Health Insurance Plans in Montgomery County, Texas, 2024

Living in Montgomery County, you find yourself transitioning quite quickly from the flat desert of the Texas plains to the dark woods of the southern states. The Sam Houston National Forrest begins here; it is the doorway to the Big Thicket National Preserve, then onto the Sabine and border with Louisiana. One can find oneself lost if not careful. The same can be said of health insurance. CoverMile is here to help you find your way through the woods and onto the best health insurance 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 Montgomery County, TX. Plans exist for as low as $0 per month with subsidies. Let us show you how.

2024 Health Insurance Facts in Montgomery County, Texas

Texas has 2.4 million residents enrolled in the Affordable Care Act. Florida is the only state with more enrolled. The Lone Star State also has the country’s highest uninsured rate, with 22.1 percent of residents not having health insurance. We’ve held that position since the exchange system was implemented.

 
Here are additional facts about health insurance in Texas.

• According to the U.S. Census estimate, Montgomery County’s population is just shy of 680 thousand residents. Of that total, 17.9 percent are uninsured.
• By gender, of those insured, 50.6 percent are female, and 49.4 percent are male.
• Eighty-seven percent of consumers had access to three or more insurers through the ACA in 2023. For 2024, Montgomery County has access to seven insurance providers.
• 85.3 percent of Montgomery County has health insurance. 53.8 percent obtain it with their employer, while 10.7 percent have it through non-group plans. 10.1 percent are on Medicare, 9.27 percent have insurance through Medicaid, and 1.36 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.
• Thirty-eight percent support the expansion to the availability of Medicaid, government health insurance, and long-term care programs for certain low-income adults and children.
• According to Niche, Montgomery County ranks third for Best Counties for Outdoor Activities in Texas for 2023. They also rank number sixteen of the healthiest counties in Texas.
• For 2024, employers are facing rising health insurance premiums well above their comfort zone of annual increases of less than 4 percent.
• The average cost for a 2024 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 Montgomery County, UnitedHealthcare offers this benefit to residents.

Here are a few fun facts about Montgomery County itself:

• Montgomery County was named after Major Lemuel P. Montgomery. He was a leader during the Civil War. Both the town and county were named after him. He served alongside Sam Houston in the Battle of Horseshoe Bend.
• The West Fork San Jacinto River diagonally zig zags through the county, flowing from Lake Conroe at the northern border. There are also several lakes; the largest is Indigo Lake. Others are Bird Lake, Carters Lake, and Rogers Lake.
• Lake Conroe is a man-made lake and recently created. Lake Conroe Dam was built in 1968 and completed in 1973. It is 2.2 miles long and 82 feet high.

• Lake Conroe has areas for fishing, camping, boating, and other recreational activities. Nightlife includes clubs and dining.
• The city of Conroe has a highway loop, HWY 336. A loop is when a single stretch of highway encircles a city.
• In 1931, the discovery of oil on one parcel of land led to a tremendous boom in the area. Wildcatter, George W. Strake, made the oil discovery, and it turned Montgomery County around.
• Fort Bend County has two ghost towns: Fastoria and Security. Both were lumber mill towns. The former paid its employees a form of money that could only be used in town. The mill controlled most of the businesses in town, except for the post office.
• Montgomery County is known as the ‘birthplace of the Texas flag.’ In 1839, the President of the Republic of Texas, Mirabeau B. Lamar, commissioned Dr. Charles Bellinger Stewart, a Montgomery resident, to create the Texas Flag. He did, and the Lone Star Flag was officially adopted in 1839.

Do I Need Health Insurance in Montgomery County, TX?

As we enter 2024, we see only five states still maintain health insurance requirements. Texas residents aren’t obligated to have health insurance to see a doctor or visit a health care facility. However, when you don’t have health insurance, you can face issues such as:

1. Healthcare costs.Without health insurance, you must pay full price at a doctor’s office or health care facility. Health insurance is like having a membership card to a retail store. When you present your card, you receive a discounted price. Health insurance is the same. Insurance companies contract with medical providers to treat individuals at a negotiated rate.
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.When you don’t have health insurance, you will need to pay for preventive care services such as immunizations and well-checkups.Under the Affordable Care Act, these services are covered with a Marketplace health insurance policy.

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

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

Affordable Care Act/Marketplace – The Marketplace is where most individuals and families go to purchase their health insurance. The ACA website provides a selection of health insurance companies in Texas based on your input. You choose the one that best fits 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 for a Direct Purchase with an insurance company, it is important to understand you won’t receive ACA subsidies. If you believe you may qualify, apply through the Marketplace website. Also, plans offered and insurance rates may vary when making a direct purchase through an insurance company.

Short-term Health Insurance – Short-term insurance is an option for those who only need health insurance temporarily. You can apply if you’ve missed Open Enrollment and you don’t qualify for a Special Enrollment period, you are within an employer’s probationary period for benefits, 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 visit doctors and 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.

Top Five Health Insurance Companies in Montgomery 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 Montgomery County based on their 2024 rates compared to their 2023 rates.

• Aetna – 14.94 % rate increase – In 2024, Aetna tops the list of insurance companies with an increase after having a nice decrease last year. 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 they include 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 only have a slight decrease. They offer more plan options than most insurers and are one of the few companies that is available nationwide.
• Oscar – 3.39% rate increase. – Oscar Insurance went from a double-digit increase in 2023 to what you see above. It’s 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 mirrors last year’s 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 Montgomery County, TX*

Below, we’ve selected two best health insurance plans from each company for Montgomery County, TX. They are in order of cost of a 2024 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
Oscar	Simple PCP Saver EPO	40%	$4750/ $9500	$7200/$14400	$20/$80	Yes	No
United Healthcare	Silver-E Virtual First HMO	35%	$3200/ $6400	$7250/ $14500	$0/$100	Yes	Dental/ Vision as separate policies
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 five health insurance companies. Other insurance providers may be available.

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

The enrollment process does not change much whether you live in Dallas, El Paso, Corpus Christi, or Montgomery 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. When you enroll by December 31^st, your health insurance will begin on January 1^st. If you choose to wait until January 15^th and enroll late, your health insurance start date will be on February 1^st.

One can enroll anytime outside of Open Enrollment if they qualify for a Special Enrollment Period (SEP). You are eligible for an SEP if 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 change zip codes, you 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. The Marketplace guides you through entering your personal information and plan selections. 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 Montgomery 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 Montgomery County, TX?

When you are insurance shopping, you want to know if your doctor will be within your insurance company’s network. You can find out by visiting the company’s website and searching for your doctor or the facility’s name to see if they are in-network or out-of-network.

Each link below will take you to the provider’s 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.