Texas health insurance

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 Health Insurance Plans & Patient Protection

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).

Texas Health Insurance Options for High Risk Individuals

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."