Health Insurance Plans in Roberts County, Texas, 2024

While there are no sandy shores here in the town of Miami, Roberts County, the seat does have a community swimming pool, but that is as close to the water as you will get. This panhandle county was once home to the Apache Indian, then the Comanche, and now we know it as North Texas. Whether you live in Austin or off the beaten path in Miami, you and your family need health insurance. You can shop online, calling until the cows come home, but we at CoverMile can quickly help you find the best policy at a price you can afford.

CoverMile helps individuals and families find the best health insurance at the lowest prices. With subsidies, you can find coverage in Roberts County for as low as $0 per month. Read with us, and we will show you how.

Health Insurance Facts for 2023 in Roberts County, Texas

Shopping for Texas health insurance is unique; the country’s uninsured rate is the highest at 22.1 percent of residents without insurance. Texas has held this position since the Affordable Care Act’s implementation. Texas also saw 2.4 million enroll in 2023. That is the country’s second largest federal exchange enrollment. Only Florida saw more sign up.

Here are additional facts about health insurance in Texas.

  • According to a U.S. Census estimate, Roberts County’s population is 803. Of that total, 16.7 percent are uninsured.
  • By gender, of those insured, 53.3 percent were men, and 46.7 percent were female.
  • Currently, through the ACA, Eighty-seven percent of Texas insurance shoppers have access to three or more companies. Roberts County can apply to three insurance providers.
  • 89.9 percent of Roberts County has health coverage. 46.9 percent obtain it with their employer, while 14.2 percent have it through non-group plans. 21.9 percent have Medicare insurance, 4.85 percent have insurance through Medicaid, and 2 percent are through the V.A. or military.
  • 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.
  • In Texas, the average cost of a Silver metal health insurance plan without subsidies is $454.

Here are a few fun facts about the tiny County itself:

  • Roberts County was named after Oran Milo Roberts. He was the 17th governor of Texas from 1879-1883.
  • Roberts County is a dry county, one of the five remaining in Texas.
  • The town of Miami is not known for the city in Florida. It is, although, called “Sweetheart of the Plains”. It’s known for its National Cow Calling Contest in June. It features a poker tournament, family fun, and BBQ. Uh-oh. Guess you better come, little doggie, when you are told.
  • Roberts County has one ghost town: Codman. This piece of land has two historical stories. The first is that the United Nations once owned it. A landowner had willed it to the U.N. upon their death. Not knowing what to do with it, the U.N. resold it to local landowners. Secondly, there is an election story that states election judges were arrested and prosecuted because 39 votes were cast in a town that was supposed to only contain eight registered voters.
  • Voted number three among the counties with the best public schools in Texas.
  • Voted among the top ten counties to buy a house in.

Do I Need Health Insurance in Roberts County, TX?

As of 2019, only a handful of states still live under the individual mandate; Texas is not one of them. However, if you choose not to have health insurance, even in a small Texas county like Roberts, you may encounter issues you have not considered.

  1. Healthcare costs.Health insurance is similar to a membership to a big box store. When you present your card at the register, you receive a discount. Insurance companies contract with medical providers to treat individuals at a negotiated rate. When you visit a doctor or medical facility and don’t have health insurance, you pay full price for your health care.
  2. Healthcare networks.After receiving medical care from your Primary Care Physician, they may order tests or other treatment. Health insurance provides a network of doctors and facilities to help you receive your doctor’s recommendations quicker and ease worries, especially since searching for a specialist or advanced care facility on your own may add to an already stressful situation.
  3. Healthcare maintenance.When you have health insurance, you have free preventive care. This is due to the Affordable Care Act mandates. These include screenings, well-checkups, and vaccinations. When you do not have health insurance, you must pay for these services out of pocket.

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

When you purchase health insurance for Individuals and families in Roberts County, you have options. You can visit the Marketplace or purchase directly from a health insurance company. Each option has its benefits.

Affordable Care Act/Marketplace – When shopping for insurance through the Marketplace, you can search for a plan based on family size and how much money you make yearly. Based on that information, you can see if you qualify for premium tax credits and subsidies like cost-sharing reductions.

Direct Purchase – Before you commit to a direct purchase from a health insurance website, verify you are not eligible for tax credits and subsidies through the Marketplace. You can save money when you qualify. If you are outside the parameters, you can direct purchase from a health insurance provider. In some cases, like with Blue Cross Blue Shield of Texas, you may have additional plan options only available on the insurance company’s website.

Short-term Health InsuranceIf you are going to purchase Marketplace insurance, but it is too early in the year, or if you are just starting a job and your benefits package has a three-month waiting period, Short-term Health Insurance may be a consideration for you. Short-term Health Insurance covers an initial period of 364 days and can be renewed for an additional 24 months. Keep in mind Short Term Health Insurance has limits. It does not cover preexisting conditions, maternity care, or prescription medication.

Types of InsuranceHMOs, EPOs, and PPOs are the most common health insurance network types. Some insurance companies offer multiple network options, whether through the Marketplace or a direct purchase. Keep your primary doctor in mind when you are considering insurers. They must be within the plan’s network for them to be covered. If they are not, you can incur out-of-network fees.

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

How much a customer will pay for their policy over time is one of the main details that top insurance ratings evaluate. Shoppers for health insurance then use those reviews to consider which insurance companies are best and purchase based on that research.

When considering insurance rates, you may ask those same questions:

  • How much has this company charged its customers in the past?
  • How much will my premium be when I sign up?
  • How much will my premiums be when I renew my policy?

To address these concerns, we’ve rated the top companies available in Roberts County based on their 2023 rates compared to 2022 rates.

