Health Insurance Plans in McMullen County, Texas, 2024

If you’ve been through South Texas on your way to either the coast or The Valley, you may have driven Highway 16. This stretch of road takes you through many cities and towns, one of them being the small town of Tilden. You will also notice on your drive many oilfields. This is what the area, and McMullen County, is known for. The county also has a lake called Choke Canyon. Whether you are a fisherman or a deckhand, we all need health insurance. We at CoverMile can help you find the best policy that won’t have you confused like a Stone Cold Stunner.

CoverMile wants to help you find the best health insurance in McMullen County 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 McMullen County, Texas

Texas Health insurance is unique, and while McMullen County is fourth among the smallest counties in the state, Texas has the largest enrollment rate for 2023 with 2.4 million individuals. However, we also hold another record: the country’s highest uninsured rate, which stands at 2.4 million. Texas has held that record since the exchange began in 2010.  

Here are additional facts about health insurance in Texas.

  • According to a U.S. Census estimate, McMullen County has a population of 576 residents. Of that total, 13.6 percent are uninsured.
  • By gender, of those insured, 54.8 percent were men, and 45.2 percent were female.
  • Currently, through the ACA, Eighty-seven percent of Texas insurance shoppers have access to three or more companies in 2023. McMullen County has access to one insurance provider.
  • 75.1 percent of McMullen County has health coverage. 17.4 percent have insurance through Medicaid. Just over 41.2 percent obtain it with their employer, and 12 percent have Medicare insurance. 3.73 percent on non-group plans, and less than 1 percent are on V.A. or military plans.
  • Overall, Fifty-nine percent of the country has access to coverage through 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 this oilfield county itself:

  • McMullen County is known for oil and gas production. It produces 1.9 million BBLs of oil per month and 10.2 MCF of natural gas per month. This is on 10 thousand wells through 64 different oil companies.
  • McMullen County is also known for hunting. From deer to duck to quail to alligator, there is a season for many critters.
  • Choke Canyon Reservoir is a State Park and lake that begins in McMullen County and crosses over into Live Oak County. It offers swimming, fishing, and camping.
  • James E. Daughtry Wildlife Area surrounds most of the Choke Canyon area. A 5341-acre recreation area provides a habitat for wildlife as well as camping and hunting.
  • The original Broken Skull Ranch, owned by Stone Cold Steve Austin, was in Tilden, Texas.

Do I Need Health Insurance in Kenedy County, TX?

Only a handful of states still require their residents to carry health insurance; Texas is not one of them. However, when you choose not to purchase health insurance, even in a small county like McMullen, you may discover issues you may not have considered.  

  1. Healthcare costs. When you visit a doctor or medical facility and do not have health coverage, you will end up paying full price for your health care. Consider health insurance as having a membership to your favorite big box store. When you present your membership card, you receive a discount. Health insurance is similar. Insurance companies contract with medical providers to provide care to individuals at a negotiated rate.
  2. Healthcare networks. When your primary doctor or provider treats you, they may recommend you see a specialist. When you have health insurance, you have a network of doctors and facilities to expedite your medical treatment. This can ease your worries, especially since searching for a specialist on your own may add to an already stressful situation.
  3. Healthcare maintenance. Having health insurance provides you and your family with preventive care benefits. These services are often free due to Affordable Care Act mandates. If you do not have health insurance, you must pay for these services out of pocket.

What are My Health Insurance Options in McMullen County, Texas?

McMullen County individuals and families have options for healthcare. They can purchase health insurance through the ACA Marketplace or directly from a health insurance provider. Each option has its benefits.

Affordable Care Act/Marketplace – When signing up through the Marketplace, you search for health insurance in Texas. After you input your information, the Affordable Care Act site will inform you if you qualify for premium tax credits and subsidies like cost-sharing reductions.

Direct Purchase – First, before you apply directly through an insurance company, always double-check to see if you qualify for tax credits and subsidies through the Marketplace. If you don’t qualify, you still have options with a direct purchase from a health insurance provider. With Blue Cross Blue Shield of Texas, you may have additional plan options on the insurance company’s website.

Types of InsuranceInsurance companies may offer different network options when you apply, either through the Marketplace or direct purchase. The primary three offered are HMOs, EPOs, and PPOs. However, ensure that your Primary Care Physician (PCP) is within the plan’s network. If they are not, you can incur out-of-network fees.

Short-term Health InsuranceShort Term Health Insurance is for those who only need health insurance for a short period of time. It is also helpful for those outside of Open Enrollment who need healthcare until January 1st or when an employer’s benefits package begins. Short-term insurance covers an initial period of 364 days and can be renewed for an additional 24 months. Keep in mind that Short Term Health Insurance has limits. It does not cover preexisting conditions, maternity care, or prescription medication.

Top Health Insurance Companies with the Highest Star Ratings in McMullen County, TX

If you are shopping for health insurance in McMullen County, which insurance company is best for your family? You may have questions about premiums, how much each has charged in the past, and what your future costs may look like. To address this concern, we have rated the top companies available in McMullen County based on their 2023 rates as compared to their 2022 rates.⃰

  • Blue Cross Blue Shield of Texas – 3.42% increase – Although BCBS of Texas has had a premium increase for 2023, they continue to provide a strong and reliable health insurance. They have more plans available than other providers and offer coverage to the entire state of Texas.

