Updated November 2026 for the 2027 plan year. This page lists the health insurance companies selling coverage in Texas: the insurers on the ACA Marketplace, the companies with the largest share of the commercial market, the Medicaid managed care plans and the leading Medicare Advantage carriers. HCSC (Blue Cross and Blue Shield of Texas) is the largest commercial health insurer in Texas, with 45% of the market, according to the American Medical Association (AMA).
For coverage you buy yourself, Texas residents use HealthCare.gov. For 2027, 13 insurers are expected to offer Marketplace plans there, based on federal and state filings.
Texas Health Insurance at a Glance
| Measure | Texas | Source |
|---|---|---|
| Largest commercial insurer (share of market) | HCSC (Blue Cross and Blue Shield of Texas) (45%) | AMA, 2024 data |
| Second-largest commercial insurer | UnitedHealth Group (21%) | AMA, 2024 data |
| ACA Marketplace | HealthCare.gov | |
| Marketplace plan selections, 2026 | 4,172,233 (+5.2% from 2025) | CMS |
| Average monthly Marketplace premium after tax credits | $89 in 2026 ($57 in 2025) | CMS |
| Medicaid enrollees, 2024 | 4,141,972 | CMS |
| Share of Medicaid enrollees in comprehensive managed care | 92.8% | CMS, 2024 |
| Medicare Advantage plans, 2027 | 421 (423 in 2026) | CMS |
| Largest Medicare Advantage carrier | UnitedHealth Group (50%) | AMA, 2024 data |
Largest Health Insurance Companies in Texas
The AMA’s annual Competition in Health Insurance report measures each insurer’s share of enrollment in the commercial market, which includes employer plans and individual coverage, and in Medicare Advantage. The latest edition uses enrollment as of January 1, 2024.
| Market | Largest insurer | Share | Second-largest insurer | Share |
|---|---|---|---|---|
| Commercial (employer and individual) | HCSC (Blue Cross and Blue Shield of Texas) | 45% | UnitedHealth Group | 21% |
| Medicare Advantage | UnitedHealth Group | 50% | Humana | 18% |
The Blue Cross Blue Shield licensee in Texas: Blue Cross and Blue Shield of Texas (division of Health Care Service Corporation). For every company, including national carriers, see our List of Health Insurance Companies.
ACA Marketplace Insurers in Texas for 2026 and 2027
| Insurer | 2026 | 2027 |
|---|---|---|
| Ambetter from Superior HealthPlan | Yes | Yes |
| Antidote Health of TX | No | Yes |
| Baylor Scott and White Health Plan | Yes | No |
| Blue Cross and Blue Shield of Texas | Yes | Yes |
| CHRISTUS Health Plan | Yes | Yes |
| Cigna Healthcare | Yes | No |
| Community First | Yes | Yes |
| Community Health Choice | Yes | Yes |
| Harbor Health | Yes | Yes |
| Imperial Insurance Companies, Inc. | Yes | Yes |
| Moda Health Plan, Inc. | Yes | No |
| Molina Healthcare | Yes | Yes |
| Oscar Insurance Company | Yes | Yes |
| Sendero Health Plans | Yes | Yes |
| UnitedHealthcare | Yes | Yes |
| WellPoint | Yes | Yes |
Three insurers are leaving the Texas Marketplace for 2027: Baylor Scott & White Health Plan, Cigna and Moda. Cigna is leaving the individual market in all 11 states where it sold ACA plans. Antidote Health is new for 2027. Texas had more Marketplace insurers than any other state in 2026, according to KFF.
Source: CMS Marketplace plan data files. Insurer names are brand names; an insurer may sell in only part of the state. Check plans for your ZIP code at HealthCare.gov.
