Articles
Newsletter
| Health Insurance - Managed Care Health Plans |
 |
 |
 |
| Written by Jordan FeRoss |
| Sunday, 25 January 2009 11:41 |
|
There are many different types of health insurance in Texas. One of the most common is the managed care health plan, which contracts with a specific group of doctors, medical professionals and hospitals (a network) to provide care to their subscribers. These contracts enable insurers and health care providers to agree upon services offered and pricing for those services to keep costs manageable without compromising patient care. If a patient chooses to see a doctor or be admitted to a hospital that is out-of-network, the out-of-pocket costs increase considerably. While choice is limited for the patient, there is advantage of more affordable care. Usually, managed health care plans are less expensive than other health care plans. When it comes to health care insurance in Texas, managed care plans extend lower rates because they have handpicked the providers that have agreed to their predetermined rates and fees. The providers also agree to avoid unnecessary tests and procedures in order to help keep costs down. Managed care health plans also provide benefits that encourage members to stay healthy, like help to quit smoking, in order to avoid more expensive health problems later in life. Managed care providers offer three different categories of health insurance in Texas: HMO (Health Maintenance Organization) - The HMO is unique in that it requires the patient to choose a Primary Care Physician (PCP) and work directly with that doctor for all care. Patients must see their PCP before visiting a specialist, receiving tests or being admitted to a hospital to get the PCP's (and insurer's) approval. The PCP will refer patients only to doctors within the HMO's network and patients pay a co-pay for office visits but there are often no deductibles. The HMO is generally the least expensive choice in managed care. PPO (Preferred Provider Organization) - A PPO allows for slightly more options because you can go to any doctor you choose. The downside of that is that you will pay more for doctors that are out of the network. As with most health insurance options in Texas, you are better off sticking with providers in the PPO network. POS (Point Of Service) - POS plans are great for anyone who's been with a doctor and does not want to change when there is a change in insurance as they tend to have sizable networks. And, like the PPO, patients can see any doctor they'd like without a referral but there is still a network of doctors. Patients choosing to leave the network will find their medical bills much higher than with other health insurance in Texas. A POS plan also the most expensive type of plan because there are fewer barriers for the patient before he/she can receive care. For health care insurance in Texas, you are required to pay a premium in order to keep the health plan active. For certain medical services, such as surgeries, you may be required to pay a deductible before the insurance will pay anything. The deductible is an out-of-pocket expense that you provide. Depending on what insurance plan you choose, you will pay that certain deductible amount before your insurance kicks in. Each time that you have to see a doctor, you will have to make a co-payment. You will also have to make a co-payment each time you get a prescription filled. There is a certain amount in out-of-pocket expenses that you are required to pay in regard to co-payments. After you have reached the limit and if you reach it within that calendar year, the insurance will kick in and pay 100% of your services. After you have paid your deductible, you will have to pay co-insurance. This is in regard to PPO and POS plans that have network and out-of-network services. Before choosing health insurance in Texas, it is important to know all the details of the plans you're considering to ensure you will be adequately covered and paying the lest amount for the coverage you need so that you won't break the bank while caring for your health. About the Author: If you are one of those looking for Texas health insurance then you can find the best deals on health insurance in Texas. Texas Health has great rates and resources to choose from! Kindly provided by LJ-Marketing.dk You are welcome to use this article on your own website, if you include the link just before this text. |
Stumble It!
Members : 1254
Content : 2297
Web Links : 1
Content View Hits : 310157
Content : 2297
Web Links : 1
Content View Hits : 310157