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How Much Does Health Insurance Cost in Texas?

How Much Does Health Insurance Cost in Texas? | Very Good Coverage

If you’re looking for a Texas health insurance plan, your main aim should be to know how much it does cost to have health insurance in Texas.

Although it’s not compulsory under the state law for Texas residents to have health insurance, the Affordable Care Act has made it a lot easier for more people to get health insurance. And because the importance of having health insurance can no longer be downplayed, you should purchase health insurance if you do not have health insurance from your employer or simply looking for private health insurance. As such, it’s important to know how much it does cost to have health insurance in Texas.

The average cost of health insurance in Texas is $440 per month. While health insurance doesn’t have many discounts as auto insurance and homeowner insurance, there are cheap and subsidized policies offered on the Texas health insurance marketplace, and you can take advantage of this.

Even though the open enrollment period for 2021 health insurance plans is long overdue, we still believe that it can be helpful to get a sense of how much health insurance costs in Texas.

The Current Health Insurance Rates in Texas

As with many things, health insurance premiums and the cost of health insurance in general always change yearly. Whether you choose to buy your health insurance from the federal health insurance marketplace or a private insurer, it’s important to note that the premiums must first be approved by the federal health insurance exchange before they’re set.

This means that you cannot be charged beyond a certain threshold as this would mean that the health insurance provider is going against the law. As noted earlier, the average cost of health insurance in Texas is $440 per month for individual coverage. Let’s break it down based on every metal tier.

  • Catastrophic - $336 per month
  • Bronze - $393 per month
  • Expanded Bronze - $510 per month
  • Silver - $547 per month
  • Gold - $680 per month

You have to keep in mind that these figures are set by the state’s health insurance marketplace and may fluctuate from one provider to the other but shouldn’t go above this threshold. You also have to remember that the cost of health insurance in Texas will vary and the premiums can be much lower if you’re in good health.

The Cost of Short-term Health Insurance in Texas

As a Texas resident, you have the right and option of buying short-term health insurance. This is per the federal guidelines, which the Lone Star state follows. It stipulates that you can purchase short-term health insurance coverage for one year and renew it for up to 36 months.

You, however, have to note that federal regulations stipulate that short-term health insurance shouldn’t cover essential health benefits such as prescription drugs, maternity care, and mental health services. That being said, you should make sure that the short-term health insurance plan covers your healthcare needs before enrolling.

You also have to keep in mind that short-term health insurance plans will require you to take medical exams and you can be denied coverage if you have pre-existing conditions.

As far as the cost of short-term health insurance is concerned, it can vary widely from company to company. Again, the variance may depend on your area or county, so it’s pretty much difficult to note the exact cost of short-term health insurance in Texas. But even with that, short-term health insurance in Texas tends to:

  • Offer budget-friendly monthly premiums
  • Offer health insurance coverage as you search for a long-term option

The Cost of Health Insurance by Family Size in Texas

Needless to say, the cost of any health insurance will be different based on certain factors including:

  • Size of your family
  • Household income, and
  • Your chosen policy

As such, the cost of your health insurance will increase based on each family member added to your insurance policy. The increase in your monthly premium may also be influenced by the age of the family member added to your insurance policy.

For example, it will cost you $305 more to add children aged 14 and younger to a silver plan in Texas. On the other hand, it would cost an additional $509 to add a 40-year-old to your silver plan. Again, you’d have to pay $610 more per month to insure a family of five than a family of three.

Let’s break it down in terms of the average monthly cost of health insurance by family size in Texas. Note that this is based on a silver plan and the adults are assumed to be aged 40.

  • An individual plus a child - $814
  • A couple - $1,019
  • A family of three consisting of a couple and a child - $1,324
  • A family of four consisting of a couple and two children - $1,628
  • A family of five consisting of a couple and three children - $1,933

Factors that may affect the Cost of Your Health Insurance Plan in Texas

Like anywhere else across the country, several factors can affect the cost of your health insurance plan. They include:

Your Body Mass Index (BMI)

It’s a known fact that a high BMI can cause chronic conditions such as high blood pressure, diabetes, and heart disease. As such, having a high BMI would increase the cost of your health insurance cost in Texas.

