|Insurance company||Insurance Plan||Co-insurance||Deductible||Out-of-Pocket Max||Copay PCP/ Specialist||$0 Virtual Care PCP||Adult Dental/ Vision|
|BCBS of Texas||Blue Advantage Gold 603 HMO||25%||$2000/ $4000||$8700/ $17400||$30/$60||Fee Applies||Dental/ Vision as separate policies|
|Baylor, Scott, and White||Elite Gold HMO 012||20%||$1500/ $3000||$9100/$18200||$0/$60||Fee Applies||No|
|Baylor, Scott, and White||Prime Silver HMO 008||40||$3400/ $6800||$7250/$14500||$30/$70*||Fee Applies||No|
|BCBS of Texas||Blue Advantage Silver 205 HMO||50%||$1500/ $4500||$7250/$14500||$15/50%||Fee Applies||Dental Vision as separate policies|
|BCBS of Texas||Blue Advantage Silver 705 HMO||40%||$5700/ $11400||$7200/$14400||$30/$60||Fee Applies||Dental/Vision as separate policies|
|Baylor, Scott, and White||Prime Silver HMO 005||10%||$0/$0||$7250/$14500||$45$95||Fee Applies||No|
*Adults: No charge for the first two sick visits. Copay thereafter. Children: No copay charge.
How to Enroll in Health Insurance in King County, TX?
Whether you live in King, Orange, Corpus Christi, or Dallas Counties, there is not much difference in the enrollment process. Everyone is bound by Affordable Care Act standards.
When – The Affordable Care Act Open Enrollment period begins on November 1st of each year and ends on December 31st. Your coverage starts on January 1st. You can also enroll up until January 15th. This late enrollment will give you a start date of February 1st.
Some may qualify for a Special Enrollment Period (SEP), where one may enroll anytime during the year. You are eligible for a SEP when:
- There is a change in your household. – This includes getting married or divorced; adding a family member through birth or adoption; or you have a death in the family.
- You have a change of residence. – Relocating out of your zip code may require an insurance rate adjustment.
- There is a change in your health coverage. – When you or your spouse lose health insurance through an employer or an alternative source, you can apply for health insurance.
How – The most common method is through the ACA Marketplace website. Signing up is simple. The website guides you through the process. As soon as you complete your application, you receive an answer. The approval process also lets you know if you qualify for tax subsidies. If you are eligible, it will factor your savings into your policy’s cost.
If you have any questions when shopping for health insurance in King County, TX, contact CoverMile. We’re here to assist you with finding the best coverage for you and your family and guiding you through the health insurance sign-up process.
How to Find Doctors Near Me in King County, TX
One primary concern insurance shoppers have when living in a small community like King County is whether you can see your regular doctor or need to find a new one. You can find your answer on the insurance company’s website. Input their name or the facility the doctor is part of into their directory, and it will let you know if they are in-network or out-of-network.
To assist you, below are links that will take you to each provider’s website. Their medical provider’s directory allows you to search by location, doctor’s name, and facility type. Keep in mind that 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.
You begin by selecting your plan type. Then, you can choose the type of specialty you are searching for, then your zip code. The search engine will show you all available doctors and facilities in that area based on the parameters you set up.
Frequently Asked Questions
How much is health insurance in King County, TX per month?
Health Insurance premiums in King County will depend on various factors such as age, marital status, and which plan you select. Tobacco usage will also determine how much you will pay for health insurance. When you move, you must notify your insurance company because where you live will also determine your insurance premium.
Can I sign up for health insurance outside of Open Enrollment in King County, TX?
If you are outside of the November 1st – December 31st Open Enrollment period, you have two options. You can enroll late, up until January 15th, with a February 1st start date, or you may qualify for a Special Enrollment Period. These include if you just got married, you recently lost a job that provided you benefits, or your family had a birth or adoption.
Can I sign up for Oscar Insurance in King County, TX?
Oscar Insurance is not available in King County through the ACA Marketplace, nor is it sold on the open market through the company’s website.
Am I able to use my health insurance when I travel outside of King County, TX?
When you sign up for Health insurance, you are provided with a local network of providers and facilities. When you travel outside your network, you will pay more for treatment, and with some providers, you may not have out-of-network coverage at all. However, in emergencies, all companies provide coverage in a hospital or medical facility. Read your policy carefully to see if you need to do anything before you travel.
Is there a penalty for not having health insurance in King County, TX?
Health insurance is no longer mandated in Texas and residents do not pay a penalty for not having health insurance. However, if you do not have health insurance you will pay more for your healthcare. If you are unsure of what insurance plan may be best for you or what you may qualify for, contact an insurance professional at CoverMile, we would be happy to guide you though the process.
Am I able to get health insurance if I do not have a job in King County, TX?
What health insurance coverage you are eligible for is not determined by your employment status. You are able to obtain health insurance based on your income level and household size. If you are unemployed, you can get health insurance through the Marketplace with savings based on your income level. You may also qualify for Medicaid or Children’s Health Insurance Program (CHIP). When you apply through the Marketplace, you will find out what policies and programs for which you are eligible.
Am I able to get Dental or Vision Insurance in King County, TX?
Insurance companies do not offer Dental and Vision other than Children’s Dental, which is mandated as part of the ACA 10 Essential Benefits. These are limited and do not include adult coverage. Blue Cross Blue Shield of Texas does offer a Dental benefit, but it is separate from its health insurance plan. Visit their website for more information.