It should go without saying that, in today’s day and age, you need Texas health insurance. Going without is a serious risk that could come back and haunt you in a big way. However, that definitely doesn’t mean it’s easy to figure out what kind of coverage you need. With so many policies to choose from and so much to consider, it can be a lot of work. Fortunately, the below should serve to at least make your options clear.
Health Management Organizations
One popular form of Texas health insurance is health management organizations or, as they’re better know, HMOs. The advantage to this form of coverage is that it’s low cost. However, the flipside is that it’s also low choice too. You choose your primary care physician who then organizes all of your healthcare needs. This means that, if you should need a specialist, you’d first go to this practitioner who would be in charge of assigning you a referral.
A big advantage with an HMO is you have one doctor essentially looking out for all your needs. So if you have serious medical issues or just a number of them, you’ll know there’s oversight in getting the help you need.
However, you have to stick within a certain network of doctors and if you wander outside of it, your HMO will no longer be of any use.
Preferred Provider Organization
With a Preferred Provider Organization, or a PPO, doctors and hospitals have agreed to offer discounted fees to your insurance company. In theory, then, these savings should get passed onto you. The healthcare providers benefit from this, though, as they are then given lots of business from the insurance company.
Unlike with an HMO, you have no practitioner in charge of your needs, so you’re free to pick whomever you like as a doctor. You’re also able to go outside the network if you like, although you won’t have those discounts to rely on.
Point of Service Plan
A Point of Service Plan combines features from both of the above types of Texas health insurance. So, like an HMO, a POS means you pick a preferred practitioner who will then be in charge of assigning you to specialists in your network as necessary. So long as you stay within the network, you’ll have a small co-payment but no deductible you need to meet.
However, should you choose to go outside of the network for treatment, this form of Texas health insurance will then act more like a PPO. That’s because you can essentially self-refer once you meet a certain deductible. You’ll probably end up with higher coinsurance though.
So while a POS offers you a strong incentive financially to stay within your network, you still have the option to go outside it if you like.
Those are the three main types of Texas health insurance you’ll need to consider when shopping the market. Keep in mind that these different versions will differ from provider to provider, so don’t be hasty in your decision.