Choosing the best plan for affordable health insurance in Texas can be stressful. If you’re looking for a plan on the exchange, you typically have limited time to find the best, most affordable health insurance for you and your family. Even off-exchange plans can be tricky to navigate if you’re not sure what to look for. If you’re looking for affordable health insurance in Texas, we have some fantastic tips to help you navigate the process.
First things first, you’ll want to consider which type of affordable health insurance in Texas that you need. There are several options:
HMO: Health Maintenance Organization: These plans require you to stay in-network to get coverage, except for emergencies. Procedures and visits to specialists require a referral. Generally, these plans have lower out-of-pocket costs but also less freedom to choose your providers. A primary care doctor will coordinate your care for you.
PPO: Preferred Provider Organization: You don’t have to stay in-network to get coverage; however, in-network care tends to be less expensive. You also don’t need to get a referral for procedures and visits to specialists. These plans have higher out-of-pocket costs but offer more provider options and do not require referrals.
EPO: Exclusive Provider Organization: These plans require you to stay in-network to get coverage, except for emergencies. You also don’t need to get a referral for procedures and visits to specialists. These plans offer lower out-of-pocket costs and do not require referrals, but there is less freedom to choose providers.
POS: Point of Service Plan: Like PPOs, you don’t have to stay in-network to get coverage, but in-network care is less expensive. These plans do require referrals. All in all, POS plans offer more provider options. You work with a primary doctor who coordinates your care for you, with referrals required.
The next consideration is how much you can afford to pay for monthly premiums as well as overall healthcare costs, should you get sick or need to use your health insurance. Premiums, copays, and deductibles are key words to pay attention to.
Premium: This is the monthly fee you pay to an insurance company or health plan to provide health coverage.
Copays and deductibles are both features of health insurance plans and dictate how much the insured pays for health services, though amounts and frequencies vary.
Copay: A fixed amount paid by a patient for receiving a particular health care service, with the remaining balance covered by the person's insurance company. It’s the small amount you must pay to receive care.
Deductible: A fixed amount a patient must pay during a given time period (usually the plan year) before their health insurance benefits begin to cover the costs. In general, the deductible represents the total amount you will have to spend on covered health care services before your health coverage starts to kick in.
Generally, plans that charge lower monthly premiums require higher copayments and higher deductibles, while plans that charge higher monthly premiums have lower copayments and lower deductibles.
When looking for affordable health insurance in Texas, you must decide whether you are going to purchase a plan through the exchange or go with an off-exchange plan. You can view more on that here. Self-employed people aren’t able to get insurance through an employer like their 9-to-5 counterparts, but that doesn’t mean there aren’t options.
Some people are most comfortable using the Texas public marketplace. Note that if you go this route, you can only enroll in a plan during open enrollment, which typically lasts from November 1 through December 15. You may qualify for a special enrollment period if you have had a qualifying life event. To find an affordable health insurance plan in Texas on the exchange, visit HealthCare.gov and enter your ZIP code during open enrollment. From there, you can peruse plans and options.
If you choose to find an off-exchange plan (e.g. through a broker, private exchange or insurer), you may have different windows to purchase, but you also won’t be eligible for premium tax credits and subsidies.
Decent offers off-exchange plans that are available for you to enroll in year-round. Yep! We offer open enrollment 365 days a year, 24/7. Our application process is straightforward, so you can get covered asap. In other words, if you’re looking for affordable health insurance in Texas, we’ve got you covered. Take a look at our three plans that we designed with the self-employed in mind:
Pathfinder Bronze Plan — Perfect for those who want to be covered in case something bad happens. Members of this plan enjoy the lowest premiums in Austin.*
Lonestar Bronze Plan — Excellent for people who expect to use their insurance from time to time. Members of this plan geek out on the $0 medical deductible.
Trailblazer Silver Plan — Best fit for people with families, medical conditions, or prescriptions. Members of this plan brag about the manageable copays for most everything.
We make it super simple to take advantage of affordable health insurance in Texas. How? By offering free primary care. You pay nothing ($0) to see your doctor, whenever and as often as you’d like. You can choose standard or virtual options depending on whether you’d prefer to see your doctor in-person or through virtual visits. No copays, just you and your doctor working together towards your best health.
Ready to check it out? Get your free quote today.