Whether you live in the valley, the panhandle, or deep in the heart of Texas, finding health insurance is essential to you and your family. Shopping for it is the challenging part. You want only the best coverage at the best price. While we may be past Open Enrollment for 2023 for Bastrop, TX, other events allow you to shop for insurance. Maybe you are losing coverage from an employer, perhaps you got married to the love of your life, or maybe you welcomed a child through birth or adoption. All of these events would trigger a Special Enrollment Period. Now the need and availability for health insurance plans in Bastrop meet.
We at Cover Mile are here to help you find the best health insurance plans in Bastrop, TX at the lowest prices. Coverage even exists for as low as $0 per month. Read on and we can show you how.
2023 Health Insurance Facts in Bastrop, Texas
Texas is unique when it comes to the health insurance market. It has one of the highest exchange enrollments in the country, with 2.4 million for 2023. Only Florida beats it. Texas also holds the highest uninsured rate in the country at 22.1 percent. Texas has held that top spot since the exchange system was implemented.
Here are additional facts about health insurance in Texas.
- 3.6 million new consumers entering the market are choosing from an average of 88 plans.
- Between 2022 and 2023, 83 percent of those insured saw at least some level of increase, even on their lowest-priced Silver plans. At least five percent of those insured through a national insurer have also seen their plans increase in pricing.
- Since 2019 both Bronze and Gold plans have been on a steady increase on plans offered, while Silver plans have been slowly decreasing.
- 82 percent of plans available to consumers are HMO and EPO plans.
- For 2023, national insurers are offering more competitively priced Silver-leveled plans compared to those sold in 2022. Their lowest-priced Silver option is up 14 percent compared to 2022. Medicaid, as well as Blue Cross Blue Shield of Texas, continues to provide the lowest Silver metal option on the individual market.
- Texas has the largest coverage gap in the nation. Forty-one percent of individuals find themselves within the coverage gap.
- The average cost for an individual Silver health insurance plan in Texas is $589.
*Our quote numbers are based on a single healthy 40-year-old male, non-smoker living in Bastrop, TX
Why Do I Need Health Insurance in Bastrop, TX?
Health insurance was once a federal mandate. But since the loosening of the laws, one can legally choose to go without health care in Texas. However, being without health insurance opens the door to many issues one may not consider.
- Healthcare costs. This is the big one. When you do not have health insurance, you have to pay full price. Think of it like having a membership card to your favorite retail store. When you show that card, you receive the discount price. Health insurance acts in the same fashion. Insurance companies contract with medical facilities to provide care to individuals at a negotiated rate.
- Healthcare networks. While you may have a regular doctor and other providers you see should you need advanced medical care, having insurance provides you with a connected list of doctors and facilities. This helps ease the concern of where to go, especially since seeking advanced medical care may be adding burdens to an already stressful situation.
- Healthcare maintenance. Having health insurance provides you and those under your plan with free annual checkups and other preventive care services. These are mandated under the Affordable Care Act. If you do not have a healthcare plan in place, you will have to pay for these services out of pocket.
What are My Health Insurance Options in Bastrop, Texas?
There is a need for individual and family healthcare in Bastrop, Texas. You can purchase through the ACA Marketplace, or you can purchase directly from the health insurance company. There are benefits to and reasons why you would select each option.
Affordable Care Act/Marketplace – This is the most common and easiest option. When you sign up on the ACA Marketplace, you will find the best option available to you and your family and see if you qualify for premium tax credits and subsidies like cost-sharing reductions.
Direct Purchase – When you purchase directly from an insurance company, you will not have access to the ACA subsidies. So, if you believe you qualify for either, your best bet will be to purchase your health insurance through the Marketplace. Rates may vary between on and off-exchange plans. Plan offerings can also differ depending on the insurance company and metal tier.
Types of Insurance – When you select an insurance plan, be it through the Marketplace or Direct purchase, you will find a few options to select from; these are called networks. While these network types are different, each insurance company chooses which network type or types they will contract with and make available to their customers. The primary three you will see are HMOs, EPOs, and PPOs.
Short Term Health Insurance – If you need temporary insurance to bridge the gap between today and Open Enrollment or your employers benefit package, STH Insurance may be an option for you. This type of policy provides temporary basic health coverage for routine care for an initial period of 364 days but can be renewed for an additional 24 months. Be aware that Short Term Health insurance has limitations. It does not cover preexisting conditions, maternity care, or prescriptions medication.
Top Four Health Insurance Companies with the Highest Star Ratings in Bastrop
With such tremendous growth of those signing up for health insurance in Texas cities like Bastrop, those who are now shopping for their plan may wonder which company they should select for themselves and their family.
- Blue Cross Blue Shield of Texas – 3.42% increase – Although you may see that BCBS of Texas has had an increase in 2023 over 2022, they have proven to be a stronger and most reliable insurance provider over the years. They have the most plans available, so you have options for you and your family.
- · Oscar – 10.9% increase – While Oscar Insurance for Bastrop residents has the largest premium increase for 2023, they do have options that the other companies do not have. One of these options is a $3 copay for prescriptions on some plans. They also offer Virtual Specialist Visits. Most companies only extend virtual visits to a PCP. You can visit the provided link to see details about how Oscar lines up against the competition.
