Health Insurance in Austin, TX

Health Insurance Plans Available in Austin

Residents of Austin, Texas can shop for ACA marketplace health insurance plans during Open Enrollment (November 1 – January 15 each year) or during a Special Enrollment Period triggered by a qualifying life event such as losing employer coverage, getting married, having a child, or moving. Marketplace plans are available to all legal residents regardless of health history, and premium tax credits may significantly reduce your monthly cost based on household income.

The carriers and plans filed in Travis County for 2026 are listed below. Plans there are sold in these metal tiers: Expanded Bronze, Bronze, Silver, Gold — lower tiers carry lower premiums and higher deductibles.

2026 Plan Data for Residents in Austin

Here is what is actually filed and for sale in Travis County for 2026.

• Austin sits in Travis County, where 9 carriers have filed 110 plans for 2026: Ambetter from Superior HealthPlan, Baylor Scott and White, Blue Cross and Blue Shield of Texas, Harbor Health, Imperial Insurance Companies, and others.
• Plan types available to Austin residents: EPO, HMO, POS.
• One of the lower-cost Silver options is Harbor Health S1 $0 PCP $0 Mental Health Office Visit $0 Express Care from Harbor Health — $652/month at age 40 with a $9,900 deductible and No Charge primary care.

Source: CMS Plan Year 2026 Qualified Health Plan Landscape file. Full-price filed rates before premium tax credits; not a quote or an offer of coverage. Verify current rates at enrollment.

Major Hospitals in Austin

Medicare’s hospital directory lists these acute-care hospitals in Austin:

• Ascension Seton Medical Center Austin
• Ascension Seton Northwest
• Ascension Seton Southwest
• Baylor Scott & White Medical Center- Austin
• Dell Seton Medical Center at the University of Tx
• North Austin Medical Center
• Northwest Hills Surgical Hospital
• St. David's Medical Center
• St. David's South Austin Medical Center
• The Hospital at Westlake Medical Center

That list says where the hospitals are, not which plans cover them. Network participation differs between plans from the same carrier and changes year to year, so check each hospital in a plan’s own provider directory before you enrol.

Source: CMS Hospital General Information (Care Compare).

What a Doctor Visit and an ER Visit Cost in Austin

For care that is not an emergency, the difference between plans shows up in what a visit costs as well as in the premium. Across the plans filed in Travis County for 2026:

• Silver (43 plans): a primary-care visit is most often a $40 copay (20 plans); an emergency-room visit is most often 40% coinsurance after the deductible (19 plans).
• Bronze (3 plans): a primary-care visit is most often no charge once the deductible is met (2 plans); an emergency-room visit is most often no charge once the deductible is met (2 plans).
• Gold (39 plans): a primary-care visit is most often a $30 copay (16 plans); an emergency-room visit is most often 25% coinsurance after the deductible (16 plans).

Urgent-care charges vary by plan and are not in the federal plan file, so check a plan’s Summary of Benefits and Coverage before relying on one.

Network Types in Austin

Of the 110 plans filed in Travis County, the network types are: HMO 72, EPO 29, POS 9. No PPO is filed in Travis County, so outside an emergency a plan pays only inside its own network.

PPO plans cover in-network providers without referrals and usually pay something out of network. HMO plans generally need a primary-care referral for specialists and pay nothing out of network except in emergencies. EPO plans also pay nothing out of network, but usually need no referral. If you see specialists or use a particular hospital, the network matters more than the plan label.

ACA Subsidies for Austin Residents

Premium tax credits are set by household income against the federal poverty level and by the cost of the benchmark plan where you live, so two people with the same income in different counties can receive different credits. In Travis County the benchmark — the second-cheapest Silver plan, which the credit is calculated from — is $625 a month for a 40-year-old at full price.

For a single adult in 2026 credits run from about $15,650 up to $62,600 of income, and to $128,600 for a family of four. Above 400% of poverty the credit stops completely — the enhanced rules that removed that cap expired on 31 December 2025.

Austin Health Insurance Market Profile

• Population: 978K
• County: Travis County
• Median Household Income: $80,000 (~511% of the 2026 FPL)
• Marketplace: healthcare.gov