Health Insurance Plans in Nueces County, Texas 2024

If you don’t recognize the name of Nueces County, you will when we give you the name of one of its most popular cities, Corpus Christi. Corpus is known for its tourist draw, beaches, and oil and gas. This year, so far, Nueces County has produced 42 thousand barrels of oil and 2.2 million cubic feet of natural gas. We get to transport partly over the work along the coast of Texas; well, our vehicles do. And speaking of work, insurance companies also work to keep us healthy. They provide the health care that, like the gas in our cars, keeps us going. We at CoverMile have reviewed the four health insurance companies that cover Nueces County. Below we have ranked them in relation to cost and benefits. Let’s take a look at each.

We at CoverMile are here to help you find the best health insurance plans in Nueces County, TX, at the lowest prices. Coverage exists for as low as $0 per month with subsidies. Read on, and we can show you how.

2023 Health Insurance Facts in Nueces County, Texas

Health insurance in Texas is unique. While Texas houses only the fifth largest port with Nueces County, we have one of the highest exchange enrollments in the country, with 2.4 million for 2023. Only Florida beats us. 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.

Do I Need Health Insurance in Travis County, TX?

The federal mandate to carry health insurance no longer exists. Only a handful of states require an individual to have health insurance. Texas isn’t one of them. However, when one chooses not to have insurance, they open the door to many issues you may not consider.

  1. Healthcare costs.This is the big one. When you do not have health insurance, you pay full price for your health care. Think of health insurance as having a membership card to your favorite retail store. When you present your card to the cashier, you receive a discounted price. Health insurance is somewhat like this. Insurance companies contract with medical facilities to provide care to individuals at a negotiated rate.
  2. Healthcare networks.First, you receive treatment from your regular doctor or provider. Now, should you need advanced medical care, having insurance provides you with a connected list of doctors and facilities. This can help ease the concern of having to search on your own. Especially since looking for a specialist or care facility may add burdens to an already stressful situation.
  3. Healthcare maintenance.When you have health insurance, it provides you and those under your plan with preventive care services that are free in most cases. Under the Affordable Care Act, these services are mandated. Not carrying health insurance places you in a position where you will have to pay for these services out of pocket.

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

There are many options for Individuals and families for healthcare in Nueces County. You can purchase health insurance through the Marketplace or directly from a health insurance company. Each option has its benefits.

Affordable Care Act/Marketplace – This is the most popular option. When you sign up for ACA insurance, you and your family will be given options of the best plans available. The site will also inform you if you qualify for premium tax credits and subsidies like cost-sharing reductions.

Direct Purchase – If you believe you qualify for tax credits, begin there because when you purchase from an insurance company directly, you will not have access to ACA subsidies. Plan benefits can also differ depending on the insurance company and metal tier. Also, understand rates may vary between on and off-exchange plans.

Types of InsuranceWhen you purchase an insurance plan, whether through the Marketplace or Direct, the insurance company may allow you to select your insurance network. The primary three are HMOs, EPOs, and PPOs. While these network types are different, each insurance company chooses which network type or types they make available to their customers. However, when you find your plan, be cautious of out-of-network fees should the doctors or specialists you usually see not be within your plan’s network.

Short-term Health Insurance– Short-Term insurance may be an option if you need temporary insurance to bridge the gap until the ACA Open Enrollment or your employer’s benefits start date. Short-Term Insurance gives the insured temporary basic health coverage for routine care. It covers an initial period of 364 days and can be renewed for an additional 24 months. Short Term Health insurance does have limitations. It does not cover preexisting conditions, maternity care, or prescription medication.

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

The number of individuals signing up for health insurance in Nueces County continues to grow. It then becomes a question of which insurance company you should select for your family. But you may wonder how much each company charges enrollees, how much they’ve charged in the past, and what your future costs may be like. To answer this concern, we have rated these four companies on 2023 rates as compared to their 2022 rates.

  • Aetna – 6.92 % decrease – We lead off with the only company that has seen a reduction. They are known for their $0 preventive care, 24/7 $0 Virtual Care, and in-network $0 walk-in clinics available seven days a week.
  • Blue Cross Blue Shield of Texas – 3.42% increase – Although BCBS of Texas has seen an increase 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.
  • ·      Ambetter – 10.7% increase – One primary benefit of Ambetter is that they offer Adult Dental and Vision options with some of their EPO network plans. Most insurance companies only provide the Children’s dental mandated by the ACA 10 Essential benefits. The one thing Ambetter lacks, however, is they do not offer a Bronze metal plan.
  • UnitedHealthcare – 13.46 % increaseWhile UnitedHealthcare for Nueces County residents has the largest premium increase for 2023, they offer benefits the other companies on our list don’t offer. One is Short Term Insurance. If you are without insurance, and you need it now to get you to Open Enrollment and don’t qualify for a Special Enrollment Period, UnitedHealthcare may be your only option.

