When most people in Houston, TX are shopping for health insurance, they mainly think about the cost of the premium. They may also consider the full cost of the plan, including deductibles, coinsurance, and copays. However, it is just as important to consider the value that health insurance provides. If you have questions, feel free to contact Insurance Over Texas to learn more.
Health insurance providers directly negotiate costs with hospitals and health care providers. Then, the rates are included in the health care plan. Some plans will only negotiate rates for in-network medical care providers, while others will offer negotiated rates for out-of-network providers. All health insurance plans provide coverage for emergency services regardless of whether the care received was from an in-network provider.
The amount charged by health care providers is typically higher than the negotiated rates. You will receive an Explanation of Benefits that will include a breakdown of the costs, including:
- The amount the provider usually charges
- The negotiated cost
- How much was paid by your insurance policy
- The amount that you owe that was not covered
Health insurance plans feature an out-of-pocket maximum and an annual deductible. The deductible is the amount that must be paid before the insurance company takes over the responsibility for the costs. Once the out-of-pocket maximum is reached, the insurance company will pay the remainder of the medical expenses.
Preventative Care Coverage
Health insurance plans offer complete coverage for preventative care. When doctors can identify a health problem in the early stages, they can begin treatment to prevent the progression of the problem. This will save you a lot of money by avoiding expensive treatment bills for preventable issues.
To find out more ways health insurance can save you money in Houston, TX, contact the experts at Insurance Over Texas today. Give us a call today.
If there is anything that is likely to make you feel inadequate it is having to deal with choosing medical insurance. Such an important decision with serious consequences for a wrong choice. Your entire healthcare for the next year depends on your choosing the right coverage. Unless you are into insurance or in the medical profession, chances are some of the terms you will come across will not be familiar. If they are familiar you may not understand their meaning in this context. At Insurance Over Texas in Houston, TX, we are here to help you to tackle this important choice with the knowledge you need.
A PPO (Preferred Provider Organization) is a type of managed healthcare plan that allows you to visit providers both in and out of your network. You also don’t need to see a Primary Care Physician for a referral to a specialist.
An HMO (Health Maintenance Organization) is a type of managed healthcare plan where you must have a Primary Care Physician who manages your care. You get your healthcare through providers within the network. If you get care outside the network you pay the entire bill out of pocket. The plans are usually less expensive but you have fewer choices.
The deductible on your policy is the amount you must pay annually before your health insurance starts to cover. Some exceptions may be preventative care. With a high deductible, you will pay less for your policy.
A Health Savings Account allows you to save money pre-tax so you are able to pay medical expenses that aren’t covered by your high deductible health insurance policy. Every year there are fixed limits on the amount you can place in your account. Talk to your financial advisor about the amount you can save.
Contact Insurance Over Texas in Houston, TX for all your insurance needs.
Choosing a health insurance policy is one of the most important decisions you make. Your health literally depends on it. For some people the question foremost on their mind is "how much will this cost" and while the cost is important, so many other things are more important. It is not worth getting a low price policy that in the end will not offer you any coverage. Talking to a trusted independent agency like Insurance Over Texas in Houston, TX makes good sense when something so important is at stake.
What type of plan is this
Is the plan you are considering a PPO (Prefered Provider Organization) or an HMO (Health Maintenance Organization). With a PPO you get the best deal by getting your health care through their network of caregivers. You don’t need to have a primary care doctor who coordinates your healthcare, you can visit anyone in the network. With an HMO you have a primary care doctor and you need to be referred to a specialist from your primary care physician.
Are my doctors on the plan?
Most people have a doctor or doctors who they regularly visit and they trust them to provide medical care. You need to check the list of doctors who are in the plan to make sure you won’t lose your favorite.
Are my prescriptions covered?
Every plan has a formulary that lists the covered drugs and places them into tiers. The tiers determine the cost. First, you need to make sure your drugs are on the list and then what tier are they in.
At Insurance Over Texas in Houston, TX, our customer’s insurance needs are our primary concern. We are here to answer any questions you have about your health insurance. Give us a call or stop into our office for the personal care you deserve.
