We’ve all faced the various struggles associated with obtaining, having and understanding health insurance. Most of us just know we need it. There are several pieces in the health insurance puzzle and we can help you put them all together. Whether you need coverage for you, your family and/or your employees, we will be glad to assist.

Here are the basic components of a health insurance policy:

  • Deductible – the amount you pay out of pocket before the insurance begins to pay, both for you and your family
  • Co-Pay – the amount you pay out of pocket for services; this amount usually does not help satisfy your deductible
  • Co-Insurance – the amount you pay out of pocket after you’ve satisfied your deductible and before you reach your out-of-pocket maximum
  • Out-Of-Pocket Maximum – the maximum amount you will have to pay out-of-pocket in a given year, both for you and your family
  • In-Network Vs. Out-Of-Network – often times, health insurance policies have different costs, benefits and limits of coverage for in-network vs. out-of-network healthcare providers; in-network offers lower costs and higher limits, because the insurance company has set negotiated rates with in-network healthcare providers which allow them to carry those discounts down to you; limits can vary for both you and your family
  • Health Maintenance Organization (HMO) vs. Preferred Provider Organization (PPO) – generally speaking, the differences between HMO and PPO plans include the size of the plan network, ability to see specialists, plan costs, and coverage for out-of-network services; HMOs are typically more expensive, but PPOs typically have better coverage

At Texas Independent Insurance & Risk Management, we can assist with not only traditional health insurance plans, but Medicare as well – including various Advantage Plans, Supplement Plans and Prescription Drug Plans.

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