Top Four Health Insurance Plans for Nueces County, TX

Below we’ve chosen the best insurance policies for Nueces County, TX, from each of the above companies. They are in order as they reflect the cost of a standard policy without Cost Sharing reductions.

Insurance companyInsurance PlanCo-insuranceDeductibleOut-of-Pocket Max Copay PCP/ Specialist$0 Virtual Care PCPAdult Dental/ Vision
BCBS of TexasBlue Advantage Plus Bronze HMO50%$6100/ $17400$9100/ $1820040%/50%Fee AppliesDental/ Vision as separate policies
AetnaAetna Silver 2 HMO 40%$4000/ $8000$6800/ $13600$25/$50YesDental as separate policy
AmbetterFocused Silver+Vison+Adult Vision HMO 50%$5100/ $10200$6300/ $12600$35/$85YesYes
United HealthcareSilver-E Standard HMO40%$5700/ $11400$7200/ $14400$30/$60$30 CopayDental/ Vision as separate policies

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

Whether you live in Nueces, El Paso, Corpus Christi, or Dallas Counties, there is not much difference in the enrollment process. Each 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 insurance will then begin on January 1st. You also have until January 15th to enroll, but your start date will be February 1st.

You can also enroll through a Special Enrollment Period (SEP). One can enroll anytime during the year. You qualify for a SEP when:

  • There is a change in your household. – This can include getting married or divorced; having a birth or adoption in your family; or there is a death in the family.
  • You have a change in your residence. – Moving out of your zip code may require an adjustment to your insurance rate.
  • You have a change to your health coverage. – When you or your spouse lose health coverage provided through an employer or from an alternative source, you can apply for health insurance.

How – The most common way is through the Affordable Care Act Marketplace website. Signing up is quick, and the site guides you through the process. You also receive an answer as soon as your application is completed. The application will also let you know if you qualify for tax subsidies. If you do, it will factor your savings into your policy’s cost.

If you have any questions when shopping for health insurance in Nueces County, TX, contact CoverMile. We can assist you with finding the best coverage that will fit your current situation. We can guide you through the health insurance sign-up process.

How to Find Doctors Near Me in Travis County, TX?

When you are insurance shopping, one of the main concerns you may have is if your doctor will be on the insurance company’s list or if you will need to look for a new doctor. You can find out simply by visiting the insurance company’s website and searching for your doctor’s name or the facility they are part of. This search will tell you if your doctor is in-network or out-of-network.

To assist you, we have provided the links below that will take you to each provider’s website and their medical provider’s directory. You will be able 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.


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.

Ambetter

Enter your plan information and your 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 within the area you selected.

Frequently Asked Questions


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

    As we addressed earlier, the average cost for a health insurance plan in Texas is $454. However, plans will vary depending on your age, family size, and the type of plan you select. Other factors that determine your insurance premium include where you live and if you are a tobacco user. If you qualify for tax credits or subsidies can lower your monthly premium.
     

  2. Do I need to wait for Open Enrollment to sign up for health insurance in Nueces County, TX?

    Under normal circumstances, yes, you must wait for Open Enrollment which begins on November 1st and runs through December 31st of each year. However, you can qualify for a Special Enrollment Period if you just got married, you recently lost a job that provided you benefits, or your family had an addition through birth or adoption.
     

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

    Oscar Insurance is not available through the ACA Marketplace, nor is it sold on the open market through its website in Nueces County.

  4. Can I use my Nueces County, TX, health insurance when I travel?

    When you have health insurance, you have a local network of providers and facilities you are able to see. When you travel outside that network, you lose the ability to use your insurance at all or without incurring a fee. However, in an emergency, your policy allows you to be seen at a hospital or other medical facility. Review your policy or call your insurance company to see if you need to do anything if you plan to travel abroad.

  5. What is the penalty for not having health insurance in Nueces County, TX?

    Since 2019 there is no longer a mandate to carry health insurance in Texas. However, if you do not carry health insurance, you may end up paying more for health care than you anticipate. Texas follows its own statutes for health care and the poverty level. This can be dangerous if you fall within the zone where you do not qualify for either Medicaid or Marketplace subsidies. This would leave you with purchasing health insurance out of pocket or going without.

  6. Does Nueces 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 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.

  7. Can I apply for Dental or Vision Insurance in Nueces County, TX?

    All ACA Insurance plans offer Children’s dental and Vision as part of the 10 Essential Benefits coverage. However, advanced child or adult dental and Vision are not mandatory coverage through the Marketplace. Only one health insurance company offers Adult Dental and Vision as part of their policies. Ambetter offers routine eye care as well as benefits for adult dental, with both with annual limits on select policies.