Texas Health Insurance

Health Insurance Overview

Texas residents have many options for health care coverage. There are numerous Texas health insurance providers to choose from, along with a variety of Texas medical insurance plans designed to meet the specific needs of individuals, families and groups.

Whether you need independent self-employed health coverage, or your employer simply doesn’t offer group Texas health insurance benefits. Whether you are looking to cover your spouse and children under the same low rate, or you are a small business that wants to provide your employees with affordable coverage. Whatever your situation, we are your one stop resource for all your health care needs – including reliable Texas medical insurance from the best Texas insurance providers around.

Each state is unique in its laws and regulations, as well as the types of coverage it offers. Here you will find an array of resources and useful information to help you better understand Texas health insurance and the range of options available to you. This includes current facts and statistics about residents, important state legislation, financial assistance and public Texas health insurance programs, and even details on some of the top Texas insurance providers.

To compare specific Texas medical insurance plans offered by the various Texas insurance providers, and get a personalized quote for the options that are right for you, contact us now for free. We’ll connect you with a highly qualified insurance agent near you who will be happy to help you with all of your Texas health insurance needs.

At Healthcare Solutions Team, we’re committed to making affordable health care accessible to everyone. Our group of elite Texas health insurance advisors is dedicated to helping match the right coverage to fit the unique needs of all families, individuals and groups. Not a resident of Texas? Find your state here.

Texas Health Insurance Facts & Statistics

Total Texas Residents – 24,840,100

Total Health Insurance Coverage In Texas:
Employer – 45%
Individual – 4%
Medicaid – 16%
Medicare – 9%
Other Public – 1%
Uninsured – 25%

Average Individual Monthly Premiums – NA

Average Annual Single Employee Contribution for Employer-Based Health Insurance Plan – 21%

Average Annual Single Employee Premium for Employer-Based Health Insurance Plan – $1,036

Average adjusted hospital cost per inpatient day – $1,923

Source data according to the Kaiser Family Foundation (http://www.kff.org/) (2009-2012 data) and http://www.statehealthfacts.org/

Texas Medical Insurance Laws, Regulations & Policies

There are several Texas health insurance laws and regulations that are put in place to protect policyholders living in the state. Under state law, Texas insurance providers may not require an exclusion period for a pre-existing health condition for any HMO health plan. Other kinds of plans may require an exclusion period or an elimination rider. Texas insurance providers are allowed to consider pregnancy a pre-existing condition.

State law requires Texas insurance providers to offer at least one plan that covers certain medical services, including:

  • Screening for breast, colorectal, prostate, cervical, and HPV cancer
  • Coverage for certain diabetes treatment
  • Continuity of care for pregnant women
  • Newborn hearing screening
  • Children’s vaccinations

Individual Texas health insurance policies are guaranteed renewable in the state, which means insurers cannot cancel a plan because a policyholder becomes ill. Additionally, group plans for groups of two to 50 people are guaranteed to be issued, and Texas health insurance law allows grandparents to keep dependent grandchildren on their health plans until they turn 25 years old. Texas residents are also protected by the federal health insurance laws HIPAA and COBRA.

Texas Health Insurance Resources

Texas Health Insurance High Risk Pool

The Patient Protection and Affordable Care Act established temporary national high risk pools to provide health insurance to those with pre-existing conditions. The Pre-Existing Condition Insurance Plan (PCIP) in Texas is administered by the federal government and is not a public program. Texas enrollees will have to pay monthly premiums and out-of-pocket costs like normal Texas health insurance plans.

PCIP enrollees pay around the same amount that Texas residents without pre-existing conditions pay on the private health insurance market. Texas enrollees pay a $2,500 deductible for covered benefits before the health insurance benefits kick in. There is also a $25 co-payment for doctor visits and a co-payment for prescription drugs.

Texas residents are eligible for enrollment in the Texas PCIP if they are a United States’ citizen, have been without insurance for six months, and been denied health insurance coverage because of a medical condition. For more information on the Texas health insurance high risk pools visit http://HealthCare.gov.

