Texas Health Insurance
Are you medically covered in the State of Texas?
Acquiring health insurance in Texas is vital in case of serious illnesses that may cause you thousands of dollars. Getting the proper coverage will protect you and your family from large financial losses. The information below will guide you through the fundamentals of what health insurance entails, from the various types of medical plans to factors for determining the costs, and details that will define your monthly rates. Any additional details can be found through the Texas Department of Insurance.
Health Plan Basics
There are 3 basic types of health plans. These plans address the type of coverage you or your employer(s) are responsible for when health services are provided by doctors or hospitals.
- Indemnity Plan – You pay for the entire cost of service when you visit any doctor/hospital
- Fee-for-Service Plan – The insurance provider will usually pay a percentage for any of your health services, and you cover the rest
- Managed Care Plan – You are only permitted to visit a set of contracted doctors/hospitals established by your employer (fixed list), and will only pay for covered services deemed to be medically necessary
Group Plans vs. Individual Plans
Group Plans: Group plans are typically members of an employer-sponsored plan
- Small-Employer Plans: are provided by businesses with 2-50 eligible employees
- Large-Employer/Other Group Plans: For business with 50+ employees and other group plans like churches, trade unions, etc.
- Self-Funded Plans: governed by the Federal Employee Retirement Income Security Act (ERISA), regulated by the U.S. Department of Labor
Individual Health Plans: Insurance companies and HMOs can sell coverage directly to individuals
- HMO Plans pay for covered health services within the HMO’s network of doctors/hospitals
- Major Medical Policies cover hospital stays and services from doctors
- Hospital Surgical Policies covers expenses related to the hospital and other surgical services
- Hospital Indemnity Policies pay up to a maximum limit for each day you’re in the hospital
- Specified or Dread Disease Policies only cover specified illnesses listed within the policy
- Short-term Policies are used for medical/financial protection when in between traditional health insurance plans
Covering Dependents Children and grandchildren are eligible under your coverage as your dependent until the age of 25 (policies differ between plan types).
Preexisting Conditions If you currently or have had a medical problem in the past, it may be covered based on the insurer’s requirements when applying for a health insurance plan in Texas.
Health Plan Rates: Health plans are administered by these factors:
- Number of covered dependents
- Number of group plan participants
- Claims experience
After determining the right health insurance bundle that fits your classification, it is time to search for local health insurance companies within the State of Texas and compare quote prices.
Here’s a list of local health insurance companies in Texas:
1. Health Care Service Corp.
2. Unitedhealthcare Insurance Company
3. Pacificare of TX Inc.
4. Aetna Life Insurance Co.
5. Humana Insurance Company
6. Amerigroup TX Inc.
7. Aetna Health Inc. TX Corp.
8. Superior Healthplan Inc.
9. Humana Health Plan of TX Inc.
10. Texas Healthspring Llc.
To compare health insurance quotes, enter your zip code to determine which premiums are best suited for you.