Top Health Insurance Plans for McMullen County, TX

Below, we have selected the best insurance plans from Blue Cross Blue Shield of TX for McMullen County, TX ⃰. We’ve listed them in order of premium for a standard policy without Cost Sharing Reductions. This list includes Bronze and Gold plans. However, be aware only Silver metal plans offer Cost Sharing Reductions.   

Insurance companyInsurance PlanCo-insuranceDeductibleOut-of-Pocket Max  Copay PCP/ Specialist
BCBS of TexasBlue Advantage Bronze 305 HMO50%$6000/ $17400$9100/ $18200$45/50%
BCBS of TexasBlue Advantage Gold 706 HMO25%$2000/ $4000$8700/ $17400$30/$60
BCBS of TexasBlue Advantage Gold 203 HMO30%$850/ $2550$9100/ $18200$20/$45
BCBS of TexasBlue Advantage Silver 205 HMO50%$1500/ $4500$7250/$14500$15/50%
BCBS of Texas Blue Advantage Silver 705 HMO 40%$5700/ $11400$7200/$14400$30/$60
BCBS of TexasBlue Advantage Silver 202 HMO50%$1500/ $4250$7250/ $14500$20/50%

 *While we only list Blue Cross Blue Shield of Texas above, other options may be available.

BCBS of Texas – Other Benefits

All Blue Cross Blue Shield of Texas plans have Virtual Visits at a copay on all tiers. They also offer Dental and Vision plans. These can be purchased separately through the BCBS website.

How to Enroll in Health Insurance in McMullen County, TX?

Whether you live in McMullen, Orange, El Paso, or Dallas Counties, there isn’t 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 and ends on December 31st  for coverage beginning on January 1st. You can also enroll up until January 15th. This late enrollment makes your start date February 1st.

You may enroll anytime during the year if you qualify for a Special Enrollment Period (SEP). You are eligible for a SEP when:

  • There is a change in your household.If you get married or divorced; add a family member through birth or adoption; or if there is a death in the family.
  • You have a change of residence. – If you move out of your current zip code, your health insurance plan in McMullen County may need an insurance rate adjustment.
  • There is a change in your health coverage.If you lose your employer-sponsored health insurance or benefit plan through an alternative source, you can apply for ACA health insurance.

How – When you sign up for health insurance, the simplest way is through the ACA Marketplace. The website guides you through the sign-up process. When you complete your application, you are shown which plans are available and if you qualify for tax subsidies. If eligible, you can see how this will factor into your policy’s cost.

If you have questions about shopping for health insurance in McMullen County, contact CoverMile. We’re here to help you find the best coverage for you and your family. We can guide you through the sign-up process.

How to Find Doctors Near Me in McMullen County, TX

If you live in McMullen County, you may be concerned about seeing a doctor. Especially your doctor. Will they be covered under your new health insurance plan? It is easy to find doctors near you in McMullen County. The easiest way is to visit your insurance provider’s website and search for the doctor’s name or the name of the facility they are part of.

Below is the link that will take you to the Blue Cross Blue Shield website. Their medical provider’s directory allows you to search by location, doctor’s name, and facility type.  

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.

Frequently Asked Questions

  1. Is health insurance in McMullen County, TX expensive?

    While McMullen County is one of the richest in the state, health insurance will still vary in cost depending on factors such as age, marital status, and the plan you select. If you use any form of tobacco, it will also determine your cost as well as your zip code; you need to notify your insurance company when you move.

  2. Can I sign up for health insurance if I am low-income in McMullen County?

    All Marketplace health insurance plans can be subsidized through tax credits or cost-sharing reductions. Tax credits are based on your income and life situation. They help with your monthly premium. You also can save with Cost Sharing Reductions (CSR). This form of savings can help you with other expenses, such as your deductible, copayments, and co-insurance. Understand that to receive the CSR benefit, you must apply for a Silver Metal plan level.

  3. Can I sign up for Oscar Insurance in McMullen County, TX?

    Oscar Insurance is not available in McMullen County through the ACA Marketplace, nor is it sold on the open market through the company’s website.

  4. Am I able to use my health insurance when I travel outside McMullen County, TX?

    When you travel outside your network area, many insurance companies will no longer provide coverage, or they will reduce your benefits. However, if you experience a medical emergency and end up in a hospital or medical facility, all insurance companies will cover you regardless of where you are, Austin, New York or overseas. Keep in touch with your provider, especially if you are going on vacation, to see if there are preferred locations or procedures to report an incident.

  5. Is there a penalty for not having health insurance in McMullen County, TX?

    Only five states still have some form of health insurance mandate; Texas is not one of them. However, if you choose to go without health insurance, you will pay more for your health care than someone with health insurance. You will pay out of pocket when you visit a doctor, receive emergency care, and for many free services generally covered by health insurance.

  6. Is Blue Cross Blue Shield of Texas the same as Anthem?

    Blue Cross Blue Shield of Texas and Anthem are part of the same family, Blue Cross Blue Shield. They work in different parts of the country, offering individual and family plans as well as stand-alone Dental and Vision insurance. Because Blue Cross Blue Shield operates nationwide, it would make sense for it to be divided into many subsidiaries like Blue Cross Blue Shield of Texas.

  7. Am I able to get Dental or Vision Insurance in McMullen County, TX?

    Dental and Vision benefits for adults in McMullen County are not offered as basic health coverage through the Marketplace. Only Children’s Dental is mandated as part of the ACA 10 Essential Benefits. However, Blue Cross Blue Shield of Texas offers Dental and Vision benefits. You can purchase it in addition to your health insurance plan. Visit their website for more information.