Texas health insurance plans are available in three major plan types: HMO, EPO, and POS. Each restricts or expands your provider access differently, and that difference shows up in your monthly premium. To put Texas rates in context, see how they compare to the average health insurance costs nationally across all plan types and metal tiers.
How Much Does Health Insurance Cost in Texas? (2026 Rates)
Updated: March 23, 2026
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Key Takeaways
A 40-year-old on a Silver HMO plan in Texas pays an average of $739 per month. Silver POS plans average $858 per month and Silver EPO plans average $777.
Age is the largest cost driver. A 60-year-old pays roughly 3x more than an 18-year-old for the same Silver HMO plan under ACA rules.
If your household income falls between 100% to 400% of the Federal Poverty Level, you may qualify for advance premium tax credits (APTC) that can reduce your monthly premium. Check eligibility at HealthCare.gov before the November 1 Open Enrollment start date.
Texas Health Insurance Cost by Plan Type
Texas HMO Plan Cost
HMO (Health Maintenance Organization) plans require you to choose a primary care physician and get referrals to see specialists. That referral requirement comes with a tradeoff: lower premiums than EPO and POS plans. A 40-year-old in Texas pays an average of $437 per month for a Catastrophic HMO plan, the lowest starting point across all metal tiers. Gold plans cost $637 with an average deductible of $1,137, while Silver plans cost $739 monthly with an average deductible of $2,791.
Texas HMO plans are available in five metal levels, including Catastrophic, Bronze, Expanded Bronze, Silver, and Gold. Catastrophic plans are only available to adults under 30 or those who qualify for a hardship or affordability exemption.
Data filtered by:
40
| 40 | Catastrophic | $437 | $10,600 | $10,600 |
| 40 | Bronze | $493 | $7,600 | $7,600 |
| 40 | Expanded Bronze | $487 | $7,535 | $5,559 |
| 40 | Silver | $739 | $5,660 | $2,791 |
| 40 | Gold | $637 | $6,334 | $1,137 |
Texas EPO Plan Cost
EPO (Exclusive Provider Organization) plans provide a middle ground between the referral requirements of HMOs and the flexibility of PPOs. You get specialist access without a referral, but you're locked into the network for all non-emergency care.
In Texas, EPO plans for a 40-year-old start at $535 per month for Expanded Bronze, which is the only entry-level tier available for this plan type. Gold plans average $678 per month and come with a $1,184 deductible, which is less than half of Silver’s $2,720. Gold plans also cost $99 less per month than Silver plans, which average $777. There are no Catastrophic or standard Bronze EPO options on the state Marketplace.
Data filtered by:
40
| 40 | Expanded Bronze | $535 | $7,078 | $5,378 |
| 40 | Silver | $777 | $5,707 | $2,720 |
| 40 | Gold | $678 | $5,920 | $1,184 |
Texas POS Plan Cost
POS (Point of Service) plans allow you to see out-of-network providers at a higher cost while still benefiting from coordinated care through a primary doctor. For a 40-year-old, Bronze and Expanded Bronze plans have lower premiums, averaging $548 and $535 per month respectively, but they come with higher deductibles and out-of-pocket limits. Gold plans cost $720 per month but offer lower deductibles and reduced overall cost-sharing.
Data filtered by:
40
| 40 | Bronze | $548 | $7,950 | $5,475 |
| 40 | Expanded Bronze | $535 | $7,678 | $4,906 |
| 40 | Silver | $858 | $5,851 | $1,769 |
| 40 | Gold | $720 | $6,675 | $1,225 |
What Affects Health Insurance Costs in Texas?
Age, metal tier, rating area, tobacco use and plan type affect your Texas health insurance cost:
Age
Under ACA rules, premiums increase roughly 3% for each year of age. Texas insurers charge 60-year-olds up to 3x the premium paid by an 18-year-old for the same Silver HMO plan. For a Silver HMO at age 40, the statewide average is $739/month. At age 60, that same tier can exceed $1,500/month before subsidies.
Metal Tier
Bronze plans carry the lowest monthly premium but the highest deductible and out-of-pocket exposure. For a 40-year-old Texas POS enrollee, a Silver plan averages $858 per month while a Bronze POS averages $548, a $310 difference. Bronze POS plan deductibles average $5,475 compared to $1,769 for Silver. If you use medical services regularly, Silver's lower deductible offsets the higher monthly premium.
Rating Area
Texas uses 26 rating areas to set premiums, meaning where you live directly affects your monthly rate. Premiums in rural West Texas and the Rio Grande Valley can differ by $100 or more per month compared to the Dallas-Fort Worth or Austin metro areas, even for the same plan type and metal level. Always check rates specific to your county, not just the statewide average.
