A Complete Guide to Health Insurance in Texas

You’ll want to shop around to find the ideal Texas health insurance option, comparing multiple companies to get the best rate for your needs. There’s no tax penalty if you go without health insurance in the Lone Star State, but getting coverage can better protect you from medical debt if you become sick or suffer an injury.

Keep reading to learn more about health insurance in Texas, the cheapest plans, the health insurance cost in some of the state’s largest cities and what types of health care options are available.

On This Page

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  Is Health Insurance Required in Texas?

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  Texas Health Insurance Rankings

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  How Much Does Health Insurance Cost in Texas?

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  Cheapest Health Insurance Options in Texas

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  What Is the Median Cost of Health Insurance in Texas by City?

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  Which Health Insurance Companies Are the Most Affordable in Texas?

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  When Is Open Enrollment for Health Insurance in Texas?

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  What Types of Health Insurance Are Available in Texas?

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  How To Get Health Insurance in Texas?

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  FAQs

Is Health Insurance Required in Texas?

Texas does not impose penalties or fines on individuals who do not have health insurance.^[1] Since 2019, there has been no federal tax penalty for not having health insurance, however, some states or districts may still impose a penalty.^[2]

Texas Health Insurance Rankings

The Commonwealth Fund ranked Texas 50th out of 51 in a holistic analysis of the health care systems in each U.S. state and Washington, D.C. Texas notably ranked last in terms of access and affordability for health care, alongside income disparity. It also ranked low in other categories, such as avoidable hospital use and cost, alongside prevention and treatment. 

Below is an overview of Texas’ national rank in each of the dimensions analyzed by the Commonwealth Fund:^[3]

How Much Does Health Insurance Cost in Texas?

Marketplace benchmark plans cost $489 per month on average in Texas, slightly less than the nationwide average of $497 per month. On average, Texans pay a monthly premium of $356 for the lowest-cost bronze plan available in the state, $482 for the lowest-cost silver plan and $432 for the lowest-cost gold plan.^[4]

Cheapest Health Insurance Options in Texas

The cheapest Texas health insurance options through the Marketplace are typically in the bronze tier, notable for lower premiums and higher deductibles, copays and coinsurance. 

However, depending on your needs, you may want to consider a higher-tier plan. For example, if you visit the doctor regularly due to a chronic condition or expect a series of treatments throughout the year — such as weight-loss surgery — you may benefit from a plan that offers lower out-of-pocket costs in exchange for a higher premium.

Health maintenance organization (HMO) plans are typically cheaper than preferred provider organization (PPO) plans, but you may lose some benefits. For example, if you choose an HMO plan, you may need to acquire a referral from your primary care physician to see a specialist, and you may be more limited to in-network coverage for non-emergency care.

What Is the Median Cost of Health Insurance in Texas by City?

Below, we’ll review the median monthly rates across all metal tiers for individual health insurance plans for 30-year-olds earning $40,000 per year in five major Texas cities, before considering premium tax credits.^[5]

Which Health Insurance Companies Are the Most Affordable in Texas?

Ambetter offers Texas' most affordable health insurance plans in the silver tier. However, Blue Cross Blue Shield offers the lowest cost gold and bronze tier plans. Below is an overview of Texas health insurers offering an average monthly premium of less than $500 for 40-year-olds purchasing silver plans.^[6]

When Is Open Enrollment for Health Insurance in Texas?

Texas residents can apply for health insurance through the federal Marketplace website during the standard open enrollment period from Nov. 1 to Jan. 15. However, any changes to your enrolled health insurance plan must be made by Dec. 15 to receive that coverage by Jan. 1 of the following year. If any changes are made after Jan. 15, the final day to do so, the plan will begin on Feb. 1 instead.^[7]

Enrollment outside the standard open enrollment period is possible, but typically only by triggering a special enrollment period after a qualifying life event.

These qualifying events can include moving to a new address, having or adopting a child, getting married or losing employer-based health insurance coverage. Depending on the type of event, you typically are given 60 days before or following the event to enroll for health insurance coverage.^[8]

What Types of Health Insurance Are Available in Texas?

Some of the major types of health insurance you can purchase in Texas include the following:

• Marketplace health plans
• Short-term health plans
• Private coverage directly from a provider
• Employer-sponsored group health insurance
• Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation coverage
• Medicare
• Medicaid
• Children’s Health Insurance Program (CHIP)
• Department of Veterans Affairs (VA) health benefits
• Student health plans

How To Get Health Insurance in Texas?

You’ll want to gauge your options by shopping around and gathering health insurance quotes from about three to five insurance providers to compare. You’ll typically need to gather quotes from each insurance company individually, which can become tedious.

You can speed up the process using an insurance marketplace such as SmartFinancial. By answering a few questions, we can connect you with one of our agents to help you find health insurance that meets your needs. Click here to get free quotes for Texas health insurance plans today!