Health Insurance Carriers in Texas
Sixteen insurers offer ACA Marketplace plans somewhere in Texas for 2026 — though no single carrier is available in every county.
2026 ACA Marketplace carriers
- Ambetter from Superior HealthPlan
- Baylor Scott & White Health Plan
- Blue Cross and Blue Shield of Texas
- CHRISTUS Health Plan
- Cigna Healthcare
- Community First Health Plans
- Community Health Choice
- Harbor Health
- Molina Healthcare of Texas
- Oscar Health
- Scott and White Health Plan
- ...and several additional regional carriers, depending on county
Availability changes by county and by year. Confirm which carriers are active in your ZIP code before comparing plans.
HMO vs. PPO: which matters more in Texas?
Most Texas ACA plans are HMOs (Health Maintenance Organizations), which require you to use an in-network primary care provider and get referrals for specialists, in exchange for lower premiums. PPOs (Preferred Provider Organizations) cost more but allow more flexibility to see out-of-network providers without a referral.
HMO
- Lower monthly premium
- Requires in-network primary care provider
- Referrals typically needed for specialists
- Little to no out-of-network coverage
PPO
- Higher monthly premium
- No primary care provider requirement
- No referral needed for specialists
- Partial out-of-network coverage available
In large metro areas like Houston, Dallas-Fort Worth, and San Antonio, HMO networks are usually broad enough that the lower premium makes sense for most people. In more rural counties with fewer contracted providers, a PPO's flexibility can be worth the extra cost.
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