If you don’t have health insurance through your place of employment, you will have to purchase it on your own. This isn’t as difficult as it sounds, especially with every state offering its own health insurance options. If you prefer, you can also talk to the agents at Insurance Over Texas. Insurance Over Texas serves residents who live in or near the Houston, TX area. While open enrollment only remains in effect from November 1st to December 15 each year, there are specific events that will allow you to alter your policy.
Open Enrollment Deadlines for Health Insurance
No matter where you get your health insurance, it must be purchased during the Open Enrollment period for your state. For the 2019-2020 year, Open Enrollment started on November 1, 2019, and ended on December 15, 2020. Insurance that has been purchased during that time went into effect on January 1, 2020. While the deadline for Open Enrollment has already passed, you can still purchase health insurance if you have a "special circumstance".
What Type of Event Will Allow You to Change Your Coverage?
Life-changing events that allow you to sign up or change your insurance coverage include divorce, marriage, the birth of a child, or the death of a spouse. Another possible circumstance would be the termination of your employment. If any of these events occur, you can apply to have your policy adjusted to account for your new situation.
In Houston, TX, the agents at Insurance Over Texas can help you find the right health insurance policy for you. They can also assist you if you need to alter or change your policy after a life-changing event. Call and speak to an agent as soon as you can!
For many people, health insurance can be confusing because it is so complex. People who select healthcare insurance policies may not entirely understand the terms and conditions of the coverage and may select the insurance based on basic, general descriptions that are provided by their employer. This is a common mistake because not all health insurance is the same.
Many Different Forms Of Coverage
There are plenty of different types of policies on the market today. Some cover general hospitalization or wellness visits, while others are more comprehensive and allow the policyholder to make lower co-pays when visiting the doctor. The best way to determine what your needs are currently is to work closely with a knowledgeable health insurance agent. People who are residents in or around the Houston, TX area can count on Insurance Over Texas to provide them with the answers they need to discover policies that help cover medical expenses that are both routine and emergency.
Finding The Right Insurance Provider
Finding the insurance provider that is right for the client’s needs can be a challenge, which is why working with an established and respected insurance agency is crucial. They can discover what the overall needs are, and then provide a selection of options to choose from. Additionally, they can help revise the policy if necessary and assist with the filing of claims if there is an issue.
People who are looking for quality health insurance in the Katy and Houston, TX area are urged to call or stop by the Insurance Over Texas office today to consult with a licensed health insurance agent. Get the protection necessary to help cover life’s medical expenses before the need arises.
There are plenty of reasons to live in Houston, TX. One of these reasons is access to world-class health services. Unfortunately, world-class health care is expensive, so you want to make sure you have reliable insurance. While comparing policies, it’s easy to get lost in the murky details. Let’s take a minute to demystify some of that murkiness. Insurance Over Texas has put together this quick list of benefits that will and won’t be covered by most insurance policies.
10 Essential Benefits
The ACA mandates certain levels of minimum coverage, regardless of state. While the applications of this coverage will vary by your policy, you can expect at least some coverage in these ten areas:
- Outpatient services (you didn’t have to be admitted to the hospital)
- Emergency services
- Maternity care
- Mental health and substance abuse services
- Prescription Drugs (though not all varieties will always be covered)
- Lab Services
- Preventative services
- Pediatric services
By federal law, health insurance has to address all ten of these benefits. That doesn’t mean that the coverage will be identical across policies. Deductibles and premiums will still vary even though these ten benefits are universal.
What Isn’t Covered
It’s hard to make broad statements about coverage because there is so much variety, but these services are rarely covered by insurance:
- Alternative medicine (like acupuncture)
- Cosmetic surgery
- Geriatric care (although there are alternatives to help with this)
- Dental and Vision (unless you get specific policies for these benefits)
- Weight loss treatment
- Some medications
You might notice that medication appears on both lists. Some amount of prescription drug coverage is required by law, but insurers have a lot of room in how they distribute those benefits. You might only be covered for generic medications as opposed to brand names, for instance.
If you want a complete view of how your policy works, it helps to talk to an expert. Your Insurance Over Texas agent can go over the details with you to make sure there is no mystery or uncertainty. Remove the doubt so you can have less stress in your life in Houston, TX.