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Have a question about Texas health insurance? Need more information?
(281) 374.7577 | tel
(281) 374.7576 | fax
10011 Cossey Rd Ste 100
Houston, TX 77070
Have a question about Texas health insurance? Need more information?
(281) 374.7577 | tel
(281) 374.7576 | fax
10011 Cossey Rd Ste 100
Houston, TX 77070
Texas Medical Insurance for Individuals & Families
(For Group or Business Health Insurance Click Here)
When shopping for health insurance in Texas, you have a large variety of Texas health insurance plans to choose from. The major Texas health insurance carriers are Aetna, Assurant, Blue Cross Blue Shield of Texas, Celtic, CIGNA, Humana One, and United Health One (also known as Golden Rule). If you want to do some of your health insurance shopping on your own, click the “Get An Instant Quote” button on the right.
However, shopping for Texas health insurance can be a daunting task, especially if you don’t deal with Texas health insurance on a day-to-day basis. So feel free to contact us to help shop your health insurance with you. We’re here to make sure that you understand your Texas health insurance options and the health benefits that are provided under each insurance plan.
Texas health insurance plans for individuals and families vary from PPOs to HMOs and from copay plans to high deductible health plans with Health Savings Accounts (HSAs). Here is some information to help you understand the different types of Texas health insurance plans.
Understanding Texas Health Insurance Plans
Many Texas health insurance plans have office visit copays and/or prescription drug copays. A copay (short for co-payment) is a fixed amount of money you pay for medical services or prescription drugs. A plan with copays is especially beneficial if you end up going to the doctor several times or getting several prescriptions in the same year.
HDHPs typically have higher deductibles than traditional health insurance plans and no office visit copays. You are responsible for the cost of nearly all of your medical care until you have reached your deductible. For this reason, HDHPs tend to have lower premiums than traditional health insurance plans; however, they still provide catastrophic coverage.
An HSA is a tax-advantaged bank account associated with an IRS-qualified HDHP. Simply put, the money you put through an HSA is never taxed. The contributions are tax deductible, the money in the account can earn interest tax-free, and the money can be withdrawn tax=free to pay for qualified medical expenses.
Health insurance plans that provide coverage starting with the very first dollar of your medical expenses. First dollar plans may split the cost of your expenses with you until your have reached a high limit (e.g. $10,000), or they may provide 100% coverage up to a certain dollar amount (e.g. $500) before requiring you to pay your deductible and coinsurance.
Health insurance plans that cover hospital and related expenses but not doctor office visits and other services performed outside of the hospital. While these plans tend to have lower costs, you could end up having significant expenses that come out of your own pocket.
Understanding Texas Health Insurance Networks
With a PPO health insurance plan, you have a network of healthcare providers that have agreed to provide medical services at a reduce rate to members of the health plan. You have the option of going to an out-of-network provider; however, it will cost more out of your pocket.
With an HMO health insurance plan, you have a designated primary care physician (PCP) who you go to first for your health needs. If you need to see a specialist, your PCP will have to refer you to a specialist who is also in the HMO network. With a few exceptions, an HMO plan does not cover services provided by an out-of-network healthcare provider. Since medical services are considered to be prepaid by your monthly premium, HMO plans often do not have a deductible for you to meet (although you may still be required to pay a copay when visiting an HMO healthcare provider).
A POS health insurance plan has characteristics of both HMO and PPO plans. A traditional POS plan acts very similar to an HMO plan except that you have the option of seeing out-of-network healthcare providers. Out-of-network services are usually subject to a deductible and a certain percentage of cost sharing after you have met your deductible (coinsurance).
An indemnity insurance plan does not have an associated network of healthcare providers. Instead, the plan covers medical expenses at a percentage (e.g. 80%) of the usual and customary rate for medical services or supplies in that region. If your healthcare provider charges more than the usual and customary rate, you are responsible for the additional cost as well. Typically, indemnity plans still have a deductible for you to meet before coverage begins.