To stay up-to-date on the latest health care reform news, visit: http://healthreform.kff.org/

Texas Medical Insurance and Health Care Programs

The state of Texas offers residents quite a few public health insurance programs to assist low-income residents in getting access to affordable health care and insurance coverage. These programs include:

  • Medicaid
    This federal- and state-funded program provides health insurance coverage for some low-income residents of Texas. For more information on the Texas Medicaid program, visit the website at http://www.hhsc.state.tx.us/medicaid/index.html
  • TexCare CHIP
    Texas’ Children’s Health Insurance Program, TexCare CHIP, provides health insurance for children who do not qualify for Medicaid coverage but are unable to afford a private plan. To learn more about this children’s Texas health insurance program, visit the website.
  • Texas Breast and Cervical Cancer Control Program
    This program offers some women who have been diagnosed with breast or cervical cancer full health insurance benefits through Medicaid. To learn more about this women’s Texas health insurance program, visit http://www.dshs.state.tx.us/bcccs/.
  • Texas Medicare
    Seniors who are eligible for Texas health insurance can find coverage through Medicare Advantage, Medicare Supplement or Original Medicare. Around 47,000 Texas residents may also benefit from Medicare Rx and community attendant services for dual eligible residents.
  • HealthyTexas Program
    A new program called HealthyTexas is a statewide program for small business owners and employees. The program helps low-income, small business workers who need Texas health insurance. Visit http://www.healthytexasonline.com for more information about this health insurance program.

Texas residents may also be able to get financial assistance in buying a health plan through the Federal Health Coverage Tax Credit. To see if you qualify for the health insurance tax credit, visit the Internal Revenue Service (IRS) online, http://www.irs.gov/individuals/article/0,,id=109960,00.html.

Texas Insurance Providers

Aetna Health Insurance

Aetna is one of the largest health insurance providers in America with more than 30 million members. Its network includes more than 787,000 health care professionals.

Aetna AARP Health Insurance

Aetna covers more than 30 million members and is one of the largest health insurance companies in the country. Policyholders have access to more than 787,000 doctors, hospitals and other health care providers.

Assurant Health Insurance

Assurant Health, headquartered in Milwaukee, has been offering quality insurance products and coverage to more than 1 million members since 1982. Assurant is committed to providing health insurance plans that have broad coverage while providing valuable protection.

Blue Cross and Blue Shield of Texas Health Insurance

BCBS of Texas provides affordable, comprehensive health protection exclusively for residents of Texas.

Celtic Health Insurance

Celtic concentrates on individual health insurance, offering a wide variety of plans for both individuals and families.

Cigna Health Insurance

CIGNA is one of the oldest insurance companies in America, providing health insurance and other coverage solutions to millions of consumers around the country.

Companion Life Insurance Company Health Insurance

Companion Life Insurance Company specializes in employee benefit plans in 45 states and the District of Columbia. It has been providing these services and coverage for the last 35 years, becoming a single source for affordable life, disability, accident, dental, vision, and other specialty insurance programs.

Golden Rule Health Insurance

Golden Rule Insurance Company provides affordable and customized health insurance plans for millions of individuals and families.

Great American Health Insurance

Great American Insurance Company, part of Great American Financial Resources Inc., is a leading provider of health insurance and other coverage solutions.

Humana Health Insurance

Through affordable health insurance options, Humana helps its members better manage their health care and make informed health decisions.

John Alden Health Insurance

John Alden Life Insurance has been selling health coverage throughout America since 1961. Today, it is part of Assurant. John Alden plans include individual health and small group coverage. It also sells Health Savings Account plans.

Scott and White Health Insurance

Scott and White launched in January 1982 and has grown to cover 200,000 members in 50 counties in Central Texas. Its mission is to provide the most personalized, comprehensive, quality health care available.

Standard Security Life Health Insurance

The Independence Holding Company (IHC) provides management services to large companies that deliver insurance solutions to groups and individuals. As divisions of IHC, the Standard Security Life Insurance Company of New York and the Independence American Insurance Company offer various lines of life, health and disability insurance.

Time Insurance Health Insurance

Today, Time Insurance is known as Assurant Health with insurance coverage for individuals, students, families, seniors, and businesses.

Time Short Term Health Insurance

Today, Time Short Term health insurance is offered through the Assurant name. Time short-term health plans provide comprehensive coverage for a temporary period of time at affordable rates.

Unicare Health Insurance

Unicare is a member of the WellPoint family serving more than 55 million Americans. It provides customized health insurance solutions for a diverse array of needs.

UnitedHealthOne Health Insurance

Golden Rule, a United Healthcare company, has been offering affordable health insurance solutions for more than 60 years.

WorldIns ExpressMed Health Insurance

World Insurance offers several types of individual health insurance ranging from dental coverage to comprehensive major medical plans.

Important Contacts and Links

Texas Department of Insurance and Health

Find the contact Information for the Texas health insurance and health departments at:

Texas Department of Insurance
P.O. Box 149104
Austin, TX 78714-9104
Phone: (512) 463-6169

Texas Department of State Health Services
1100 West 49th Street
Austin, TX 78756
Phone: (888) 963-7111