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The Self-Employed and Uninsured Turn to Individual Texas Health Insurance Plans

Wednesday, December 30th, 2009

uninsured turn to individual Texas health insurance plansWhile the majority of Texas health insurance policies are issued through and subsidized by employers as part of an employee’s health benefits, people who have lost their jobs, decided to work for themselves or have jobs that don’t offer insurance often opt for individual Texas health insurance plans to ensure they’re covered.

There are some advantages to purchasing your own health insurance; for instance, you can scale back coverage to your essential needs to save money on your monthly premiums.  And you often have more options in choosing your health care policy than when you were receiving employer-provided benefits.

Individuals purchasing health insurance can choose between indemnity plans (also known as fee-for-service plans), preferred provider organizations (PPOs), health maintenance organizations (HMOs), point-of-service (POS) plans and even health savings accounts (HSAs).  This freedom to choose between various health insurance plans available in a variety of cost structures can result in finding the best plan that’s most tailored to your specific needs.

Another option to consider if you have lost your job and want to continue your current health coverage is COBRA, which grants individuals meeting certain criteria the ability to continue the health insurance policy from their prior job, generally for up to 18 months.  Coverage for COBRA participants is usually more expensive than health coverage for active employees, however, since COBRA participants generally pay the entire premium themselves.  But through a government subsidy included in the February 2009 stimulus bill and amended in a December 2009 appropriations act, the government may cover up to 65 percent of COBRA’s costs for up to fifteen months, making it much more affordable for individuals.

Paying for individual health insurance may seem like an unnecessary cost to some, but since emergency medical care, unexpected operations and hospital stays are so expensive, maintaining health insurance while unemployed or self-employed can save you thousands of dollars in the long run.  To find the best Texas health insurance plans and rates for you, try using a qualified Texas health insurance broker to match an insurance plan with your needs and budget.

How to Find the Best Texas Health Insurance Plans

Thursday, December 24th, 2009

Texas health insuranceIf you’re uninsured, you’re not alone.  Millions of Americans are without health insurance, whether they lost it when they lost their job, are self-employed and must cover their own benefits or simply haven’t found the right plan yet. Finding and choosing Texas health insurance plans can be difficult if you don’t know where to start.

Since Texas health insurance rates are regulated by the state government, those interested in purchasing health insurance should focus on more than just price.  Pay close attention to the following items when choosing a Texas health insurance plan to ensure you’re getting the plan that best suits your needs.

Covered services – What medical services are covered?  Depending on your health and health care needs, look for policies regarding annual checkups, immunizations, maternity benefits and whether vision and dental insurance are included or covered under a separate policy.  Another important consideration is whether specialist services are covered, including chiropractic care, acupuncture and physical therapy.

Deductible – A deductible refers to the amount an individual must pay for health care expenses before insurance starts to help cover the costs.  Those requiring frequent doctor visits and prescriptions might benefit from a plan with a small deductible; other individuals might opt to pay out-of-pocket for their infrequent doctor visits and instead pair a Health Savings Account with a high-deductible health plan to cover them in case of emergencies or catastrophic events.

Co-payments – Co-payments are predetermined flat fees that one pays for health care services, in addition to what their insurance covers.  Co-payments often kick in once a deductible is reached, and different costs may be applied when seeing a primary care physician versus a specialist, and when filling prescriptions.

Co-insurance – Similar to a co-payment, co-insurance refers to money that an individual is required to pay for services.  But rather than a flat fee co-payment, co-insurance is a percentage that an individual must pay toward a particular service.  For example, an individual could pay 20 percent of prescription costs, while the insurance company picks up the remaining 80 percent.  Depending on your needs and the amount you’re required to pay for services, calculate whether co-insurance or a co-payment is the best option for you.

Network of providers – Is your doctor covered under your insurance policy?  If not, you may have to pay more to see your “out-of-network” physician.  If you have a favorite doctor, or see a particular doctor regularly, make sure he or she is covered by your insurance.  Contact prospective insurance providers for a list of covered doctors, or simply ask your doctor if he accepts your insurance.

Pre-existing conditions – When choosing a health insurance plan or receiving a Texas health insurance quote, it’s important to know if the plan covers health problems you already have. Often a medical condition will be excluded from coverage by an insurance company if the condition existed prior to your obtaining benefits.  Ask potential health insurance carriers their policies regarding pre-existing conditions to ensure you’re covered.