Updated: October 25, 2024
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Best Health InsuranceTexasBest Health Insurance in Texas
Why Trust MoneyGeek? We downloaded plan data for Texas directly from the Centers for Medicare & Medicaid Services (CMS). MoneyGeek’s scoring methodology balances costs, claims approval and plan types to find the best providers in the state.
Plan data was updated with the CMS exchange data released in October 2023 for the 2024 enrollment period.
Ambetter offers the best health insurance in Texas with a MoneyGeek score of 63 out of 100. Ambetter has affordable plan options and low out-of-pocket costs, and it approves more claims than average.
We evaluated a total of 77 Silver plans in Texas, including EPO, POS and HMO plans, for this analysis.
Few denied claims
Low out-of-pocket maximum costs
Only offers HMO and EPO plans
Above-average premium rates
MoneyGeek's top pick for the best health insurance in Texas is Ambetter. The provider offers eight Silver EPO plans and six Silver HMO plans. The average premium for these Silver plans is $577 per month, and the average MOOP cost is $5,400.
EPO plans offer more flexibility as they don't require referrals for specialists. HMO and EPO plans both typically require members to stay within their network for services, except in emergencies. Ambetter has a denial rate of 14.84%, which is lower than most of the competition, meaning members are more likely to have their claims approved.
Plan Recommendations
MoneyGeek recommends the following Silver plans:
Oscar Health is the best health insurance in Texas for low out-of-pocket costs, with a MoneyGeek score of 78 out of 100. The company offers plans with affordable premiums and does not deny many claims.
For this analysis, we evaluated 62 Gold plans in Texas.
Affordable premiums
Low out-of-pocket costs
Denies fewer claims than average
MoneyGeek's top pick for the best health insurance in Texas for low out-of-pocket costs is Oscar. It offers six Gold EPO plans. EPO plans provide a network of doctors and hospitals you can visit without needing a referral.
Oscar offers plans with an average premium of $485 and an average maximum out of pocket cost of $7,067. The insurer has a claims denial rate of 11.72%, which is lower than most of the competition.
Plan Recommendations
MoneyGeek recommends the following Gold and Platinum plans:
Aetna is the best cheap health insurance provider in Texas, earning a MoneyGeek score of 70 out of 100. The provider offers plans with the lowest rates, and it has a better-than-average record for approving claims.
For this category, MoneyGeek evaluated 24 Silver EPO plans, 3 Silver POS plans and 50 Silver HMO plans. In picking the best cheap plan, MoneyGeek paid more attention to plans with low monthly costs. Usually, paying less each month for health insurance means you will likely have to pay more when you actually get care.
Affordable premiums
Denies more claims than average
Only provides HMO plans
MoneyGeek's top pick for the best cheap health insurance in Texas is Aetna. It offers five different Silver plans, which can help families find an affordable choice for their medical needs. Aetna provides Silver HMO plans in Texas. HMO plans require you to see doctors in the plan's network except in emergencies.
Aetna offers an average premium of $518 and an average maximum out of pocket cost of $8,765. Aetna has a claims denial rate of 21%, which is higher than most of the competition, so members have a higher likelihood of not having their claims approved.
Plan Recommendations
MoneyGeek recommends the following cheap Silver plans:
Aetna offers the best health insurance in Texas for those with low income, scoring 66 out of 100 and offering the cheapest plan options. We evaluated 24 Silver CSR EPO plans, 50 Silver CSR HMO plans and 3 Silver CSR POS plans in Texas for this analysis.
In our analysis, we prioritized plans with low monthly premiums and included only those with cost-sharing reductions (CSRs). CSRs help lower your out-of-pocket costs and deductibles if your income is within certain brackets, so you don't have to choose between paying less each month and paying less when you need care.
A regular Silver plan covers about 70% of healthcare costs, but CSR Silver plans cover more, based on the following brackets:
These income brackets can change depending on how many people live in your home.
Low premiums
Offers HMO plans only
Denies more claims than average
MoneyGeek's top pick for the best health insurance in Texas for low-income individuals is Aetna. This provider offers cost-effective plans for those earning below 250% of the FPL. Aetna provides five Silver CSR plans to Texas residents eligible for these offerings at an average premium of $518 per month. The average MOOP cost for these plans is $7,259.
Aetna does not offer any PPO or POS plans in Texas. However, EPO plans often have more affordable monthly premiums. The company's denial rate is 21%, which means it denies slightly more claims than average.
Plan Recommendations
Aetna's top-rated plan offers lower out-of-pocket expenses for the same premium for people in different income brackets. Here are some of the lower overall out-of-pocket costs based on income levels:
Moda offers the best health insurance in Texas for young adults, with a MoneyGeek score of 78 out of 100. Moda provides plan options that are among the cheapest, it has MOOP costs that are lower compared to other companies and it denies few claims.
To find the best insurance for young adults, we looked at several plans, including one Bronze POS plan, five Bronze HMO plans, 29 Expanded Bronze HMO plans, 14 Expanded Bronze EPO plans, two Expanded Bronze POS plans and 2 Catastrophic HMO plans. Only individuals under age 30 can choose Catastrophic plans.
