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Texas Health Insurance Basics

Health insurance. Everyone needs it, but notyou to pay any or all of the following:o
everyone has it. And with medical expenses onCo-payment - The amount paid for each visit
a seemingly endless rise, payingto a health insurance provider. This is
out-of-pocket for them could land you in thegenerally required by HMOs.o Deductible
poor house. So when choosing a health-The amount paid toward your medical
insurance plan, it's good to know the basicsexpenses, most probably annually, before the
to help you make better, more financiallyinsurance company pays any claims. This is
sound  choices  when  selecting  a  plan.generally required by indemnity plans.o
Coinsurance - The percentage of your medical
Health insurance plans generally fall intocosts paid after reaching any applied
one of three categories: indemnity plans,deductibles.
also known as reimbursement plans, preferred
provider plans (PPOs), and managed care plansNow that you've established the why and what
(HMOs).of health insurance, you need to find out
where you can get it. Health insurance can be
An indemnity plan allows you to choose youracquired through a group plan at work or
own doctors and it completely pays for yourthrough a group affiliation, such as a
medical expenses, either in full or accordingschool, a club, association, etc. Or you can
to a schedule of benefits. The schedule ofpurchase an individual plan. When buying an
benefits may be substantially less than yourindividual health insurance plan, you can
actual costs. Preferred provider plans andmost probably customize it for your
managed care plans can provide broaderparticular needs. If you're looking for an
coverage, but they involve an arrangementindividual plan, start by going online to
between the insurer and a specified networkcompare coverages and rates from a number of
of health-care providers. In addition,companies to find the best plan and rate that
managed care plans require pre-approval ofmeets  your  needs.
many health care services. For example, an
HMO may require that a primary care physicianYou now know the what's, why's and where's of
in its network coordinate all of your care asthe health insurance game. Your next step is
well as refer you to specialists that belongto select the best health insurance plan that
exclusively  to  the  network.meets your needs. You should select one that
gives you the greatest flexibility and the
No matter which kind of health insurance youbest benefits for the lowest cost. Since this
buy, make sure it provides you with the rightis a major purchase, you should shop around
kinds of coverage. And when it comes toand get several quotes before choosing a
coverage, a good health insurance plan shouldplan. But before you dive in, here are a few
offer several types. For example, hospitalthings  to  consider:
expense insurance pays room and board as well
as incidental services costs if you're1. Co-pays, deductibles, and coinsurance
hospitalized. A surgical expense insurancerequirements,  which  ones  apply?
covers surgeons' fees and all other related
costs. A physicians' expense insurance policy2. Do you have the freedom to choose your own
pays for visits to a doctor's office or whenhealth-care  providers?
a doctor's visits you in the hospital.
Finally, major medical insurance offers very3. Does the plan you're considering cover the
broad coverage with an extremely high maximumhealth  services  you  need?
benefit that's designed to protect you
against losses due to serious illness or4. Does the plan you're considering work with
injury.the health-care providers you're currently
using?
So what might be covered in a health
insurance plan? When comparing plans, make5. Does the plan you're considering offer
sure they provide additional benefits thatfamily,  and  individual,  coverage?
you may need, including:o Prescription
drugso Preventive careo Mental6. Does the plan you're considering cover
health benefitso Maternity careopre-existing conditions? If so, is there a
Vision  carewaiting period? FYI - The average waiting
period  can  be  three  months  to  one year.
And what can all this cost? In addition to
the monthly premium expense, there may be7. Does the insurance company you're
other out-of-pocket expenses that can reallyconsidering have a good reputation and a
add up, especially if you have children orpositive rating from a major ratings
other family members who make frequent visitsorganization? For more information, contact
a doctor. You should check to see if theyour state's department of insurance.
health insurance plan you're considering asks



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