HEALTH INSURANCE POLICIES IN TEXAS
When looking for Texas Health Insurance, you have to be thorough and efficient at the same time. You really have to understand insurance before purchasing anything. The Quote is an important step in the insurance purchasing process. The terminology can be hard, but read the fine print, it will help you find the policy that fits you best. The following is a list of terms used in the Individual Health Insurance industry.
Deductible- The fixed amount you have to pay before your insurance starts to pay.
Co-insurance- A percentage of the claim you Health Insurance pays. You insure payment to the provider and the health insurance pays a portion.
Co-insurance limit - The dollar amount you have to pay with Co-insurance before the insurance company begins paying your bills at 100% for the remainder of the plan year.
Out of Pocket Maximum- The total dollar amount paid out by a subscriber (deductible plus co-insurance)
Co-pay- A fixed fee you pay for services rendered. Most plans cover 100% after the co-pay for services rendered, however this can be adjusted to any amount depending on how the plan is set up.
Life time maximum- The total you policy will pay out. Many plans have a yearly restoration amount which will replenish the total so that after the policy money is exhausted there will still be some money in the following plan year for new claims.
Co-ordination of benefits or COB- How your plan pays when it is second to another plan. There are three principle methods in U.S. health plans.
- Maintenance of benefits- If the other plan pays the same amount or greater than your plan, then you plan pays nothing. If the other plan pays less, your plan pays only the difference between what it would have paid and what the other did pay.
- 100% allowable- The secondary plan pays the patient responsibility up to the full allowed amount by the plan.
- Government Exclusion- In general these plans take the patient responsibility remaining from the primary plan and treat it as a brand new claim and pay it under the normal plan benefits.
Self-Insured- Many major U.S. and world corporations hire insurance companies as administrators to manage a pool of money held by the company. Many state and federal laws do not apply to these plans.
Fully Insured- The insurance company collects the premiums and pays claims from its own money.
Reciprocity - Most insurance plans deal with networks of doctors. If for example you have an HMO plan that allows you to see any HMO provider anywhere in the country, it is called Full Reciprocity, but if it only allows you access to local area networks of providers it is called Limited Reciprocity and if you can only go to select networks that your company has purchased access to, it is called No Reciprocity
Now that you have done your homework on the terminology, you are ready to start shopping. Select the quote button below to get several Insurance Quotes from different insurance carriers. health insurance can be compared utilizing the internet. Often times you kind find better suited coverage, than your current insurance is providing.
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