Texas health insurance options are similar in many ways to those
found elsewhere in the United States; however, their patient protection
laws and the Texas Health Insurance Risk Pool make the state unique.
Texas prides itself on having strong patient protection laws
in place. These laws prevent Texas health insurance plan providers
from taking advantage of patients and their need for affordable
health care.
When it comes to HMOs, these patient protection rights guarantee
access to specialties, prescription drugs, and annual physical
examinations. These laws also prohibit HMOs from rewarding doctors
who save money by not providing certain treatments to their patients
and from limiting the options for treatments doctors can discuss
with patients.
Despite these protections, TX health insurance plans - particularly
HMOs - aren't always doing enough for patients. The Office of
Public Insurance Counsel released a report
on the quality of HMO care in Texas and found that, on average,
these Texas health insurance plans were not meeting the quality
standards set by NCQA. You can learn more about the NCQA
(National Committee for Quality Assurance) and their standards
by visiting their web site (http://www.ncqa.org).
Because every state must comply with HIPPA (Health Insurance
Portability and Accountability Act), the state developed the Texas
Health Insurance Risk Pool which provides health care to people
who are unable to acquire Texas health insurance because of a
medical condition.
The Pool's coverage does cover most of the same care as the average
Texas health insurance plan, including hospital stays, emergency
care (although each visit includes a $75 deductible), prescription
drugs (with a $100 deductible), etc. Additionally, the first year
of coverage won't pay for any treatments for any pre-existing
conditions.
Although the Pool is a good option for many Texans, the costs
of the insurance are fairly high for the average person. For example,
a 35-year old man who chooses a plan with a $1,000 deductible
may end up paying between $324 and $458 per month in premiums
(depending on where in Texas he lives). The same insurance for
a 35-year old woman would cost anywhere from $419 to $591 every
month.
If you're interested in seeing how Texas health insurance stacks
up against other states, then you may want to read our articles
on: "Georgia
Health Insurance," "Florida
Health Insurance," and "California
Health Insurance."
