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You are here: Home / Financial Wellness / What is the Average Cost of Health Insurance in Texas?

What is the Average Cost of Health Insurance in Texas?

November 23, 2022 by Janey Danes Leave a Comment

average cost of health insurance in Texas

The older you are, the more you are forced to spend your hard-earned money on health care and health insurance.

Now is the time to evaluate your household items, including your health insurance. Have you thought about your medical insurance cost? What is the average cost of health insurance in Texas?

It doesn’t matter how much you earn. You need to re-evaluate your health insurance to know whether or not it is sufficient for the next year.

How Much is the Average Cost of Health Insurance in Texas? 

It is not easy to give you an answer because the exact cost depends on your circumstance. But it doesn’t mean that there’s no way to know the average cost.

According to a Bloomberg report that you can read here, the average documented cost for family health coverage in Texas is $20,00 a year. That’s $1,667 a month for a family.

However, most families in Texas receive health insurance through their employers. In that case, the worker’s average cost of health insurance is $500 per month. And that is taken out of the worker’s paycheck.

When you think about it, the amount doesn’t sound that bad.

But when you study the out-of-pocket expenses, like co-pays and deductibles, the average cost can go up. Those expenses can quickly escalate.

You should study all your options before picking the right plan.

What is the Cheapest Health Insurance Coverage in Texas? 

It varies by county. But the most affordable is the Blue Advantage Silver HMO. Or you can pick FirstCare Prime Silver HMO.

But just because it is the most affordable, it doesn’t mean that it is the most suitable plan for you.

To determine what’s best for you and your family, you need to evaluate your healthcare costs in a given year.

Then, study the savings you have and know your household income.

If you need expensive healthcare, gold plans are the perfect option. They are designed for people with higher medical needs.

If you need routine prescriptions, a Gold-tier plan is ideal. It has a higher monthly cost, though.

But it can help in reducing your out-of-pocket expenses for your medical care. As a result, you can accumulate significant savings.

Low-Income Consumer

If you have a low income, Silver health plans are ideal as they are designed for the middle ground. They balance out-of-pocket costs and monthly premiums.

They also offer benefits for low-income households. If your income is less than 205% of the federal poverty level, a Silver plan is the best option.

It offers lower monthly premiums compared to the Gold plans. The cost share can also be adjusted to match your expenses.

Young and Healthy

ideal health insurance for young and healthy

If you are still young and healthy, then bronze and catastrophic plans in Texas are ideal.

They have low monthly premiums but they have high out-of-pocket expenses. These also come with high deductibles with low out-of-pocket maximums.

However, just because they have lower monthly premiums, it doesn’t mean that they are ideal for you. Keep in mind that they generally cover nothing until you pay thousands of dollars first.

If you don’t have disposable savings, then these plans can be problematic.

You might find yourself in moderate medical care. You might pay for the cost yourself when it comes to some medical expenses.

What are the Health Insurance Options in Texas? 

There are various options available here are the most common:

Affordable Care Act (ACA)

The policies are sold on the Exchange. They also have different coverage levels. Some plans have higher deductibles and they can be cost-effective in lowering your monthly costs by 20%.

But if you are hospitalized, the expenses can skyrocket. Thus, you need to balance your monthly premiums and healthcare expenses.

Short Term Plans

They are an attractive option for many Texas. They can exclude required components of health insurance plans that are available on the Exchange.

The cost savings can be significant if you are not dealing with pre-existing conditions that would exclude you from clearing underwriting.

And most short-term plans offer maternity benefits.

Major Medical Plan

It mirrors the Affordable Care Act requirements. The plans are sold through association benefits. Thus, they can be accessed through your employers, if you are employed.

Because of that, they offer better coverage at a better price.

Compare Plans 

When finding the best health insurance, make sure to look at the costs. Not just the monthly premiums but the deductibles, coinsurance, and out-of-pocket maximum.

If you want lower premiums, you can choose HMOs. However, they have restrictions.

PPOs offer more freedom if you want to get better out-of-network care.

Deductible and Premium

If you don’t need much healthcare, you may want a lower premium with a high deductible.

But if you need to see a doctor regularly, consider a higher premium with lower out-of-pocket costs.

Weigh the Pros and Cons

Don’t just stop there. When comparing plans, dig into the details about the benefits and weigh the pros and cons of PPOs, HMOs, EPOS, and other plans being offered.

You should also check the list of providers to ensure that your preferred doctors and hospitals are in-network. Keep in mind that if you choose HMO and your preferred doctor is not in your plan’s network, you may not get coverage for the medical care you get from that doctor. It really depends on your plans. That’s why you must study each plan before you choose one

Study Your Prescription

If you are taking medicines, make sure that your plan covers most of the medicines you’re taking. And if some of your prescription drugs are not included, find out how much out-of-pocket expenses you will have to pay.

And if you need a 24/7 nurse, make sure that your health plan covers it. Otherwise, you will have to shoulder the entire cost.

The Cost of Health Insurance 

The average cost of health insurance in Texas will depend on a variety of factors. Ideally, you contact a health insurance agent to help you out. Or use a comparison shopping tool to assist you in finding the best medical insurance that can pay for your medical costs.

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