It’s, therefore, important that you eat right, exercise, and lead a healthier lifestyle. This will help in losing weight and lowering your BMI, which will in turn reduce the cost of your health insurance in Texas.

Tobacco Usage

According to statistics, 16% of Texas residents smoke tobacco.  Unfortunately, the cost of your health insurance in Texas will be much higher if you’re a smoker. It’s assumed that tobacco users are more vulnerable and may suffer from diseases such as lung cancer, respiratory problems, erectile problems, and many more.

That being said, you should quit using tobacco and your health insurance cost in Texas might be much lower.

Your Age

Your age will affect your cost of health insurance in Texas. In short, you’ll pay much higher premiums if you are older than if you are younger. The idea here is that younger people tend to have fewer health problems than their older counterparts and will pay less.

Of course, you can’t do much to change your age but it’s essential to improve your overall health so that you do not have major medical complications. This would then mean that you have to pay less for your health insurance since you’re in great shape health-wise and rarely visits a doctor or specialist.

How to Choose an Affordable Health Insurance Plan in Texas

Choosing an affordable health insurance plan in Texas generally depends on understanding the type of coverage that you need. As such, here are a few things that you should know.

Do you have Higher Medical Needs?

If you have a medical condition and anticipate that you’ll have regular visits to the doctor, higher drug prescriptions, or more-than-average medical care needs in 2021, you should consider going for a gold plan.

Although it’s one of the most expensive health insurance plans not just in Texas but in the entire country, it may work best for you if you anticipate regular medical issues during the year. This is because a gold plan will offer higher coverage and lower out-of-pocket expenses whenever you need care.

Are You Young and Healthy?

It’s natural for you to wonder why there’s a lot of fuss about health insurance when you’re young and healthy. You may be young, energetic, healthy, and might perhaps think that you don’t need health insurance.

But the truth is, life does happen and even a broken arm (God forbid) can sneak up on you during your outdoor adventures. The costs of medical care will be extremely high, and so you might see the essence of having health insurance.

So if you are young and healthy, you can consider catastrophic or bronze plans just in case you find yourself in a situation where you need coverage. Such plans have low premiums but very high deductibles and out-of-pocket costs.

What’s Your Average Household Income?

Your average household income will affect the cost of your health insurance plan in Texas. This is why you should try to find the right balance between the monthly premiums and out-of-pocket costs depending on your average household income.

As such, you should look for insurance coverage that has affordable monthly premiums as well as reasonable out-of-pocket costs. If you are a low-income individual or family (250% below the federal poverty level), you can choose the silver plan and also apply for federal subsidies that can help in lowering the cost of health insurance.

Tips on How to Make Your Health Insurance in Texas more Affordable

Here are a few tips to make your health insurance in Texas more affordable.

Choose a Health Insurance Plan that Suits Your Needs

You should choose a health insurance plan based on your medical needs. You have to remember that some plans have high premiums and low out-of-pocket costs and vice versa.

For example, if you have a medical condition and anticipate that you may have regular visits to the doctor, you can go for a Gold plan that has high premiums but low out-of-pocket costs. On the other hand, you can go for the bronze plan if you’re young and healthy and do not anticipate regular visits to the doctor during the year.

Understand Your Plan’s Benefits

It’s important to know the benefits and coverage that your health insurance plan offers before enrolling. You should understand what’s included and what’s not.

Exhaust Prescription Discounts

You should take a keen look at your plan and see whether there are discounts for certain prescription drugs and services. You can exploit such discounts and save on the costs of prescription drugs. For example, you can choose to use a generic version of your drug if it’s allowed.

Stay in-network

Using a particular network is a great way of lowering the costs of your medical insurance. Here are different types of health insurance plans. You can learn more and understand how they work and why it’s important to stay in-network.

Exploit Membership Incentives

Some health insurance plans offer membership discounts in the form of gym memberships, vision services as well as incentives to quit smoking, exercise more, and lose weight. Take advantage of these membership perks and you’ll save on the money that you’d otherwise spend somewhere else to get these services.

Maintain Your Health

In addition to making you feel good and vibrant, maintaining and improving your health can help you save a lot in health insurance costs. You have to keep in mind that your health insurance costs in Texas will be high if your health is poor, so you need to eat right, exercise more, and go for regular health screenings while also encouraging your family members to do the same.


Greg McKnight

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