What to Look For in a Health Insurance Policy

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Texas health insurance options are numerous, and it is good to know the critical differences between them when you are shopping for health care coverage.
Selecting the right health insurance policy can have a profound effect on you and your family should the need for health services arise.
Medical costs have soared in recent years, without the right type of insurance for your needs, you can find yourself facing significant medical expenses, or worse.
Here are four of the most common types of health insurance policies: 1) PPO (or preferred provider organizations.
) PPOs help to keep cost low by focusing members on working with physicians that are inside the network.
You do not have to work with a doctor in the network, but the costs increase if you go outside the network for treatment.
The advantage to this program is that is usually keeps the out of pocket costs relatively low, generally limited to $1,200 for individuals and $2,400 for families.
Out of network out of pockets will range from $2,000 for individuals to $3,500 families.
2) HMOs (health maintenance organizations) are like PPOs in many respects, as they both have a strong focus on preventative care, but HMOs tend to have lower costs associated with them.
HMOs tend also to have higher or no lifetime maximum benefit, which is important for those with long-term medical issues.
When you sign up with an HMO, you get a primary care physician, who is like your point person inside the organization.
S/he will be your first point of contact for your medical needs.
HMOs have lower out of pocket expenses, however, it can be more difficult to find specialized care in these systems.
3) High Deductible plans (like those for health savings accounts), are another option.
These plans have high deductibles, amounts which must be paid out of pocket before benefits kick in.
However, when they are matched with health savings accounts, they can provide long-term financial benefits through tax deferral.
These plans are also portable; you don't have to lose the plan if you switch employers for example.
4) Point of Service Plan (POS), which combines facets for HMOs and PPOs.
Like with an HMO, there is no deductible, and typically nominal co pays when you are working with a provider who is in-network.
POS' provide a great deal of flexibility; however, there is a financial penalty for using medical professionals who are not part of the network.
And like with an HMO, you must select a primary care provider, which can complicate the issue of finding specialized care in certain situations.
The two most important questions to ask yourself are: How important is it to me to be able to work with specific doctors, and How much can I afford to spend on deductibles, co pays and any other out of pocket expense.
These two questions will help you hone in on which type of Texas health insurance plan is going to best meet your needs and those of your family.
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