Policy Price

Article by Wiley Long

Most of the insurance coverage we buy is meant to keep us afloat in case of a major mishap, but one type of insurance can do a whole lot more. Health insurance doesn’t just help after the fact, your health plan can actually change your future. The right health insurance coverage enables you to monitor health problems, to reverse trouble before it gets too big to manage and to actually prevent disease.

With that kind of potential, Texas health insurance coverage should get more of your attention than some other forms of insurance. Typically, most people look at the price tag first and sometimes neglect to even consider other parts of their coverage. While price is critical, there are three main aspects to be sure you check before you buy.

Texas Health Insurance Legitimacy And Reputation Can Be Verified

Unfortunately, problems with insurance companies don’t always attract attention from regulators until a lot of policyholders have already lost too much. Their claims may not be paid or the health care services they need may not be covered, but there are several ways to verify the legitimacy and reputation of health insurance for Texas.

The Texas Department of Insurance hosts a website where you can look up information about insurers, including whether they have a current license, how their financial soundness is rated and the company’s complaint index and ratio.

You can also find independent health insurance brokers online who pre-screen health insurance companies before offering you access to their plans. Before you run quotes to see the premiums available for Texas Health Insurance plans, review the standards posted on that website. Does the broker offer you coverage from companies with questionable ratings for financial stability or only companies that earn A ratings from independent groups?

Check Texas Health Insurance For Exclusions And Limits

After health care reform passed, insurers were no longer allowed to place lifetime limits on the amount of health care coverage you could get over a lifetime. While that is a great help, there are still other exclusions and limits that can cut your coverage.

Even though your plan may have a specified deductible, that doesn’t guarantee all health care is covered once the deductible is met. Plans may exclude outpatient charges, for example, that could lead to major out-of-pocket costs. Numerous plans also don’t cover prescriptions.

If you deal with an insurance agent who sells multiple forms of insurance, like auto and home, the odds are that he’s less well informed about all of the specific details in the Texas Health Insurance plans he has to offer. Take the time to find a health insurance specialist. Test his knowledge by asking a few questions. For example, does he know how health savings accounts work? Does he know that HMO provider networks restrict your access to second opinions and specialists?

Investigate Texas Health Insurance Provider Networks

HMOs are just one of the types of provider networks available and, like most, they have advantages and disadvantages. While it’s true that HMO plans require you to select a primary care physician who controls your access to other doctors, HMOs don’t require you to pay for your health care up-front. There aren’t any claim forms to fill out or long waiting periods for reimbursement. Most HMO plans require relatively small co-payments for office visits, hospital stays and prescriptions.

Another popular provider network is known as a PPO. These networks, unlike HMOs, have some coverage for providers outside of their network, but the big savings are to be found on the discounted pricing for in-network services. Before or after you meet a PPO plan’s deductible, your charges for in-network doctors, hospitals or medical labs are discounted, sometimes substantially. When you run Texas health insurance quotes, remember to compare like plans and take possible discounts into account when making your final decision.

Another main consideration is whether any doctor you like is listed in the network. You could have little or no coverage to see an out-of-network provider and plan networks do change from time to time. Having had a plan in the past does not guarantee that it still covers the same providers years later.

Investigating the reputation of Texas health insurance companies, reading each plan for exclusions and limits as well as exploring each plan’s network of providers can go a long way toward ensuring you end up with the coverage you really want.

About the Author

By Wiley Long – President, eTXHealthinsurance.com – Texas’s leading independent online health insurance agency specializing in individual and