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Ashley PoynterAug 29, 20196 min read

How much is Texas health insurance? A breakdown of costs

Updated: Jun 24

If you’re self employed and looking for a Texas health insurance plan, you can likely find cheap subsidized policies on the Texas health insurance exchange. In 2019, there were eight companies that offered plans on the exchanges, but not all eight companies offered plans in every county in Texas.

As we move toward open enrollment for 2020 plans, it can be helpful to get a sense for what types of plans you may want to buy, but also how much those plans will cost.

According to ValuePenguin, the cheapest Texas health insurance policies by metal tier follow the following cost structure:

If you are curious about what the average costs of Texas health insurance are, ValuePenguin also breaks this down by metal tier:

But wait!

Since we’re looking for Texas health plans for 2020, you should know there’s a new option coming to the market! Decent offers both a Trailblazer Silver plan and a Pathfinder bronze plan that both compete heavily against what’s listed in the table above.

Blazing a new trail in Texas health insurance

We realized that self employed people needed better options in health care. We created our Trailblazer silver plan so people wouldn’t have to decide between reasonable rates and excellent health care. Instead, you can pioneer the path to awesome health coverage for you and your family. Since our plan has a little more meat to it, let’s compare it to a traditional silver plan rather than the cheapest one:

This is our most popular Texas health insurance plan for freelancers or self employed individuals that make over $55,000 per year (and their families!). With affordable monthly premiums and a reasonable deductible and out-of-pocket maximum, this plan makes covering health care costs simple and painless. Even better? We provide free primary care. Never pay anything to see the doctor you trust for routine visits.

Let’s do the math. Imagine you’re a 30-something freelance real estate agent who decides to enroll in Decent’s Trailblazer plan. Your monthly premium amounts to $390, your deductible is $4,500, and your out-of-pocket max is $7,150. One quick win off-the-bat: as a self employed 1099 contractor, your health insurance premiums may be tax deductible!

Now let’s say you have an annual skiing trip you take with friends (fun!). While tackling the Diamond slope, you have an accident (not fun), resulting in a complicated leg fracture that requires surgery. Total diagnostic and treatment for the leg fracture will run upwards of $30,000 (super not fun).

If you don’t have health insurance, you may end up paying for all of that out of your own pocket. If you had Decent’s Trailblazer plan, your total out-of-pocket financial responsibility would be $7,150. But remember⁠—if you’ve already paid for other covered medical services throughout the current year, it may actually be lower than that. Phew! Congrats, you just saved yourself tens of thousands of dollars.

Helping the young & healthy find the path to affordable Texas health insurance

One of the biggest obstacles to buying health care is cost. When you’re young and healthy, health insurance can seem like an unnecessary expense. The thing is, if something happens, you often end up paying way more than you would have if you had elected to purchase a plan. We wanted to strike the perfect balance between affordable health insurance and great coverage, so we created our Pathfinder bronze plan. With low premiums and free primary care, it’s the perfect plan for those who don’t anticipate needing a ton of medical services throughout the year. It doesn’t cost an arm and a leg—but if you break an arm or a leg, we’ve got you covered. See for yourself!

We believe that the doctor-patient relationship should sit at the center of healthcare, so we’ve built our health care plans around this concept. No more fussing with co-pays or trying to figure out whether or not your doctor is in-network. With our Pathfinder Bronze plan, you go to your doctor when you want...for free. If your doctor isn’t already a part of our network, just give us their contact information and we’ll do our best to get them on board. We want you to feel good about getting the care you need.

Choosing a cost-effective Texas health insurance plan

At the end of the day, choosing the most cost-effective Texas health insurance comes down to understanding what type of coverage you need. Ask yourself which bucket you fall into:

High expected medical care needs If you know you will have regular prescription or other higher-than-average medical care needs in 2020, a gold plan may work best for you. Gold plans are most expensive, but they also provide higher coverage and lower out-of-pocket costs when medical care is needed. If you expect to have regular visits to a doctor or specialist, need prescription medication, or need certain non-routine medical procedures, a gold plan will offer lower copays, deductibles, and coinsurance.

Average income household Average income households are usually looking to find a balance between monthly premiums and out-of-pocket costs. If you fall into this category, you’re probably looking for a health plan that has an affordable monthly premium without an exorbitant out-of-pocket maximum. Lower income individuals or families may also opt for a silver plan, specifically households that have incomes that fall below 250% of the federal poverty level. At that income level, you may be able to qualify for subsidies through the exchange.

Young & healthy If you are young and healthy, you may be wondering what all the fuss is about. “Why do I need health insurance?” is the top question for people who fall into this category, and the answer is important: because life happens. The best case scenario is that no one has to use the full extent of their health care coverage. But even a broken ankle while snowboarding can sneak up on you⁠—and believe us, the costs will, too. Thankfully, bronze and catastrophic plans can be a good fit for people who need basic or “just in case” coverage.

These plans come with the cheapest premiums and higher deductibles and out-of-pocket maximums (in some cases, the highest allowable by law). The lower premiums are super appealing to younger generations who may not have a ton of income to throw at a lofty health insurance plan as well as healthy individuals who figure they won’t need that many health care services throughout the year. When buying one of these plans, consider all the pros and cons. Also be sure that you have enough money saved up to cover your out-of-pocket responsibilities if the need should arise. Either plan could cut your healthcare costs substantially should you need to use it.

Finding an affordable Texas health insurance plan shouldn’t be rocket science. We’ve simplified it down to two plans with exceptional coverage—built around your needs. What’s more, we offer year-round enrollment, so you can switch to one of our plans at any time. Looking for a change? Get a free quote today.