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MoneyGeek Logo IconBest Health InsuranceTexas
2023

Best Health Insurance in Texas

Best Overall for Health Insurance in Texas

According to our research, Ambetter from Superior Health Plan is the best overall health insurance company in Texas, earning a 73 out of 100 MoneyGeek score. The company was rated high for its affordable rates and claims management. It also approves most claims.

To choose the winner in this category, MoneyGeek collected data from 31 Silver EPO plans and 56 HMO plans in Texas.

MoneyGeek Pick: Ambetter from Superior Health Plan

Ambetter from Superior HealthPlan

pros

Accepts most claims

Affordable rates

Low MOOP costs

cons

Limited plans available

COMPANY HIGHLIGHTS

Ambetter from Superior Health Plan is our pick for the best overall Texas health insurance company. Its six Silver plans are all HMOs (Health Maintenance Organizations). HMO plans are inexpensive, but you must stay inside your provider network for treatments to be covered.

Ambetter from Superior Health Plan typically charges approximately $524 per month for health insurance with an average MOOP of $7,949. With an average denial rate of 0%, the plan is likely to approve most insurance claims and pay for any qualifying medical services.

Plan Recommendations

MoneyGeek recommends the following Silver plans that Ambetter from Superior Health Plan offers in Texas:

  • Clear VALUE Silver: approximately $487 per month; MOOP $5,400
  • Focused VALUE Silver: approximately $485 per month; MOOP $7,500
  • Complete VALUE Silver: approximately $492 per month; MOOP $8,500

Best Health Insurance in Texas for Low Out-of-Pocket Costs

Moda is the best health insurance provider in Texas for low out-of-pocket expenses, with a MoneyGeek rating of 84 out of 100. The company also obtained good ratings for affordability and claims denial, as well as affordable rates and a low MOOP.

MoneyGeek examined 40 Gold HMO plans and 15 Gold EPO Plans in order to rank the best in this category.

MoneyGeek Pick: Moda

Moda Health

pros

Low MOOP costs

Doesn’t deny many claims

Offers affordable monthly premiums

Ranked well in terms of plan types compared to competitors

cons

Only EPO plans are offered

COMPANY HIGHLIGHTS

Moda offers three Gold EPO plans in the state of Texas. The average MOOP cost for these plans is $7,900, one of the lowest in the state. The monthly average premium for this provider's health plans is $454, which is more affordable than most others we compared. Moda almost never denies policyholder claims.

The company exclusively offers EPO plans, which are great for lower monthly costs but lack provider flexibility, so that is one potential drawback. Unlike HMO plans, you might not necessarily require a referral to see a specialist.

Plan Recommendations

For Texas residents, we suggest the following Moda low-MOOP health plans:

  • Moda Select Gold 1800: approximately $449 per month; MOOP $7,000
  • Moda Select Gold 1000: approximately $459 per month; MOOP $8,000
  • Moda Select Texas Standard Gold: approximately $454 per month; MOOP $8,700

Best Cheap Health Insurance in Texas

According to MoneyGeek, Ambetter from Superior Health Plan offers the best low-cost health insurance in Texas, earning a MoneyGeek score of 76 out of a possible 100.

We scored this area differently, giving greater weight to premium affordability. Keep in mind that out-of-pocket expenses are typically higher for plans with lower monthly premiums. If you don't think you'll need much care, this trade-off can be worthwhile.

We examined 31 Silver EPO plans and 56 Silver HMO plans to identify the category's winning company and recommended plans.

If you're focused soley on cost, MoneyGeek also determined the cheapest health insurance in Texas.

MoneyGeek Pick: Ambetter from Superior Health Plan

Ambetter from Superior HealthPlan

pros

Doesn’t deny valid claims

Low MOOP costs

Affordable rates

cons

Offers limited plan types

COMPANY HIGHLIGHTS

Ambetter from Superior Health Plan carries a $524 monthly premium on average. The average monthly out-of-pocket expense for its health plans is $7,949. With its 0% denial rate, this company also excels at handling policyholder claims.

Ambetter from Superior Health Plan offers only six Silver HMO plans to Texas residents. If you want low monthly payments and are comfortable keeping inside your provider's network when you need treatment, these plans can work for you.

