Affordable Health Insurance
Affordable Health Insurance
According to America’s Health Rankings, Texas ranks 50th in the nation in terms of percentage of population lacking health insurance , with 25.1% of its population lacking health insurance.
Texas’s health insurance companies determine rates for individual insurance policies based on geographical location, age, medical history and other rating factors. Individual insurance policies are subject to medical underwriting and can be denied due to pre-existing medical conditions for twelve months.
When do you need to buy individual Texas Health Insurance?
One needs to pursue individual health insurance if all of the following are true:
a) If your employer does not offer health insurance benefits
b) If you cannot be named as a dependent on another person’s insurance policy
c) If you are not a member of a professional or a trade organization that offers health insurance
a) Indemnity Policies (Traditional Fee for Service Health Insurance)
Indemnity Policies offer tremendous freedom with respect to choice; one is free to visit any provider in Texas for covered medical services.
b) Preferred Provider Organization (PPO)
A Preferred Provider Organization provides a list of contracted providers; one receives the best services at the lowest cost if one restricts oneself to the limited list of providers in Texas for their health insurance needs.
c) Health Maintenance Organization (HMOs or Managed Care)
HMOs require members to obtain their medical services from doctors and hospitals affiliated with the particular HMO in Texas for their health insurance needs.
d) Self-Insured Health Plans
Large employers in Texas often have self-insured health insurance plans where all contributing employees pool in their contributions to pay for the medical services for the members of the plan.
Health Information Counseling & Advocacy Program of Texas
The Texas Health Information, Counseling & Advocacy Program (HICAP) provides one-on-one insurance counseling and assistance to senior Texans.
Texas Family Planning Program
The Texas Family Planning Program includes more than 350 clinic sites that offer preventative medical and educational services under the direction of licensed physicians.
Texas Health Insurance Risk Pool Program
The Texas Health Insurance Risk Pool, a state-funded program, provides health insurance to Texas residents who cannot obtain health insurance coverage because of their medical conditions, or (ii) are considered ‘Federally Eligible Individuals’, as defined by the Health Insurance Portability and Accountability Act of 1996.
Texas-COBRA
The Consolidated Omnibus Budget Reconciliation Act (COBRA) is federal law that extends one’s current group health insurance under certain qualifying events such as termination of employment or reduction of hours to part-time status. To be eligible for COBRA, the employer needs to have more than 20 employees.
Texas has a mini COBRA law that provides COBRA provisions for employers less than 20 employees and provides employees with ability to extend one’s group coverage for six months under certain qualifying events such as termination of employment.
Resources for Health Care Insurance in Texas
Georgetown University’s guide to Health Insurance in Texas
Georgetown’s Health Policy Institute has researched and written state guides for buying affordable health insurance in every state.
US News Rankings for best commercially-available health plans. Rankings reflect member satisfaction and success in preventing and treating illness compared with other commercial plans. The highest possible score is 100.
Health Care Advocacy Groups in Texas
Health Care for All Texas
Health Care for All Texas is a grassroots organization that believes health care is a human right. Every person in the state of Texas deserves access to high quality health care at an affordable cost.
Texas Association of Community Health Centers
The Texas Association of Community Health Centers (TACHC) is a private, non-profit membership association that represents safety-net health care providers in the state of Texas.