State profile · TX · CMS + NAIC
Insurance in Texas
How health insurers handle claims in Texas, and what drivers pay for auto cover — measured from CMS Transparency-in-Coverage and NAIC data.
- 21.9%
- Avg claims denied
- #10
- denial rank of 31
- $1429
- Avg auto / yr
- +25%
- Auto, 5-yr
- 14
- Insurers w/ data
The verdict
Marketplace insurers in Texas deny 21.9% of claims — near the 21% national average, the 10th-highest of 31 states, and drivers pay an average $1429 a year for auto cover, more than the $1191 national average.
- 21.9%
- avg claims denied
- #10
- of 31 states
- $1429
- avg auto / yr
- 38%
- highest (UnitedHealthcare o)
Denial rates are aggregate marketplace figures from CMS filings; auto figures are NAIC average expenditures. State regulation, risk pool and plan design all shape these numbers.
Highest claim-denial rates in Texas
Health insurers by share of marketplace claims denied (≥1,000 claims on file)
- UnitedHealthcare of Texa
UnitedHealthcare of Texas, Inc.: 38.3% denied (2,205,234 of 5,751,304)
38.3 % of claims denied
- Community First Insuranc
Community First Insurance Plans: 29.4% denied (30,081 of 102,375)
29.4 % of claims denied
- Aetna Health Inc. (a TX
Aetna Health Inc. (a TX corp.): 29.3% denied (2,682,053 of 9,161,325)
29.3 % of claims denied
- Moda Health Plan
Moda Health Plan, Inc.: 29.1% denied (32,356 of 111,108)
29.1 % of claims denied
- Molina Healthcare of Tex
Molina Healthcare of Texas, Inc.: 28.1% denied (407,844 of 1,451,577)
28.1 % of claims denied
- Sendero Health Plans
Sendero Health Plans, Inc.: 28.0% denied (71,156 of 253,760)
28 % of claims denied
- Cigna HealthCare of Texa
Cigna HealthCare of Texas, Inc.: 25.8% denied (1,721,710 of 6,667,945)
25.8 % of claims denied
- Blue Cross Blue Shield o
Blue Cross Blue Shield of Texas: 24.2% denied (9,992,111 of 41,368,969)
24.2 % of claims denied
- Oscar
Oscar Insurance Company: 22.5% denied (479,462 of 2,134,298)
22.5 % of claims denied
- Community Health Choice
Community Health Choice, Inc.: 20.0% denied (1,548,772 of 7,733,538)
20 % of claims denied
What this shows These carriers deny the largest share of marketplace claims filed in Texas. Denial rates reflect plan design and network rules as much as carrier behaviour.
Health insurers in Texas, by denial rate
14 insurers reporting marketplace claims in Texas
| # | Insurer | Claim denial rate | Claims |
|---|---|---|---|
| 1 | UnitedHealthcare of Texas, Inc. F | 5,751,304 | |
| 2 | Community First Insurance Plans F | 102,375 | |
| 3 | Aetna Health Inc. (a TX corp.) F | 9,161,325 | |
| 4 | Moda Health Plan, Inc. D | 111,108 | |
| 5 | Molina Healthcare of Texas, Inc. D | 1,451,577 | |
| 6 | Sendero Health Plans, Inc. D | 253,760 | |
| 7 | Cigna HealthCare of Texas, Inc. D | 6,667,945 | |
| 8 | Blue Cross Blue Shield of Texas D | 41,368,969 | |
| 9 | Oscar Insurance Company D | 2,134,298 | |
| 10 | Community Health Choice, Inc. C | 7,733,538 | |
| 11 | Scott and White Health Plan C | 6,023,772 | |
| 12 | CHRISTUS Health Plan C | 941,478 | |
| 13 | Superior Health Plan B | 10,282,176 | |
| 14 | Celtic Insurance Company B | 19,905,468 |
Auto insurance in Texas
Auto premiums in Texas are climbing
Average annual auto-insurance expenditure by year (NAIC)
- 2019
2019: $1144 average expenditure
$1,144 avg expenditure
- 2020
2020: $1085 average expenditure
$1,085 avg expenditure
- 2021
2021: $1123 average expenditure
$1,123 avg expenditure
- 2022
2022: $1233 average expenditure
$1,233 avg expenditure
- 2023
2023: $1429 average expenditure
$1,429 avg expenditure
What this shows Texas drivers' average auto cost rose 25% between 2019 and 2023.
What the data shows for Texas
Texas's marketplace insurers denied 21.9% of submitted claims in the CMS data, the 10th-highest rate of the 31 states with federal marketplace filings. Denial rates this far above the 21% national average usually reflect the state's mix of plan types and risk pool rather than any single carrier — Medicaid managed-care and narrow-network plans route more claims through utilization review.
On the auto side, drivers in Texas pay an average $1429 a year — more than the $1191 national average — split across $798 liability, $529 collision and $400 comprehensive premiums. That figure has moved up 25% since 2019, tracking the national surge in repair and medical-claim costs.
Because rate regulation, licensing and guaranty-fund coverage are set state by state, an insurer's record in Texas can differ from its national average — which is why the state view matters for local consumers. Source: CMS Transparency in Coverage PUF PY2025, cms.gov. Source: NAIC 2023 Auto Insurance Database; state commissioner registry, NAIC member directory.
For Texas residents
Use the state view before you buy or appeal a denial here.
- Check a specific carrier's full national and per-state record. Browse insurers
- Compare Texas's auto costs against the rest of the country. Auto rankings
- Denied a claim in this state? Walk through the appeal process. Appeal a denial
Verify coverage availability and terms directly with any insurer or a licensed agent. Informational only — not insurance advice.
Data: CMS Transparency in Coverage PUF PY2025 (per-state claim denials) · NAIC 2023 Auto Insurance Database. State commissioner links from the NAIC member directory. Not affiliated with NAIC or CMS. Read our methodology.