Texas is divided into 26 health insurance rating areas. Each contains specific counties and ZIPs. Premiums, plan availability, and carrier participation are set per rating area — meaning your address dictates a lot more than just network access.
What changes between areas
- Which carriers offer plans (BCBS Texas covers all 26, others vary).
- Number of plans available (DFW and Houston typically have 70+, smaller metros 30–40).
- Premium baseline (urban areas often 10–20% higher than rural for same plan tier).
- Provider network depth (rating area determines which hospitals are in-network).
What doesn't change
- Subsidy eligibility (federal calculation, same nationwide).
- Essential health benefits (federal floor, same in every state).
- Pre-existing condition coverage (federal, all ACA plans).