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.

For some employees, coverage starts on the day they are hired so there is no lapse between one insurance plan to the next. More commonly, however, there is a waiting period of at least thirty days before an insurance plan is effective with a new employer. You'll want to be sure all paperwork is completed within your company's open enrollment. If you miss this period, you'll have to wait until the next open enrollment cycle begins before you'll be able to submit your paperwork for health insurance in Texas. As this is a quarterly or annual occurrence (depending on the insurer) it can be difficult if you are hired outside of the open enrollment timeline. It is during this time that your employer may choose a different insurance company if they are unhappy with the benefits their employees are receiving.

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.

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. - 15790

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