ABOUT INDIVIDUAL HEALTH PLANS
If you have questions and need additional assistance, please contact:
James Rodriguez, President & CEO
TexHealth Central Texas
TexHealth offers a variety of individual and family major medical health insurance plans from some of the best carriers in the nation. Below are some of the most common insurance plans available to individuals on the open market that we may recommend, depending on needs.
A Health Maintenance Organization or HMO health plan requires you to appoint a primary care physician and to use doctors and facilities that are affiliated with the HMO. If you use healthcare service providers outside of the HMO, there is a good chance those charges won’t be covered by your policy. The great thing about an HMO is that the only charges you incur, outside of your premiums, are co-pays for doctor's visits and other services such as procedures and prescriptions.
A Preferred Provider Organization or PPO will save you money on services if you use the preferred providers within the network. Keep in mind that deductibles must be met on this plan before some services will be covered. The good thing about a PPO is they generally will allow a certain amount of services annually outside of the deductible with a small co-pay, and most often the PPO has a large network with quality care providers and excellent prescription drug coverage.
A Health Savings Account or HSA is an option that many carriers are now offering as an enhancement to a traditional HMO or PPO plan. HSAs combine a tax-favored savings account with a high deductible/low premium plan designed to save you money. Funds in the savings account are used to pay for out-of-pocket medical expenses until the deductible is met. Money left in the savings account at the end of the plan year continues to earns interest, tax free and rolls over to the next year.
Fixed Benefit, No Deductible Plans provides a set cash amount for covered medical events like doctor visits, urgent care, x-rays, prescriptions* and hospital expenses. After the set benefit has been used, you pay the difference going forward.
Catastrophic Plans are great for those healthy individuals who do not expect to need medical care throughout the year, other than routine preventative care.