Answers to 5 Common Questions About Texas Health Insurance

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Answers to 5 Common Questions About Texas Health Insurance


Texas leads the nation in the number of uninsured residents, yet finding affordable health insurance in the state is easier than you might think. Here are answers to five frequently asked questions about securing health insurance in Texas.

1. Why should I get insurance if I'm young and healthy?


Having insurance is like carrying an umbrella?"you might not need it often, but you'll be glad you have it during a downpour. Even young, healthy individuals face accidents, seasonal illnesses, and unforeseen health issues. If you suddenly develop a serious condition, obtaining insurance might become challenging, and pre-existing conditions could be excluded. Plus, you can secure lower premiums while you're young, making coverage an excellent bargain.

2. Should I use a health insurance agency or get quotes on my own?


Using a health insurance agency offers multiple benefits. Agencies have established relationships with numerous insurance companies, giving you access to a variety of plans without bias toward any single insurer. Unlike individual agents tied to specific companies, agencies provide you with comprehensive options, saving you time and effort at no additional cost.

3. What features should I prioritize when buying health insurance?


Two crucial features to consider are lifetime maximum coverage and maximum out-of-pocket expenses. While co-payments and prescription coverage may seem pressing, in cases of catastrophic illness, overall coverage and out-of-pocket limits become critical. Aim for a policy with at least $3 million in lifetime maximum coverage and a yearly out-of-pocket maximum between $2,000 and $3,000.

4. Can I trust online comparisons for Texas health insurance?


Absolutely. Legally, identical plans must have identical pricing, whether you buy directly from the insurer or through an agency. For example, the price for a specific plan from XYZ Company will be the same whether you inquire online, by phone, or through an agency. However, prices can vary based on factors like age, gender, smoking status, and pre-existing conditions, with your medical history playing a significant role.

5. What’s the difference between an HMO and a PPO?


With Texas medical insurance, a Health Maintenance Organization (HMO) requires using their approved physicians and hospitals for non-emergency services. A Preferred Provider Organization (PPO), on the other hand, offers more flexibility, allowing you to visit any healthcare provider but providing greater benefits if you stay within their network.

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