Health Insurance in Texas ✅ ACA/Obamacare 2025
Dec 4, 2024
What's up everyone? Welcome back to a brand new video here at Cuspide Insurance. Today we have a
very special video in Texas, right? The health insurance in Texas, the ACA slash Obamacare for
2025. We're going to be learning the income limits to qualify for a subsidize, all the health
insurance companies that are available in the marketplace, the average cost of ACA plans in
the state of Texas, and all the new changes that are happening in 2025. And real quick, before
this starts, call the number on the screen here because the marketplace is officially open if you
want to renew your health insurance or apply for you and your family for the year 2025. It is open
right now 305-970-8583. Let's get into it. So the new changes to the ACA plans for 2025 in Texas,
there are four key ones. The first one being that dental care for adults is now considered an
essential health benefits. So under the ACA, there are 10 essential health benefits. I'm going to put
them up on the screen here. So so all the companies under the ACA under the Obamacare have to give
these coverage that you see on the screen, it is mandatory or they cannot be put up as a health
insurance company, they have to give you these benefits, right. So also, new in 2025, our new
lower cost plans for managing chronic slash high cost conditions. If you speak to your insurance
agent, you should be able to find plans for that households making less than 150% of the federal
poverty level can now apply year round. This one is huge. So before you needed a special to qualify
for the special enrollment period, you needed to either make have an income change, move addresses,
get divorced, get married, some huge lifestyle change, right. But now, any household making an
individual or a family making under 150% of the federal poverty level, which we're going to get
into in the next slide, any household making under 150% can now qualify year round. So if you make
under 150% of the federal poverty level, you can apply year round in the Obamacare in the ACA,
you don't longer need to wait for open enrollment. So that one is huge. And lastly, ACA protections
such as bans on annual and lifetime limits now apply to non essential health benefits,
prescription drugs, if covered by a plan. So what this means is now if your health insurance plan
gave you coverage for a prescription drug that's not really covered under the essential health
benefits, they cannot place a limit on you or a lifetime limit or an annual limit on that
prescription drug. So you can pretty much use it freely like if it was an EHB prescription drug,
which is really, really cool. So who qualifies for Texas ACA in 2025? Very simple. You must have a
residency in Texas, you must be a US citizen or legal resident. So have some sort of documentation,
you need your social, right? It's a huge thing. Now they updated this in 2025, applicants without
a social security number cannot apply, right? So anything like the green card, your worker's permit,
residency card, you're going to need if you want to apply and the income level for subsidized
qualification, which we're going to get into right now. So for the household size of one person,
you need a minimum income of $15,060 a year to qualify for a subsidized. You can still apply
without it, but if you're making that little, you will not be able to afford a plan without a
subsidized anyways. So if you are over a hundred percent, you qualify and under 400% you qualify.
So for one person under 400% is 60,000 and over a hundred percent is 15,000. So if you're anywhere
in that range, you qualify for a subsidized. Now, the closer you are to a hundred percent of the
federal poverty level, the cheaper your plan is going to be because you're getting more
government tax credit to help you pay for your plan every month. And the closer you are to 400%,
that means you're making more money. That means you need less help. So you're going to pay more
for your plan. And that goes on with two household size, three, four, five, the income limit goes
higher, but it's all relative to your household size and your household income. So what I would
say before those under 150% of the federal poverty level. So around $25,000 for a single
person. If you make under that a year, you can apply year round for Obamacare for the ACA.
You do not need to wait until open enrollment, which is huge, right? So there it is on the
screen. Anybody in your tax household qualifies to be inside the plan, whether they are getting
coverage or not. So if it's a husband, wife, two kids, that means four people in the household
size, the household must make at least $31,200 and so on. So the list of health insurance companies
in Texas for 2025 are on the screen. We got the big, the big, the big boys, Blue Cross and Better,
Molina, United Healthcare, Oscar, as well as the smaller kind of local ones with Wellpoint being
a new one in the 2025 marketplace. They came out in three states, Florida, Texas, Georgia,
which are usually huge, like hotspots in health insurance. So there it is on the screen. I'm not
really going to get into the list of the health insurance companies, but these are the ones that
you're going to be able to find in the marketplace. And for the average cost, the average premium
after subsidized in Texas is around $123 a month. The average subsidized that is given to households
is $783 a month. The average deductible being $1,307. And the average out of pocket maximum,
which is fairly low, to be honest, is $3,214. But if that seems too high, guess what the average
cost by client here under us only pays around $40 a month with many of our clients paying under $10
a month and many have $0 a month plans. So again, the marketplace is open right now 305-970-8583.
Don't miss out on the open enrollment. Find yourself a cheap plan under us with great
coverage $0 deductible low out of pocket costs. Again, 305-970-8583. Hopefully you learned a
little more about health insurance in Texas for 2025. I will see you all in another video. Bye

