What Is a HMO (Health Maintenance Organization)?
HMO plans require you to choose a primary care physician who coordinates your care. You need referrals to see specialists, and out-of-network care is generally not covered except in emergencies. HMOs typically have the lowest premiums of any plan type.
Best for: people who want lower premiums and are comfortable using a primary care physician for coordination and referrals.
Watch out for: HMOs can be restrictive if you have established specialist relationships or may need care outside your local area. Always confirm your specific doctors are in the HMO network before enrolling.
HMO Plans Available in Texas
The following carriers offer HMO health insurance plans in Texas for 2026: BCBS of Texas, Ambetter from Superior HealthPlan, Aetna, Cigna, Molina Healthcare, Oscar Health.
The dominant carrier in most Texas counties is Blue Cross Blue Shield of Texas.
Texas has not expanded Medicaid. PPO options from BCBS of Texas are among the most popular for access to large medical centers like MD Anderson and Texas Medical Center.
Plan availability and premium amounts vary by ZIP code and county. Rural counties often have fewer
carrier options than major metro areas. Always compare all plans available in your specific ZIP code
rather than shopping by carrier name alone.
How to Compare HMO Plans in Texas
When comparing HMO plans in Texas, look at:
- Network: Confirm your doctors and preferred hospitals are in the plan’s network
- Deductible: How much you pay before insurance starts covering costs
- Out-of-pocket maximum: The most you’ll pay in a plan year
- Premium: Your monthly cost after any applicable ACA subsidies
- Drug formulary: Whether your prescription medications are covered at a preferred tier
An independent broker compares all Texas marketplace plans in your ZIP code without charging fees.