Claim Denial Rates for Texas Marketplace Insurers
In 2024, Texas HealthCare.gov insurers denied 18.5% of in-network claims, compared with 18.7% nationally. Rates by insurer:
| Insurer (as filed) | In-Network Claims | In-Network Denial Rate |
|---|---|---|
| Blue Cross Blue Shield of Texas | 58,806,743 | 18.8% |
| Celtic Insurance Company | 16,238,521 | 16.3% |
| UnitedHealthcare of Texas, Inc. | 14,698,969 | 17.4% |
| Scott and White Health Plan | 8,274,564 | 14.6% |
| Community Health Choice, Inc. | 6,776,421 | 21.4% |
| Superior Health Plan | 5,807,390 | 22.2% |
| Cigna HealthCare of Texas, Inc. | 4,080,439 | 21.7% |
| Oscar Insurance Company | 3,001,076 | 25.5% |
| CHRISTUS Health Plan | 1,206,500 | 11.7% |
| Molina Healthcare of Texas, Inc. | 987,573 | 24.0% |
| Sendero Health Plans, Inc. | 471,218 | 21.5% |
| Moda Health Plan, Inc. | 142,112 | 24.3% |
| Community First Insurance Plans | 112,382 | 30.6% |
| Imperial Insurance Companies, Inc. | 2,530 | 35.7% |
Full methodology and national rankings are in our claim denial rates by insurer report.
Medicaid Managed Care Plans in Texas
Texas Health and Human Services Commission (HHSC) runs Medicaid in Texas. In 2024, 92.8% of the state’s 4,141,972 Medicaid enrollees were in comprehensive managed care plans, according to CMS; see our Medicaid managed care by state data. Programs: STAR; STAR+PLUS; STAR Kids; STAR Health (children in state conservatorship; Superior statewide); CHIP / CHIP Perinatal.
- Aetna Better Health
- Blue Cross and Blue Shield of Texas
- Community First
- Community Health Choice
- Cook Children’s Health Plan
- Dell Children’s Health Plan
- Driscoll Health Plan
- El Paso Health
- FirstCare
- Molina Healthcare
- Parkland Community Health Plan
- RightCare (Scott and White) — exiting Medicaid by end of Aug 2026
- Superior HealthPlan
- Texas Children’s Health Plan
- UnitedHealthcare Community Plan
- Wellpoint
Source: Texas Health and Human Services Commission (HHSC).
Medicare Advantage in Texas
People with Medicare in Texas can choose from 421 Medicare Advantage plans for 2027, compared with 423 in 2026, and 100% have access to a plan with a $0 monthly premium, according to CMS. The largest Medicare Advantage carriers are UnitedHealth Group (50%) and Humana (18%), according to the AMA. Compare every state on our Medicare Advantage plans by state page, and see our Medigap vs Medicare Advantage guide before you choose.
Recent Developments in Texas
- Baylor Scott & White Health Plan announced (April 2026) it will leave Texas Medicaid managed care by the end of August 2026 (~125,000 enrollees) and stop selling individual Marketplace plans after 2026 (~100,000 covered), cutting 321 jobs. (source)
- Cigna is leaving the individual market in all 11 of its states for 2027, including Texas. (source)
- AMA (Dec. 2025): HCSC/BCBSTX holds 45% of Texas’s combined commercial market and 60% of the PPO market (2024 data). (source)
How To Choose a Health Insurer in Texas
- Compare Marketplace plans for your ZIP code and update your income to get the right tax credit.
- Check that your doctors and hospitals are in network; our HMO vs PPO vs EPO guide explains the differences.
- Compare the out-of-pocket maximum as well as the premium.
- If your insurer is leaving the Marketplace for 2027, choose a new plan by December 15 for coverage starting January 1.
- For complaints or help with a denied claim, contact the Texas Department of Insurance.
For statewide enrollment and premium trends, see our ACA Marketplace enrollment by state data, and follow our Health Insurance Companies hub for insurer news.
Sources
American Medical Association, Competition in Health Insurance: A Comprehensive Study of U.S. Markets (2025 update, 2024 data); CMS 2026 and 2025 Open Enrollment State-Level Public Use Files; CMS Marketplace plan data files for 2026 and 2027; CMS Medicaid Managed Care Enrollment (2024); CMS 2027 Medicare Advantage and Part D state fact sheets; KFF 2024 Transparency in Coverage data; Texas Health and Human Services Commission (HHSC).