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Education

Texas is one of the most popular states for individual health insurance.  This is because Texas is full of motivated business owners and entrepreneurs.  However, many of us continue to stay uninsured. Over twenty-five percent of our state is uninsured.  Whats worse is that of the 25%, 40% qualify for government assistance through Medicaid, CHIP, or the new government high risk pool called PCIP. If you fall into this category call us now at 888 803 5917 so we can push you in the right direction.

The rest of the 25% need to shop for an individual, Texas health insurance plan on our Texas health insurance website.

Texas Health Insurance Choices

Most of the time when we write an article on health insurance education, we will review the major health insurance plan types and the differences between them. However, in 2012, the only plan type available in the individual market in Texas is the PPO or Preferred Provider Organization. There used to be HMO’s in Texas, but HealthNet left the market last year and Obamacare frankly changed the market considerably (in some ways the change was positive, but in this respect it was most definitely negative).

So what is a PPO? Essentially it is simply a network of physicians and providers that offer their services. When using a PPO network, referrals are not necessary, nor is it necessary to maintain a relationship with a primary physician. In fact you can use your dermatologist as your primary if you wanted to (though I would highly advice against this). Many women use their gynecologists as their primary.

In these networks, you will receive a negotiated rate on all rendered services, meaning that even if you have not met your calender year deductible, you will not pay full price for services. Even though it is a PPO, you will still want to stay in the network or you will end up paying full price. So if you call a doctor and they don’t take your plan, it is best to find one that does.

Keep in mind that carriers can come and go as they please and on any given day they will leave a network.

Other Factors to Be Mindful Of

If you are over 50, AARP and Aetna offer great coverage if  you can qualify. Call us at 888 803 5917 for a run down of options if you don’t see them when running your quote.

Child-only policies are pretty much history for now as children can stay on their parents plans well into their late 20′s.

One of the most important factors of health insurance shopping is coinsurance. Some less than reputable carriers use coinsurance to conceal coverage deficiencies. Coinsurance is the percentage after the deductible that you are responsible to pay. Typically it is twenty to thirty percent. However, coinsurance is exhausted at some point usually between three and ten thousand dollars per year. Companies or brokers will occasionally sell plans with no limit on coinsurance in order to make lousy carriers look competitive. East Coast Health Insurance doesn’t even contract with any of these type of carriers, and the best way to stay away from them is to check your coinsurance and to only sign up for coverage with well known carriers.