Ranked 12 of 15 states · median $807/mo · CMS PY2026
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A 40-year-old physical therapist 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.
Patient-facing and standing work means steady, predictable utilization — regular visits, prescriptions, physical therapy. Copay structure and network breadth drive real annual cost more than the headline premium, so these pages rank states on median premium and carrier count together.
Occupational context: Lifting and transfer injuries; chronic back 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 physical therapist 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 physical therapist 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 |
|---|---|---|---|---|
| Floyd | $779 | Baylor Scott and White | $6,000 | 3 |
| Lynn | $779 | Baylor Scott and White | $6,000 | 4 |
| Hood | $785 | Molina Healthcare | $7,000 | 4 |
| Lavaca | $786 | Ambetter from Superior HealthPlan | $6,000 | 3 |
| Hemphill | $796 | Blue Cross and Blue Shield of Texas | $4,000 | 3 |
| Lamar | $799 | Blue Cross and Blue Shield of Texas | $4,000 | 2 |
The spread across just these six is $20/month — $240 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 physical therapist 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
This only matters if you can actually choose — you buy in the state where you live, not where you work. If you are a physical therapist who moved this year, that move is a qualifying life event and opens a special enrollment period.
Deduction categories that generally fit this trade: Licensing, equipment, malpractice insurance, CE. Note the ordering problem with health premiums: the §162(l) deduction lowers your AGI, and your AGI is what sets your premium tax credit, so the two calculate against each other. That is a CPA conversation and worth having before you enroll, not after.
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 physical therapist 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 is above the cliff in all 21 states reported.
What this figure is. It is the median annual wage BLS reports for Physical Therapists (SOC 29-1123) 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 physical therapist. 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 Physical Therapists in Texas and a blog covering deductibles, subsidies and special enrollment.
One of Texas’s 15 carriers is leaving. Cigna exits the individual market entirely on January 1, 2027, so if you are a physical therapist covered by them the question is not whether you switch but whether you choose the switch yourself.
On price the only honest number today is national: the Peterson-KFF read of 2027 filings puts the median proposed rise near 15%, spanning −1% to 54%. Final Texas rates are not approved, so any precise 2027 figure quoted for this state is guesswork.
The window opens November 1, 2026, and December 15 is the date worth writing down — it is what secures January 1 cover in Texas and everywhere else. You will find later dates quoted; they stem from a 2025 rule that was vacated in June 2026 and is under appeal.
There is still no PPO on the Texas marketplace — not in any of its 254 counties. Every plan is an HMO, EPO or POS, which for a physical therapist working across a wide area is the binding constraint, not price.
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:
The sticker price is rarely what Physical Therapists in Texas end up paying. Start with a ZIP and I will work out your actual number.