Monday, December 29, 2008

Individual Texas Health Insurance Through Employers

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.

If you are employed full-time, then check with your employer to see what kind of health insurance is available in Texas. Some employers don't even offer health plans to their employees because they think it would cost them too much to invest in. With group health insurance coverage, it's an easy process and you can choose the coverage that is most affordable 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.

One thing about an employee-sponsored health insurance plan in Texas is that your selection may be limited. You only have so many choices to choose from as far as health insurance is concerned. The terms of coverage are decided on between your employer and the health care system. So you can either reject what they have, or you can try and find something else. Or your employer may have other selections to choose from at different prices.

As health insurance in Texas is such an expense for employers, they often choose the most cost-conscious plans. For the employee, this can be frustrating as these plans usually offer fewer benefits and choice in providers. This is especially true if you work for a small company with fewer than 50 full-time employees. Employees of larger companies generally are offered more comprehensive plans, with lower monthly premiums because their employers can afford the additional costs of ever-rising health insurance in Texas.

Finally, there are two major types of health insurance offered by employers - manged care and indemnity plans. The most important distinction between these plans is the issue of up-front costs. A managed care plan offers a choice of in-network providers where costs are controlled by the insurer. Patients pay deductibles and co-pays for the services they need but do not pay any other up-front costs. Indemnity plans require payment in full each time a patient sees a doctor or has any procedure and then requires the submission of a claim to the insurer for reimbursement. You will not get to choose which of these is offered by your employer as they will have the final say based on their own financial situation and number of employees. For many, the costs of health insurance in Texas have a direct impact on what type of job they choose and the type of company with whom they work.

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