Monday, December 29, 2008

Individuals Can Get Texas Health Insurance Through Their Employer

By Jordan FeRoss

Often it is difficult for a person to choose the right type of health insurance in Texas for them. Sometimes it seems there are so many to choose from and it can be tough to figure out which plan will best suit your needs.

Full-time employees need to check with their employers in order to find out which options they have for health insurance in Texas. There are few employers that don't offer insurance for their employees because it is usually required. And usually adding group health insurance coverage is a simple process and you should be able to look over your options and choose the one that is best for you.

When you are hired, you can enroll in a health insurance plan in Texas. As a new hire, you have 30 days from the time you start work to enroll. If you don't do it then, you will have to wait until the next open enrollment session. Open enrollment is the period when all employees can choose the health care coverage that they want to have. Each open enrollment period is for 30 days.

Depending on the insurance plan your employer provides, there may be out-of-pocket costs for you when you go to the doctor or are admitted to a hospital. This is due to an agreement between the medical professional you're working with and the insurer regarding payment. If you are requiring to pay for an office visit or procedure, you'll need to file a claim for the amount to the insurer to be reimbursed. And, the reimbursement will only happen if you've met your deductible so be sure to track this as well. As is typical for most health insurance in Texas, there are provider networks who work with insurers on patient care in order to keep costs down.

With employer-sponsored health insurance in Texas, the downside is that your choices in providers are somewhat narrow. You are given a limited number of choices of providers. Your coverage options are determined by your employer and the insurance company so you either take what they offer you or strike out on your own to buy insurance coverage, which will usually cost a bit more, but may be worth it if you need better coverage than they are offering.

The reason that the employer's selection is limited because of what they can include in the health insurance package. Since health insurance in Texas increases every year, they also have a budget as to how much of the package they will pay on behalf of their employees. If the company is large (more than 50 employees working full-time) or small (less than 50 full time employees), the health insurance coverage will be set up according to that. There are some things that a large employer has that a small employer doesn't and vice versa.

In addition to that, health insurance in Texas for employers is comprised of a managed care plan and an indemnity coverage health plan. A managed care plan means that you have to get medical services using a certain network of doctors and other medical personnel. An indemnity health plan is when you have to pay for medical services upfront and then submit claims to get reimbursed. So depending on the size of the employer, you may be looking at either one of these plans listed above. Just make sure that you have some type of health insurance coverage so that you won't be so much out of pocket for expenses.

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