  • Baylor, Scott, and White – 1.7% increase – Although having a rise in 2023, Baylor, Scott, and White had 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 cover major cities such as Austin, Dallas, San Antonio, and surrounding areas.
  • Blue Cross Blue Shield of Texas – 3.42% increase – Although BCBS of Texas has seen a premium increase for 2023, they continue to prove they are a strong and reliable insurance company. They have more plans available than other providers. They offer coverage to the entire state of Texas.

Top Health Insurance Plans for Roberts County, TX

Below, we’ve listed the best insurance plans for Roberts County, TX. We’ve outlined them in order of premium for a standard policy without Cost Sharing Reductions. In addition to Silver, we have included Bronze and Gold plans. However, understand that only Silver metal plans offer Cost Sharing Reductions. 

Insurance companyInsurance PlanCo-insuranceDeductibleOut-of-Pocket Max Copay PCP/ Specialist$0 Virtual Care PCPAdult Dental/ Vision
BCBS of TexasBlue Advantage Gold HMO 70625%$2000/$4000$8700/$17400$30/$60Fee AppliesDental/Vision as separate policies
BCBS of TexasBlue Advantage Gold 603 HMO40%$1500/ $4500$5000/ $10000$45/40%Fee AppliesDental/ Vision as separate policies
Baylor, Scott, and WhiteElite Gold HMO 01220%$1500/ $3000$9100/$18200$0/$60Fee AppliesNo
Baylor, Scott, and WhitePrime Silver HMO 00840%$3400/ $6800$7250/$14500$30/$70*Fee AppliesNo
BCBS of TexasBlue Advantage Silver 205 HMO50%$1500/ $4500$7250/$14500$15/50%Fee AppliesDental Vision as separate policies
Baylor, Scott, and WhitePrime Silver HMO 00510%$0/$0$7250/$14500$45/$85**Fee AppliesNo

*Adults: No charge for the first two sick visits. Copay thereafter. Children: No copay charge.

**Adults: No charge for first sick visit. Copay thereafter.

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

Whether you live in Roberts, Orange, Kennedy, or El Paso Counties, there aren’t many differences in how you enroll. All insurance companies are bound by Affordable Care Act standards.

When – Affordable Care Act Open Enrollment begins on November 1st and ends December 31st, coverage begins on January 1st. You can also enroll until January 15th. The late enrollment period gives you a start date of February 1st.

You may also enroll if you qualify for a Special Enrollment Period (SEP). You are eligible to enroll at any time under a SEP when:

  • You have 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. – When you move into a new zip code. However, this can also cause your insurance rate to change.
  • You experience a change in your health coverage.If you lose employer-sponsored health insurance or a benefit plan through an alternative source, you can apply for ACA health insurance.

How – The simplest way to apply for health coverage is through the ACA Marketplace. The website guides you through the process. When filling out your application, you can select your plan and see if you qualify for tax subsidies.  

If you have questions about health insurance in Roberts County, contact CoverMile. We’re happy to assist you with finding the best coverage for you and your family and guide you through the sign-up process.

How to Find Doctors Near Me in Roberts County, TX

You don’t need a special cow call to find a doctor living in Roberts County. If you have an existing doctor or need to find one covered under your health insurance plan, it is simple to find answers. The best way is to search for your doctor’s name on your insurance provider’s website. This will let you know if they are in or out-of-network.

Below are the links that will take you to each provider’s website. Their medical directory allows you to search by location, doctor’s name, and facility type. 

Baylor, Scott, and White

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.

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. Can I see any doctor I choose in Roberts County, TX?

    Both BCBS of Texas and Baylor, Scott, and White work with networks. You can search the health insurance company’s website for the doctor’s name or facility you plan to visit. BCBS of Texas has a wider network as they are available statewide. BSW is only available in selected areas of Texas. Visit their website for more information.

  2. Is it better to have a high or low deductible in Roberts County, TX?

    A high deductible will generally bring a lower insurance premium. As you lower your deductible, you increase your monthly premium. Whether it is better to have a higher or lower deductible would depend on one’s health and how much one uses their insurance. We at CoverMile can help you determine which deductible amount would fit your situation. Contact us today.

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

    Blue Cross Blue Shield of Texas and Baylor, Scott, and White are available in Roberts County. However, Oscar Insurance is unavailable through the ACA Marketplace, nor is it sold on the open market through the company’s website.

  4. Does Texas penalize you for not having health insurance in Roberts County, TX?

    The mandate that everyone carry health insurance no longer exists. You are not penalized when you file your taxes as you were before 2019. However, if you do not carry health insurance, you will pay more for your medical care and miss out on many benefits, such as preventive care services.  

  5. Can I talk to a doctor after hours in Roberts County, TX?

    If you are in a non-emergency situation and need to see a doctor after hours, you can contact a doctor through an insurance program’s telehealth program. Most offer services 24/7. All you need is your phone or computer. Most ask a few medical questions and then connect you with a medical professional. It may require a small copay.

  6. Is individual health insurance available in Roberts County, TX?

    Individual health coverage can be purchased through the ACA Marketplace or the open market. If you are low-income and qualify for tax subsidies, you may benefit from applying through the Marketplace. If your income is too high, you can purchase through the open market with insurance companies such as Blue Cross Blue Shield of Texas. If you need help in your search, contact the professionals atCoverMile. We will be happy to help you.

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

    Under the Affordable Care Act 10 Essential Benefits, all plans carry Children’s Dental and Vision benefits. However, these services are limited. Blue Cross Blue Shield of Texas offers adult and children’s Dental and Vision benefit. They are separate from its health insurance plan. Visit their website for more information.