Texas Health Insurance Plan “Fee for Service”
Texas Health Insurance Indemnity plans, also called “Fee for Service Plans” are plans sold by most insurance companies. One of the benefits of Texas Health Insurance Indemnity plans is, that you can visit any doctor you choose and with no referral for Specialist visit. Texas Health Insurance Indemnity plan will cover most of costs, but there are exceptions.
Most of the time under indemnity plans, the provider will send the bill to the insurance company directly, but in some cases you might have to pay the bill yourself and later file a claim with your insurance company to get your money back. The good news is that Texas law requires insurance companies to reimburse the claim quickly. The worst case scenario would be several weeks.
Next, we will cover basic terminology used with indemnity plans.
Premiums– Most of you are familiar with this word, probably because you see it on your bill every month. Yes, premium means the amount of you monthly bill, no matter where you get this bill, either direct from your insurance of your employer.
Deductible– Is out of pocket expense that you need to pay to the provider. This amount has to be paid up front prior to insurance company taking over the bill. When applying for health insurance in Texas Indemnity plans, please pay very close attention to the deductible amount and make sure you can afford the deductible.
Coinsurance– Is pretty much the sharing cost between you and your insurance provider. The amount shared will be stated in your plan, so pay close attention to the amount. Common sharing plan is usually 80 / 20 split, with 80 being covered by the insurance companies. According to Texas law, the most percentage that can be split is 50/50. It is very important that you read your insurance plan. Also, 1 million is the total amount that Texas Health Insurance Indemnity Plan will pay over the lifetime of your plan.
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