You have two choices when it comes to health insurance in Texas: group coverage and individual policies. But which is better?
People are often wary of individual plans, but you should know that there are restrictions on individual health insurance in Texas. Rate bands are restricted. This means that premiums cannot vary by too much across one policy due to health status. This is a good restriction and means that your health coverage will not be as high a cost compared to people in other states that could see a 100% increase due to poor health status.
Below are three questions about Texas group and individual health insurance residents ask ? the answers might help you make your decision.
1. Should I Choose an Individual Policy or a Group Policy?
If your employer offers an affordable group policy and you?re eligible to enroll, enrolling with that plan might make more sense than to purchasing individual health insurance. Texas employees need to consider the cost and coverage of each plan before making a decision.
2. Aren?t Individual Policies More Expensive Than Group Policies?
Group health coverage policies are usually less expensive than individual plans; however, this is not always the case ? especially if you work for a fairly small company or your employer only offers one or two plans.
Before you sign up for your employer?s group health benefits, browse a few carriers that offer individual health insurance. Texas residents who work for companies that offer expensive group health coverage might be able to find insurance carriers that offer individual plans for less expensive prices.
3. What Happens If I?m Denied Health Coverage?
Employees of companies that offer group health plans are rarely denied; however, it does happen.
For example, the insurance carrier with which your employer does business might not offer any coverage ? or, only limited coverage ? to employees with certain health conditions. Too, if your employer only offers health benefits to full-time employees and you only work part-time hours, you can?t take advantage of group health benefits.
If this is the case for you and you don?t have a spouse with a health plan you can join, you should look into purchasing individual health insurance. Texas fortunately has many health carriers to choose from!
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Help answer the question about Health
Question by synchronised: How does health insurance work in the US?
I am a non-US citizen and need this information to do a case.
Specifically:
1) Is health insurance compulsory for everyone?
2) What happens if someone cannot afford it?
3) In the event that a medical procedure needs to be done, does health insurance cover all the bills? Does the patient need to pay anything extra?
4) Does the patient have any say over what kind of procedure he can take? Say if 2 treatments are available for his condition, can the patient choose the more expensive treatment? And if so, is it covered by the insurance?
Thanks for reading this. Your help in answering any part of the questions would be greatly appreciated!
Thanks to those who have responded so far.
I would like to further ask:
Does a health insurance contract state that it will only cover the ?normal? rates for a procedure? For eg. if there are 2 possible treatments for a disease, 1 of which is more expensive but more effective than the other, will the patient only be covered by the LESS expensive one?
Or is it a case in which the patient can opt for the more expensive one and ?top-up? the difference?
This is a crucial question to my understanding the case. Thanks!
Best answer:
Answer by Pinky Lee
Health insurance doesnt work in the US. If you cant afford it (it is very expensive) you dont have it. We do have programs to provide insurance to those that cant afford it, but it is primarily for children. You can choose any treatment you want as long as you are going to pay for it. If you do have insurance the insurance company pretty much tells you what they will pay for, otherwise you are on your own. Insurance companies rule in the US, and if you dont like it?..too bad.
Know better? Leave your own answer in the comments!
Source: http://www.thelifeguide.net/individual-health-insurance-compared-to-group-plans.html
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