Ranked 12 of 15 states · median $807/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old speech 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: Vocal strain; infectious exposure in clinical settings.
This is background for choosing a plan, not for pricing one. Since 2014 every Texas exchange plan has been guaranteed issue and community rated: same age, same ZIP, same tobacco status means the same filed premium whether you are a speech therapist or an accountant. Occupation changes the shopping criteria, nothing else.
Premium is set by rating area, so a speech 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 |
|---|---|---|---|---|
| Menard | $920 | Ambetter from Superior HealthPlan | $6,000 | 3 |
| Callahan | $953 | Blue Cross and Blue Shield of Texas | $4,000 | 2 |
| Stephens | $953 | Blue Cross and Blue Shield of Texas | $4,000 | 2 |
| Harris | $586 | Community Health Choice | $4,500 | 7 |
| Hays | $608 | Sendero Health Plans, Local Nonprofit | $6,000 | 9 |
| Jefferson | $625 | CHRISTUS | $5,990 | 6 |
The spread across just these six is $367/month — $4,402 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 speech 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
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 speech therapist weighing a relocation for other reasons, the premium difference is a real line item worth putting in the decision.
Expense categories that typically apply to this trade: Licensing, materials, malpractice insurance, CE. Premiums are generally deductible above the line under IRC §162(l) when no employer plan is available to you or your spouse — a question for your CPA, not your agent.
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. Under the ACA, carriers cannot rate, decline, or exclude based on occupation or health history. Rates vary only by age, ZIP code, tobacco use and household size.
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.
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 Speech Therapists in Texas and a blog covering deductibles, subsidies and special enrollment.