Find the Texas Health Insurance Plans Right for You
Texas health insurance plans can be found in various forms but most health care benefits packages will belong to one of three main categories. There are HMO (Health Maintenance Organization) plans, Preferred Provider Organization (PPO) programs and Indemnity coverage plans, each with unique benefits and restrictions. Each of these packages offers reasonable levels of health coverage for most consumers, but the packages differ in requirements and restrictions, approved health providers and pricing.
In an HMO, only health care received from a network-affiliated health service provider will be included in the plan, and any specialized care must be referred by the assigned primary physician in order for the services to be covered. In a PPO, health care is covered at a greater percentage when you use an in-network provider with discount network rates, but you may also go to out-of-network health service providers and receive a lower percentage reimbursement of your covered expenses. With an Indemnity plan, you may select any health service provider you wish, and you will have coverage for a fixed level reimbursement of your covered health expenses. Of these programs, HMO packages will have the least expensive premium rates, while Indemnity packages are very comprehensive and come with the most expensive premiums.
When choosing between an HMO, a PPO or an Indemnity plan, you should first determine whether your preferred physicians and hospitals participate as part of the HMO or PPO network. Next, you should decide how much flexibility you would want in selecting specialists should you require one. Finally, you will need to evaluate the trade-off between more freedom in choosing physicians, labs and hospitals versus the significantly more expensive premiums associated with having greater flexibility.