Plan Recommendations

  • Clear VALUE Silver: approximately $487 per month; MOOP $5,400
  • Focused VALUE Silver: approximately $485 per month; $7,500 MOOP
  • CMS Standard Silver VALUE: approximately $485 per month; MOOP $8,900

Best Health Insurance for Low Income in Texas

The best affordable health insurance in Texas for individuals with low income, according to MoneyGeek, is from Moda, which received a score of 75 out of 100.

MoneyGeek’s study exclusively rated providers offering plans with cost-sharing reductions (CSRs) and low monthly prices. In Texas, this included 31 Silver EPO and 56 Silver HMO plans.

Earning below 250% of the federal poverty level (FPL) can qualify you for CSR discounts that reduce MOOPs and deductibles, letting you avoid the trade-off between higher out-of-pocket costs and cheaper premiums. CSR policies have more cost-sharing than basic Silver plans, which cover around 70% of medical expenses. For Texas residents:

  • Earning between $27,180 and $33,975 yearly (201% to 250% of the FPL) qualifies them for a plan that covers around 73% of medical expenses.
  • Earning between $20,385 and $27,180 (151% to 200% of the FPL) qualifies for a plan covering roughly 87% of medical expenses.
  • Plans covering around 94% of medical expenses are available to those with annual incomes below $20,385 (up to 150% of the FPL).

These brackets change based on the number of people living in your home.

MoneyGeek Pick: Moda

Moda Health

pros

Affordable premiums

Low MOOPs

Ranked well for denied claims

Has a reasonable number of plans

cons

Only offers EPO plans

COMPANY HIGHLIGHTS

For Texans who lack sufficient means or finances, Moda can be the best option. Its low-income health plans cost an average of $6,563 MOOP and $523 per month for people with incomes below 250% of the FPL. The company has a low percentage of denied claims, indicating that it accepts most legitimate claims.

In Texas, Moda provides four different EPO plans.

Plan Recommendations

Moda Select Silver 3500 from Moda is the top plan for low-income residents in Texas. They have access to the following plans based on their income levels, all for the same premium and different but considerably lower MOOP costs:

  • 201% to 250% of the FPL: approximately $522 per month; MOOP $6,350
  • 151% to 200% of the FPL: approximately $522 per month; MOOP $2,000
  • Up to 150% of the FPL: approximately $522 per month; MOOP $750

Best Health Insurance for Young Adults in Texas

Moda offers the best health insurance for young adults in Texas, as determined by a MoneyGeek score of 88 out of 100.

We identified the best insurers for young adults by evaluating providers offering Bronze or Catastrophic policies, which have the lowest premiums but the most out-of-pocket expenses. Only individuals under 30 years of age can purchase Catastrophic plans.

For this analysis, we evaluated the following numbers of plan types and tiers in Texas:

  • Bronze: Five EPO and 14 HMO plans
  • Expanded Bronze: 18 EPO plans and 33 HMO plans
  • Catastrophic: Two HMO plans

MoneyGeek Pick: Moda

Moda Health

pros

Rarely denies claims

Low MOOPs

Cheap premiums

Offers a reasonable number of plans

cons

Only offers EPO plans in Texas

COMPANY HIGHLIGHTS

Young adults in Texas can purchase health insurance through Moda for an average cost of $268 per month and a MOOP of $8,233. It offers two Expanded Bronze EPO plans and 10 Bronze EPO plans. This company only rejects around 4% of insurance claims, which is significantly less than the majority of other providers in the state.

The level of protection you'll have depends on the metal tier of your plan. Young adults commonly opt for Catastrophic, Bronze or Expanded Bronze plans because they are typically in good health and don't require extensive coverage.

Plan Recommendations

Moda's best health plans for young adults in Texas are as follows:

  • Moda Select Bronze HSA 6900: approximately $250 per month for 18-year-olds and $281 per month for 26-year-olds; MOOP $6,900
  • Moda Select Texas Standard Bronze: approximately $229 per month for 18-year-olds and $257 per month for 26-year-olds; MOOP $9,100
  • Moda Select Bronze 8700: approximately $238 per month for 18-year-olds and $267 per month for 26-year-olds; MOOP $8,700

Best Health Insurance by Plan Type in Texas

Health insurance companies typically offer various plan types. Here are the best providers in Texas for all available plan types:

  • HMO: Ambetter from Superior Health Plan (MoneyGeek score: 95 out of 100)
  • EPO: Moda (MoneyGeek score: 72 out of 100)

Our recommendations are limited to Silver plans. In terms of cost and coverage, this metal tier strikes the ideal balance, making it the best option for the average individual looking for affordable health insurance premiums.