Tobacco Use
Texas allows insurers to apply a tobacco surcharge of up to 50% on ACA Marketplace premiums for confirmed tobacco users. On a $739 per month Silver HMO plan, that surcharge adds up to $370, pushing the effective premium to over $1,100 monthly before any subsidies. APTC subsidies are applied before the tobacco surcharge, meaning you pay the full surcharge out of pocket regardless of income eligibility.
Plan Type
HMO, EPO, and POS plans carry different premium profiles for the same metal tier. For a 40-year-old in Texas on a Silver plan, HMO averages $739/month and EPO averages $777/month. POS availability varies by rating area. The plan type also determines whether you need referrals and whether any out-of-network care is covered, which affects what you'll actually spend, not just your monthly bill.
How to Lower Your Health Insurance Premium in Texas
Health insurance costs vary by more than $500 per month across plan types and metal tiers for the same 40-year-old in Texas.
- 1Check Your APTC Eligibility
For 2026, advance premium tax credits (APTC) are available to households earning between 100% and 400% of the Federal Poverty Level (FPL). The enhanced subsidies that previously extended eligibility above 400% FPL expired at the end of 2025. Only the standard 100% to 400% FPL range applies for 2026. A 40-year-old enrolling in a Silver HMO plan could see their premium reduced to near $0 at lower income levels. Check your eligibility at HealthCare.gov before Open Enrollment opens on November 1.
- 2Choose the Right Metal Tier for Your Usage
For a 40-year-old in Texas, switching from a Silver HMO plan to a Bronze HMO plan saves you $246 per month but raises your average deductible from $2,791 to $7,600. If your income falls between 100% and 250% FPL, a Silver plan may qualify you for Cost-Sharing Reduction (CSR) subsidies that lower deductibles and copays. Silver is the better financial choice in that income band.
- 3Compare Plans During Open Enrollment
Texas uses the federal Marketplace at HealthCare.gov. There's no separate state-based exchange. The federal Open Enrollment Period (OEP) runs November 1 through January 15. Plans selected by December 15 take effect January 1, while plans selected January 1 through 15 take effect February 1. Use the OEP to compare all available plan types side by side. Understanding the differences between HMO vs. PPO plans can help you pick the right network structure for your health care needs and budget.
- 4Check Medicaid Eligibility
Texas has not expanded Medicaid under the ACA. Traditional Texas Medicaid for adults is limited to parents and caretakers with income below 15% FPL (approximately $2,259/year for a single adult in 2026). Most childless adults don't qualify regardless of income. If your income falls above the Texas Medicaid cutoff but below 100% FPL, you fall into the coverage gap and are ineligible for both Medicaid and APTC Marketplace subsidies. This affects an estimated 700,000+ Texans. If you're in this gap, look into community health centers and state-funded programs as alternatives.
- 5Set an Open Enrollment Calendar Reminder
Missing Open Enrollment means waiting until the following year unless you qualify for a Special Enrollment Period (SEP) due to a qualifying life event such as job loss, marriage, or the birth of a child. Set a calendar reminder for November 1, the first day you can enroll in or change a 2026 Marketplace plan. Enrolling early gives you the full selection of available plans and secures January 1 coverage if you need it.
How Texas Health Insurance Costs Compare to National Averages
The average Silver HMO premium for a 40-year-old in Texas is $739 month, which is 11% higher than the national average of $663 for the same profile. Texas's large geographic footprint and 26 distinct rating areas create real rate differences across the state. If you're in a metro area like Houston and Dallas-Fort Worth you'll see rates closer to the statewide average, while enrollees in rural West Texas and the Rio Grande Valley can see premiums diverge by $100 or more per month for comparable coverage.
Frequently Asked Questions
What is the cheapest health insurance plan available in Texas?
HMO plans are cheapest health insurance in Texas. The Expanded Bronze Christus Health Plan has the lowest monthly premium of $419 for 40-year-olds but carries a high $7,575 out-of-pocket maximum and $6,493 deductible.
Does Texas use HealthCare.gov or a state-based Marketplace?
Texas uses HealthCare.gov and doesn't operate a state-based Marketplace. Residents must apply for APTC subsidies and enroll in ACA-compliant Marketplace plans through HealthCare.gov during the federal Open Enrollment Period of November 1 through January 15.
What is the tobacco surcharge in Texas?
Texas allows insurers to apply a tobacco surcharge of up to 50% on ACA Marketplace premiums for confirmed tobacco users. This surcharge is applied on top of your base premium. APTC subsidies are calculated on the base premium only. You pay the full tobacco surcharge out of pocket, regardless of income eligibility.
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About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. He has analyzed the insurance market for over five years, conducting original research for insurance shoppers. His insights have been featured in CNBC, NBC News and Mashable.
Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!
He writes about economics and insurance, breaking down complex topics so people know what they're buying.