Ranked 12 of 15 states · median $807/mo · CMS PY2026
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A 40-year-old dietitian in Texas pays a median $807/month for a Silver plan before subsidies — 12th of 15 on cost. The cheapest plan in the state is $540 from Blue Cross and Blue Shield of Texas in Cameron. On median Silver premium, Texas ranks 12 of 15 for this occupation.
When you use coverage regularly, the annual total is driven by what each visit costs and whether the clinician you already see is contracted. A plan $40 cheaper that drops your specialist is not cheaper. These rankings pair median premium with how many carriers actually file in the state.
Occupational context: Prolonged standing and sedentary counseling strain.
Two things get confused here constantly. Risk exposure decides what coverage you should buy. It does not decide what you are charged — Texas carriers rate on age, ZIP, tobacco and family size, full stop. A dietitian with a bad back and a healthy 40-year-old office worker in the same county see the same number.
Premium is set by rating area, so a dietitian in one Texas county can pay materially more than one an hour away. Six counties from across the state, cheapest Silver plan for a 40-year-old:
| County | Cheapest Silver @40 | Issuer | Deductible | Carriers |
|---|---|---|---|---|
| Cameron | $540 | Blue Cross and Blue Shield of Texas | $1,500 | 5 |
| Bastrop | $608 | Sendero Health Plans, Local Nonprofit | $6,000 | 4 |
| Williamson | $608 | Sendero Health Plans, Local Nonprofit | $6,000 | 9 |
| Panola | $629 | Ambetter from Superior HealthPlan | $6,000 | 3 |
| Jasper | $644 | CHRISTUS | $6,000 | 4 |
| San Jacinto | $645 | Ambetter from Superior HealthPlan | $6,000 | 5 |
The spread across just these six is $105/month — $1,263 a year for the same metal tier. Statewide the range runs $540 to $1,409. Coverage by County publishes all 254 Texas counties individually.
| Texas — network and cost | 2026 |
|---|---|
| Median Silver premium @40 | $807 |
| Cheapest Silver @40 | $540 — Blue Cross and Blue Shield of Texas (Cameron) |
| Most expensive Silver @40 | $1,409 |
| Carriers filing in the state | 15 — Ambetter from Superior HealthPlan, Baylor Scott and White, Blue Cross and Blue Shield of Texas, CHRISTUS |
| Plan types available | EPO, HMO, POS |
| Counties with only one carrier | 7 of 254 |
Texas has 15 carriers filing and 7 of 254 counties served by a single issuer. For a dietitian with an established provider relationship, that carrier count is the number that decides whether you keep your doctor.
Source: CMS Plan Year 2026 Qualified Health Plan Landscape file. 13,013 plan records across 254 Texas counties. Full-price filed rates before premium tax credits — verify at enrollment.
Cheaper for the same coverage: Kansas ($765), Florida ($789), Utah ($805). More expensive: North Carolina ($828), Arkansas ($828), Nebraska ($875).
Side-by-side: Texas vs Florida · Texas vs Utah · Texas vs North Carolina · Texas vs Arkansas
Cross-state numbers are useful for understanding whether Texas is treating you well, not for arbitrage. You cannot buy an out-of-state exchange plan. If you are a dietitian weighing a relocation for other reasons, the premium difference is a real line item worth putting in the decision.
If you file a Schedule C as a dietitian, the categories that usually show up are: Licensing, CE credits, practice-management software. The health premium itself is normally an above-the-line deduction under IRC §162(l), which reduces AGI rather than requiring you to itemize. Your CPA should confirm it against your actual situation.
If your household income is above the subsidy range, ACA is not automatically the answer. There are other categories of coverage that may fit, and they work very differently. That is a conversation, not a web page.
The cheapest Silver plan for a 40-year-old in Texas is $540 per month from Blue Cross and Blue Shield of Texas, with a state median of $807. Both figures are full price before premium tax credits; most buyers pay less after subsidies.
No. Texas exchange plans are guaranteed issue and community rated, so a dietitian pays exactly what anyone else of the same age in the same ZIP pays. Occupation is not on the application as a rating factor.
No. Only EPO and HMO and POS plans were filed for 2026.
Texas ranks 12 of 15 states covered here, at a median $807 per month. Indiana is cheapest at $558 and Nebraska is most expensive at $875.
Above the cliff. At this income a single-person household receives no premium tax credit for 2026 and pays the full premium.
This occupation sits above the cliff in 18 of the 21 states reported and below it in the other 3, so the answer changes with the state.
What this figure is. It is the median annual wage BLS reports for Dietitians and Nutritionists (SOC 29-1031) in Texas. BLS surveys wage and salary workers and excludes the self-employed, so it is a benchmark for the occupation in this state — not the income of a self-employed dietitian. Premium tax credit eligibility is set by household modified adjusted gross income and household size, not by occupation, so treat this as a reference point rather than a determination of what you qualify for.
Why the cliff is back. The enhanced premium tax credits expired on 31 December 2025. For plan year 2026 the 400% FPL limit applies again, so household income above $62,600 ends premium tax credit eligibility outright.
This page compares states. For Texas specifically — county-by-county carriers, plan data and enrollment help — I publish that on Coverage by County, including a page written for Dietitians in Texas and a blog covering deductibles, subsidies and special enrollment.
The biggest change here is a carrier walking away. Cigna leaves the ACA individual market on January 1, 2027 — one of the 15 carriers writing in Texas today. Every a dietitian on a Cigna plan is moving, and doing nothing just means the marketplace chooses the replacement.
Nobody can tell you your 2027 Texas premium yet. Filings nationally cluster around a 15% median increase, with the full spread running −1% to 54% — and until this state signs off, a specific local number is invention.
Mark November 1, 2026 to open and December 15 to act. That second date guarantees cover from January 1 in Texas regardless of how the current litigation over the enrollment window resolves.
One thing 2027 will not fix: no PPO is sold anywhere in Texas. All 254 counties offer HMO, EPO or POS only, so care outside the network is effectively emergency-only. If your work as a dietitian crosses county lines, weigh that above the premium.
You already know you are changing plans — Cigna is leaving. The only real question is whether you pick the replacement or the marketplace picks it for you, and that is a much easier decision made in August than in the second week of December.
Give me a ZIP and I will tell you three things:
Two Dietitians on opposite sides of Texas can be quoted very different premiums for the same plan. Your ZIP is what decides it.