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Frequently Asked Questions - Texas Insurance
A premium is the monthly amount you pay for your insurance policy. Texas Health insurance premiums are determined by a variety of factors, including your medical history, the area in which you live, your lifestyle, and your current health status.
A deductible is an amount of medical expenses you are responsible for paying before your insurance starts covering you. A common deductible is $2500. This means you would be responsible for paying the first $2500 in medical bills before receiving coverage, with the exception on some plans of getting doctor copays without having to meet the deductible. Choosing a higher deductible usually means you will enjoy lower monthly premiums.
A co-payment, or copay, is a fixed-dollar amount that you are responsible for paying for a particular medical service. For example, a plan may have a $25 co-payments for a visit to your primary care doctor. This means it will cost you $25 to see that doctor.
Coinsurance is the percentage of the cost of a medical service for which you will be responsible to pay. Unlike a co-payment, which is a fixed-dollar amount, coinsurance is expressed as a percentage. Many insurance plans have 20% coinsurance for hospital costs - in this example, that would mean you would pay 20% of the total cost of a trip to the hospital, unless your expenses exceed your out-of-pocket limit.
An out-of-pocket expense is any cost you have to pay yourself when receiving health care. Expenses include your deductible, co-payments, and coinsurance. Most health insurance policies have an annual maximum out-of-pocket expense. Once you have paid out that amount, your insurance company will pay the rest of your medical costs for the year.
Managed care is a form of health insurance that stresses preventive medicine and affordability. In a managed care plan, you typically choose a Primary Care Physician who is responsible for approving specialist and hospital care. Managed care was originally introduced as a way to control healthcare costs. Today it is the most common form of health insurance in the United States. HMOs and PPOs are examples of managed care.
Health Savings Accounts aren't health insurance plans. Instead, they are individual savings accounts designed to help you save for future medical expenses. The money you deposit into an HSA is tax-free. You don't pay taxes on qualified withdrawals, either, and in many cases, the account earns interest. When you use money from your HSA to pay for a medical expense, you are paying with tax-free dollars. To qualify to open an HSA, you first have to purchase a high deductible health plan that is listed as HSA-compatible by the insurance carrier.
Health insurance isn't just about paying your medical bills. Being covered by a health insurance plan gives you the peace of mind that you will always have access to quality care. Health insurance also makes seeing the doctor easy and more affordable, which means you are more likely to get your preventive care and stay healthy.
The best way to explore your health insurance options is to get the advice of a professional Texas health insurance agent. Our instant quote tool will let you get started comparing plans in just minutes. When you request free quotes, you'll see your options side-by-side. To learn more about which options are right for you, contact us. We're always happy to answer your questions.
There is no single best policy for everyone, because each person has different goals or needs for their coverage. To find out which plans are right for you, fill out this short form and get your free online quotes.
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