7 Things to Consider Before Choosing a Texas Health Insurance Plan

Are you looking for Texas health insurance to cover you and your family?

The average American spends $10,345 a year on health care, even with insurance. Yet, your costs will be much lower if you procure a Texas health insurance plan for your family.

But choosing your health insurance shouldn’t be done in a hasty manner. Instead, you need to know how to compare the available plans and select one that fits your family’s needs.

What should you consider while selecting a plan? We’ll go over the top 7 items to think about below. Keep reading to learn more!

1. What Is Your Purpose for Getting Texas Health Insurance?

Before you commit to a plan, consider the reason you want to enroll in a Texas health insurance policy in the first place.

Are you hoping to save money on all of your medical expenses? Or do you only plan on going to the doctor in the case of an emergency?

Not all Texas health insurance policies provide the same amount of coverage. As such, ask yourself what you plan to use your health insurance to cover. If you only want coverage in case you need to unexpectedly go to the hospital, consider a catastrophe plan. If you want to use your insurance for a wider range of procedures, look for plans that cover more.

2. What Are Your Family’s Needs?

Do you have family members who need specific types of treatment or medications?

If so, you need to look for plans that cover those items. Because not all plans cover everything, policies can vary widely. To discern what types of prescription medication and procedures a policy covers, go to the insurance company’s website. Look for a document labeled “benefits”, “coverage”, or something similar.

This should lead you to pages that give you information on how much you will pay for each procedure and medication. Consider the benefits of several different policies to ensure you’re getting the best deal.

3. What Is the Premium?

When you purchase an insurance plan, you will need to pay for it on a monthly basis. Failure to do so may result in the health insurance company revoking your coverage.

Premiums range from under $100 to more than $500. Generally, the more a plan covers, the more expensive it will be. If you want to get your premium at a cheaper rate, check healthcare.gov. This website hosts the U.S.’s Healthcare Marketplace. Through it, U.S. residents can apply for premium tax credits.

If granted, these credits reduce the cost of the premium.

How do you know how much your premium will be?

Most plans list the amount you will have to pay per month somewhere on the policy’s description. So, if you want to look for information on how much you’ll pay, take a look at the individual plan.

4. What Is the Deductible?

Insurance policies feature a deductible. Put simply, deductibles list how much you must pay before you become eligible for the full benefits of the plan.

A low-cost deductible might be hundreds of dollars, but many range into the thousands. Most insurance companies offer partial coverage before you meet your deductible, too. For instance, if you go to the doctor for a check-up, you might need to pay the copay (find more information on copays below).

To learn more about what gets covered before you meet your deductible, contact the insurance company.

5. Is the Plan an HMO or PPO?

Many insurance plans fall into one of two categories: HMO or PPO.

HMO stands for Health Maintenance Organization. Under this type of insurance, covered persons may seek medical care from a group of physicians in a network. Once you get this insurance, you will choose a primary care provider (PCP). This is the person you will go to for your basic medical needs. Should you need to go to a specialist, you will need to get a referral from your PCP.

Otherwise, you will not receive coverage.

A PPO is short for a Preferred Provider Organization. With a PPO, you can go to whoever accepts your insurance and receive coverage. You also don’t need a referral before seeing a specialist. This gives you more flexibility over who oversees your healthcare.

6. Does Your Primary Care Doctor Accept Your Insurance?

Next, find out whether your usual physician takes an insurance plan. To do this, call or email the doctor’s office.

You’ll also want to do this if you don’t have a doctor you regularly see yet, too. Not all doctors keep their websites up-to-date regarding what insurances they take, so it’s best to confirm before committing to a plan.

This is especially applicable if you want to enroll in an HMO policy and need to list someone as your PCP.

7. What Are the Copays and Coinsurances Like?

Another important aspect of an insurance plan consists of its copay and coinsurances.

A copay is what you will pay every time you visit an in-network doctor. Copays usually apply both before and after you meet your deductible. They generally cost less than uninsured trip to the doctor would.

Coinsurances are what you pay on a specific procedure after you meet your deductible. For instance, you might still have to pay for 20% of a surgery.

Looking over your copays and coinsurances can give you an idea of how much you will spend at the doctor under an insurance plan.

Ready to get health insurance? Try these family options.

Want to Learn More?

Getting Texas health insurance ensures you and your loved ones can always afford your medical care while living in Texas.

By asking yourself the questions above, you boost your likelihood of finding a plan that fits your needs. This ensures you get all your family’s medical necessities taken care of.

To learn more about getting your health needs met, read the rest of the articles in our health section!