Affordable premiums
Low out-of-pocket costs
Few claims denied
Only offers EPO and HMO plans
MoneyGeek's top pick for the best health insurance in Texas for young adults is Moda. For those who might not need a lot of health services, there are three Expanded Bronze plans and one Catastrophic plan available. Moda does not offer PPO or POS plans in Texas.
The average premium for these plans is $290, the average maximum out of pocket cost is $8,533. Moda has a denial rate of 15%, which is lower than most of the competition.
Plan Recommendations
MoneyGeek recommends the following plans for young adults:
Health insurance companies offer a variety of plans for different needs. The best providers for all plan categories are:
-[EPO]: Ambetter (MoneyGeek score: 62 out of 100) -[HMO]: Ambetter (MoneyGeek score: 71 out of 100) -[POS]: Blue Cross Blue Shield (MoneyGeek score: 100 out of 100)
MoneyGeek's recommendations are based on Silver plans. Silver plans usually balance monthly costs and what you pay when you get care. In Texas, there are 24 Silver EPO plans, three Silver POS plans and 50 Silver HMO plans available.
MoneyGeek's top pick for the best health insurance in Texas for Silver EPO plans is Ambetter. It offers eight plans, with an average premium of $591 and an average maximum out of pocket cost of $7,750. Ambetter has a claims denial rate of 14.84%, which means it denies fewer claims than average.
Silver EPO plans are popular for several reasons, including that you generally will not need a referral to see a specialist. However, there are some downsides — for example, you must visit doctors in the plan’s network unless it’s an emergency.
Plan Recommendations
We suggest the following Silver EPO plans from Ambetter:
MoneyGeek's top pick for the best health insurance in Texas for Silver POS plans is Blue Cross Blue Shield, which offers three different plans. It has an average plan rate of $641, and the average maximum out of pocket cost for these plans is $9,333. The provider denies around 17% of claims, which means it denies fewer claims than average.
Silver POS plans let you see in-network doctors at a lower out-of-pocket cost but also allow you to get care outside the network at a higher cost. They also require a referral to see specialists.
Plan Recommendations
We suggest the following Silver POS plans from Blue Cross Blue Shield:
MoneyGeek's top pick for the best health insurance in Texas for Silver HMO plans is Ambetter. It offers an average plan rate of $565, and the average maximum out of pocket cost for these plans is $8,064. The provider has a denial rate of 14.844%, which is good because it denies fewer claims than average.
Silver HMO plans can be a good choice because they usually have the cheapest monthly premiums. However, you can only go to doctors in the plan's network unless it's an emergency. To see a specialist, you need a referral from your regular doctor. These plans work well if saving money each month is important and the doctors in the network are close by.
Plan Recommendations
We suggest the following Silver HMO plans from Ambetter:
According to MoneyGeek's ratings, National General Accident & Health is the best short-term health insurance in Texas, with a score of 95 out of 100. Since short-term health insurance doesn't provide all the necessary health benefits that are available with Affordable Care Act (ACA) compliant plans, it is ideal for temporarily addressing coverage gaps.
National General Accident and Health stands out because it offers a wide range of plan options to accommodate various health care demands. For high-risk patients, the company offers plans with modest co-insurance and out-of-pocket expenses. Plans can have durations of three months to three years and offer several options for cost-sharing and prescription drug coverage.
In Texas, the best health insurance for you will depend on your medical needs and how much you are willing to spend on monthly payments. You may choose to pay more each month in premiums to avoid paying as much when you need treatment or the opposite.
You may find the following tips helpful if you are shopping for health insurance in Texas.
Understand when a health insurance plan will cover you
In-network coverage is when your health insurance pays for care from doctors and hospitals it has deals with. Out-of-network is care from those without deals with your insurance. Some plans let you use both types, while others limit you to just in-network.
Texas has different plans. Some let you pick any doctor, and others offer lower costs by making you stick with certain doctors. Texas has 24 EPO plans and 50 HMO plans. There are also three POS plans available.
Weigh the cost of premiums vs. the cost of care
When choosing the best health insurance, think about how much you pay each month and the highest yearly cost for services. Plans with low monthly payments often mean you pay more if you need care. Look for a balance that works for you based on how often you need medical care.
For example, the Silver plan from Ambetter with the lowest MOOP ($5,400) is the Clear VALUE Silver, which costs $521 each month. This is around the same as other Silver plans, but it has a lower MOOP, making it a decent choice.
Medicare is a federal health insurance program for people 65 and older, people with disabilities or those with certain medical conditions. Its monthly payments depend on the policyholder’s income and plan type. It comprises three parts:
MoneyGeek also offers details about the best Medicare Advantage and best Medicare Supplement plans in Texas.
Medicaid, a free federal program, provides health coverage to Texans whose income falls below a state-mandated limit. This coverage is only available to those who meet the state-specific requirements. To be eligible, you must typically come from a household with a very low income, have children with a low income, be pregnant or have a disability.
Finding an ideal health insurance plan can be complicated due to concerns about price and availability. MoneyGeek answers some frequently asked questions to help you research options.
The best health insurance in Texas for 2024 is provided by Ambetter. However, the best choice for you will depend on your unique circumstances and needs.
A plan with reasonable prices and sufficient coverage is what you should be looking for. Despite offering reduced prices, some plans and companies might only offer a few services that may not suit all your medical needs. Your unique needs will determine what the best health insurance plan for you is.
About Mark Fitzpatrick
Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.
Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
