Finding Health Insurance
The Texas Department of Insurance’s online brochure, Your Health Care Coverage, also briefly covers special health plans for small employers, coverage available through the Texas Health Insurance Risk Pool, the Children’s Health Insurance Program and employers’ self-funded health plans.
Private Insurance Coverage
Self-employed individuals and workers who do not have access to health insurance through their employers may purchase individual and/or group health policies. The following resource may help you:
A Consumer Guide for Getting and Keeping Health Insurance
State-by-state information on your rights under federal and state law that will protect you when you seek to buy, keep, or switch your health insurance (Georgetown University Health Policy Institute)Guide to Health Insurance
Discusses the basic forms of health coverage and includes a checklist to help you compare plans. (Health Insurance Association of America)Managed Care Answer Guide
Guide to assist you in choosing, understanding, and utilizing your health plan. (Patient Advocate Foundation)
TDI’s Web site may help you understand health insurance options. TDI has lists of:
- Companies authorized to offer consumer choice benefit plans;
- Companies offering small employer accident and health coverage;
- Insurance companies authorized to sell individual health policies;
- Insurance companies authorized to offer Preferred Provider Organization health plans;
- Insurance companies authorized to offer medical savings accounts; and
- Insurance companies authorized to Offer dental plans.
If you cannot obtain health insurance as a result of a pre-existing medical condition, or qualify as a “Federally Eligible” individual, you may be able to purchase insurance through the Texas Health Insurance Risk Pool.
If you have insurance through your employer and leave the company, a federal law allows you to continue your insurance coverage through your former employer for up to 18 months, although you will have to pay the entire premium. For more information about COBRA continuation of coverage, go to http://www.cms.hhs.gov/COBRAContinuationofCov/
Government Programs
Medicare is a federal health insurance program that covers those age 65 and older, as well as disabled individuals. Supplemental insurance may be purchased to help offset the costs not covered by Medicare. These resources will help you learn more about Medicare coverage:
Medicare Personal Plan Finder
Allows you to identify and compare Medicare health plans that are available in your area. (Centers for Medicare & Medicaid Services)Understand Your Health Insurance and Medicare Options
Information to help you understand Medicare, Medicare supplemental insurance (Medigap), managed care, and other health insurance options. (American Association of Retired Persons)Your Medicare Coverage
and Frequently Asked Questions
Provide information about health care benefits in the Original Medicare plan. (Centers for Medicare & Medicaid Services)
Medicaid provides access to health care for qualified low-income pregnant women and children as well as people who are elderly or who have a disability. Applications for Medicaid and other services for low-income families are taken at local Medicaid offices, or may be made online. Call the toll-free Texas Medicaid Hotline at 800/252-8263 between 7:30 a.m. and 5:30 p.m., Monday through Friday for assistance, or visit the Texas Medicaid Web at http://www.hhsc.state.tx.us/medicaid/cs/CS_home.html. Additional information is available at http://www.cms.hhs.gov/home/medicaid.asp.
The Children’s Health Insurance Program provides coverage for children whose family income exceeds the amount to qualify for Medicaid but do not earn enough to buy private health insurance. Families pay premiums and share the cost of services based on their income for doctor visits, prescription drugs and emergency care. To find out more, call toll-free 800/647-6558 or visit the CHIP Web site at http://www.hhsc.state.tx.us/chip/index.html. Additional information is available at http://www.cms.hhs.gov/home/schip.asp.
Resources for Businesses
Texas has several options to help employers provide health insurance coverage to their workers. Check out the following resources:
Small Businesses:
http://www.texashealthoptions.com/cp/smallbiz.htmlMid-Sized or Large Employer:
http://www.texashealthoptions.com/cp/largebiz.html
Charity Care
If you cannot afford to purchase insurance and do not qualify for Medicare, Medicaid or CHIP, you may be eligible to receive free care under a hospital’s charity care policy. Contact the hospital business office. You may be asked to verify your income or other assets to determine whether or not you qualify for charity care.
These resources may assist you:
Access to Health Care/Charity hospital care in Texas (Attorney General of Texas/Consumer Protection) -
http://www.oag.state.tx.us/AG_Publications/txts/access.shtml
http://www.oag.state.tx.us/AG_Publications/pdfs/access.pdfLow-cost Health Care
Searchable directory of primary care centers for underserved populations. (Bureau of Primary Health Care)Obtaining Free Care
Information on receiving free or reduced cost care under the Hill-Burton program. (Health Resources and Services Administration)