There are 56 Silver HMO plans and 31 Silver EPO plans in Texas.

MoneyGeek Pick for HMO: Ambetter from Superior Health Plan

Ambetter from Superior HealthPlan
COMPANY HIGHLIGHTS

Ambetter from Superior Health Plan has six HMO Silver plans costing $524 per month on average and $7,949 MOOP. It had the lowest MOOP cost and was rated high for claims management in our comparison.

HMO (Health Maintenance Organization) plans are the most common of all health insurance plan types. Compared to other insurance plans, they offer cheaper monthly premiums, but their services are limited to the hospitals and providers within their network. To visit a specialist, you'll also need a referral.

Plan Recommendations

For those looking for Silver-tier HMO plans in Texas, we recommend:

  • Clear VALUE Silver: approximately $487 per month; MOOP $5,400
  • Focused VALUE Silver: approximately $485 per month; MOOP $7,500

MoneyGeek Pick for EPO: Moda

Moda Health
COMPANY HIGHLIGHTS

In Texas, Moda offers four EPO Silver plans with an average monthly cost of $523 and an average MOOP of $8,213. This insurer rarely rejects health insurance claims.

EPO plans function like HMOs, except you are not required to get a referral before seeing a specialist. In comparison to HMO plans, they are more expensive options that provide more flexibility of choice.

Plan Recommendations

MoneyGeek recommends the following Silver EPO plans from Moda:

  • Moda Select Silver 6400: approximately $530 per month; MOOP $7,400
  • Moda Select Silver 4800: approximately $524 per month; MOOP $7,850

Best Short-Term Health Insurance in Texas

According to MoneyGeek's ratings, National General Accident & Health is the best provider of 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.

mglogo
MoneyGeek Top Pick: National General Accident & Health
National General Accident & Health

National General Accident & Health is our top option due to its high coverage limits, flexible term lengths and low out-of-pocket maximums among most insurance carriers in Texas. It has many products, such as temporary health insurance, accident, critical illness and dental plans.

How to Find the Best Health Insurance for You in Texas

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.

  • doctor icon

    Understand when a health insurance plan will cover you

    HMO plans limit coverage to treatment received inside your provider's approved network. EPO plans work similarly, but you do not need referrals to visit specialists. Both these plan types are ideal if you are prepared to receive treatments from in-network providers and doctors. EPO plans are generally more expensive than HMO plan types. There are 100 EPO plans and 201 HMO plans in Texas.

  • money2 icon

    Weigh the cost of premiums vs. the cost of care

    Typically, plans with lower monthly premiums have higher out-of-pocket expenses. Ambetter from Superior Health Plan's Focused VALUE Silver plan is offered at an average premium of $485 and a maximum out-of-pocket cost of $8,500, while its Ambetter Virtual Access Silver plan is offered at an average premium of $535 and a maximum out-of-pocket cost of $7,400. This indicates that if your premiums are lower, you may end up paying more out-of-pocket in a given year.

Consider Texas Medicare or Medicaid if You’re Eligible

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:

  • Part A (hospital insurance): Free and provides coverage for hospital stays, hospice care, a few home health care services and nursing facilities.
  • Part B (medical insurance): Covers services like outpatient care, doctor visits and preventive services.
  • Part D (prescription drug coverage): Covers prescription drugs and vaccines.

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.

Frequently Asked Questions About Health Insurance in Texas

When looking for health insurance plans, availability and price can be concerns. We answered some questions about health insurance in Texas.

About Brenna Kelly, Licensed Health Insurance Agent


Brenna Kelly, Licensed Health Insurance Agent headshot

Brenna Kelly is a licensed health insurance agent and health insurance content manager at MoneyGeek. Licensed in Florida, Brenna is qualified to advise on medical insurance, disability, long-term care, critical illness, Medicare Supplements and Medicare Advantage Plans. She combines her experience in content production with expert insight into state, regional and local health insurance markets and policies. Brenna has also earned a Bachelor of Science and Master of Arts in Applied Sociology from the University of Central Florida.