- Ambetter – 10.7% increase – If you are searching for a Bronze metal plan, continue searching. Ambetter does not offer them. The one advantage they have is an Adult Dental and Vision benefit with their EPO network option. Other insurance companies only provide Children’s Dental that is mandated under the ACA’s 10 Essential benefits.
- Ascension (US Health and Life) – New to exchange. By being new to consumers in the Marketplace, it is hard to say how they will fully match up. However, US Health and Life offers Bastrop plans that offer a zero-dollar premium with tax credits applied. Like Oscar, they offer a zero-dollar virtual PCP visit and a zero-dollar virtual specialist visit copay.
Top Eight Health Insurance Plans for Bastrop, TX
The following policies will be based on standard policies without Cost Savings reductions. The ratings are on the insurance companies table they have posted on their sites for a Standard policy. We’ve selected two best insurance policies for Bastrop, TX from each of the above companies.
|Insurance company||Insurance Plan||Co-insuranceo||Deductible||Out of Pocket Max||$0 Virtual Care PCP||$0 Virtual Care Specialist||Adult Dental/ Vision|
|BCBS of Texas||HMO BLUE ADV. PLUS SILVER||50%||$1500/ $4250||$9100/ $18200||No||No||No|
|Ambetter||EPO COMPLETE GOLD||20%||$1450/ $2900||$7500/ $15,000||Yes||No||Yes|
|Oscar||HMO GOLD CLASSIC||20%||$2000/ $4000||$8700/ $17400||Yes||Yes||No|
|Oscar||HMO SILVER CLASSIC||30%||$5400/ $10,800||$8700/ $17,400||Yes||Yes||No|
|BCBS of Texas||HMO BLUE ADV. SILVER||40%||$5800/ $11600||$8900/ $17800||No||No||No|
|Ambetter||EPO COMPLETE SILVER||40%||$6000/ $12,000||$8500/ $12,000||Yes||No||Yes|
|US Health||EPO SILVER NO DECUTIBLE||0%||$0||$9100/ $18,000||$15||$45||No|
|US Health||EPO SILVER||40%||5800/ 11600||8900/ 17800||Yes||$40||No|
How to Enroll in Health Insurance in Bastrop, TX?
There is little difference in the enrollment process whether you live in Bastrop, El Paso, Corpus Christi, or Dallas. 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. That will give you a January 1st start date. One can enroll until January 15th, but your start date will be February 1st.
There are also Special Enrollment periods where one can enroll anytime during the year. Once qualifies for a SEP for these events:
- Changes in household. – This can include getting married, divorced, birth or adoption, or a death in the family.
- Changes in residence. – If you move out of your zip code, this would require an adjustment to your insurance rate.
- Changes in 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. It is quick and guides you through the process. It also gives you an answer as soon as your application is completed, with the option to apply for your health insurance. It will also inform you if you qualify for tax subsidies. If you do, it will factor your savings into your policy’s cost.
If you have any questions as you shop for health insurance in Bastrop, TX you can contact Cover Mile. We can assist with finding the best coverage that fits your current situation and guide you in signing up for health care for you and your family.
How to Find Doctors Near Me in Bastrop, TX?
One question most new insurance enrollees have is, which doctors can I see? The answer will depend on your provider’s network. You can find this easily by visiting your insurer’s website and searching for doctors or medical facilities.
You can search by location, doctor’s name, or 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 also can search pharmacy information, as well as for dental and vision care.
Once you select your plan, you can find Primary Care Providers (PCPs), hospitals, pharmacies, and urgent care centers in your area.
Enter your plan information and your location and you can find doctor and facilities in your area. You area also given the option to connect with Tele-health or to talk with a nurse directly.
Find a doctor or facility based on your location, specialty, gender, or other preferences.
Frequently Asked Questions
Is health insurance expensive in Bastrop, TX?
Health insurance costs have seen a slow increase over the past several years. It has been across the board on all tiers at about 5%. The average cost for a health insurance plan for a single adult about forty years old and healthy is about $589 for 2023.
Do I need to wait for Open Enrollment to sign up for health insurance in Bastrop, TX?
Open Enrollment is from November 1 through December 31 of each year. You can trigger a special enrollment period if you have: a change in your household, a change of employment, or a change in your health care coverage.
Can I sign up for Blue Cross Blue Shield in Bastrop, TX?
Blue Cross Blue Shield of Texas has both on-exchange and off-exchange policies. BCBS of Texas has a total of 35 plans. Twenty-nine plans are available through the Marketplace. Six of them you will only find on their off-exchange website.
Can I use my Bastrop, TX, health insurance away from home?
This will depend on your insurance company and how you use your insurance. If you are traveling abroad and have a medical emergency, then all insurance plans have a provision for emergency coverage. You may need to contact them to trigger this benefit. However, if you are attempting to see a doctor for routine medical care, you may either find yourself without coverage or paying an out-of-network fee, depending on the network type you have. A PPO would be the most lenient, with just reduced coverage.
Does my Bastrop, TX, health insurance cover my medication?
One of the Affordable Care Act 10 Essential Health Benefits is prescription drugs. Insurance companies cover medication at different levels. They are often called tiers, offering from four to six tier levels. The most popular are Generic, Preferred, Brand, and Specialty. Each different level costs more than the level below it.