Health Insurance Options in Texas
The rate of uninsured Texans has dropped since 2011; however, figures released by the US census bureau show that Texas still has the highest number of uninsured people. The federal law requires that US citizens should have health insurance that satisfies the federal coverage standards or be liable for a penalty. In 2015, Individuals who lack health insurance in Texas are expected to pay a penalty of $325 or 2 percent of their taxable income. This penalty is expected to double in 2016, and will keep increasing as the cost of living increases. It is best for Texans to understand health insurance Texas plans so as to make an informed decision.
Types of health insurance Texas Plans
There are basically three health insurance Texas plans: preferred provider benefits plan (PPO), health maintenance organization (HMO) and exclusive provider benefit plan (EPO).
Health Maintenance Organizations
This health insurance Texas plan pays only for hospitals and doctors within its network. The hospitals and networks that are listed are often subject to revision, so it is wise to keep reviewing your HMO plan. There are exceptions in this plan in the case of medical emergencies or for necessary medical services that may not be available in the listed network. If you choose this health insurance Texas plan, you will be expected to select a doctor from the network. The physician you choose will handle all your health care issues. The doctor is referred t as the primary care physician. In case you want to see a specialist in this health insurance Texas plan, your primary care physician will give you a referral. Women, however, do not need to obtain a referral for an OB/GYN routine checkup if the specialist is within the HMO network.
You can find a HMO health insurance Texas plan that offers you more flexibility. Such a plan will allow you to pick your doctors. You will still be expected to name a primary care physician, but you will not need referrals to visit a doctor outside the network. This health insurance Texas plan gives you more freedom, but you may be required to pay more if you use doctors outside the HMO network.
Preferred Provider Benefit Plans
A PPO is another health insurance Texas plan that is offered by various health insurance Texas companies. Under this plan the insured is free to choose any doctor; the only difference is that you will pay less if you use doctors that are listed in the PPO network. Hospitals and doctors that are recommended under the PPO network charge a discounted rate. Doctors outside the network will charge more and you will be required to pay for the extra charge. In addition to this, health insurance Texas providers will charge a higher deductible, co-payments and coinsurance for services provided outside the PPO network.
Exclusive Provider Benefit plan
This health insurance Texas plan is similar to a PPO. The EPO plans make special arrangements with hospitals and doctors to provide health care to the members at discounted rates. Insured persons are free to use hospitals and doctors that are listed in the EPO network. The difference between EPOs and PPOs is that in the PPO health insurance Texas plan, the insurer will pay part of the cost if you go to a doctor or hospital outside the network, unlike in EPOs. There are however, exceptions to this health insurance Texas plan, in the event of medical emergencies or if a patient needs crucial and necessary medical services that are not provided within the network.
There are several health insurance Texas providers with different rates under each of the plans. Now that you know the health insurance Texas options, you can choose a plan that will match your needs.