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Frequently Asked Questions About Health Insurance for Individuals

No denying that the cost of healthcare, which has been a basic need of our every life, is rising in the US like anything. Have a quick look to the facts which likely to be more than incredible, worris...

No denying that the cost of healthcare, which has been a basic need of our every life, is rising in the US like anything. Have a quick look to the facts which likely to be more than incredible, worrisome, and scary for anyone.

§  Surgery of a broken leg tends to cost nearly $7,500 - $10,000

§  The cost of 3 days of hospital stay will cost you $30,000

§  Critical cancer care is likely to cost more than hundreds of thousands of dollars.

To be precise, the largest part of Americans can hardly afford such huge expenses simply because illness or injury strikes us all of a sudden without giving us any prior intimation and can simply jeopardize our happy family life. Here comes the essentiality of having health insurance for individuals in Texas.

How Does it work?

Typically, the way health insurance works are that you buy a health insurance policy that requires you paying a certain amount of premium depending on the value of the policy you buy. Paying this minimum premium enables you to get through almost all kinds of costly healthcare services without spending anything or on a sharing basis as per the policy terms. If it feels you wondering that how do they bear those massive expenses against you minimal premium amount, this is reasonable to understand that compared to the number of sick people, the percent of healthy people is more. Thus, a large amount of premium collected from the enrollees can be utilized to support the small number of sick or injured people.

Where Will You Receive Care?

Establishments that offer health insurance for individuals in Texas are geared up with an extensive network of providers including recognized healthcare facilities, laboratories, pharmacies and obviously hundreds of thousands of physicians and specialist doctors. Insurance companies work together with a specific network of healthcare providers who agree to provide services to the members or enrollees in a budget-friendly way with the support of insurers. Thereby it is vital for you to ensure whether or not the hospital or physician is within the network. If the provider is not under the network, the insurance company may not entertain you for the service provided or likely to pay only a small portion of your expenses. So, naturally, under such circumstances, you have to pay much higher than having a service from someone who is under the network (get internet help to ensure).

What Does the Healthcare Plan Cover?

Subsequent to the standardization of healthcare plan benefits and with the implementation of the Affordable Care Act, these days health insurance for individuals in Texas are required to offer you ‘essential healthcare benefits’ without having a variation among plans. According to the standardization, you can now expect to enjoy services as stated below:

•  Emergency services

•  Hospitalization

•  Maternity and newborn care

•  Laboratory tests

•  Mental healthcare/ substance-abuse rehabilitation

•  Outpatient care service (this you can avail from physicians in their personal clinic, outside of a hospice.

•  Pediatric care included with dental and vision care

•  Preventive services (immunizations and management of critical diseases)

•  Prescription drugs

•  Rehabilitation services

How Much Will It Cost?

In reality, understanding the coverage cost by the insurance company is a bit complex. In a nutshell, apart from paying an enrollment and yearly premium, you have to share some portion of the total expense as a payout of your pocket. Because all healthcare costs are paid according to the standard rule of deductibles, co-pays, and coinsurance. Finally, it is worth noting that as a thumb rule, the more premium you payFree Reprint Articles, the less you’ll have to pay out as and when you access healthcare services.

Source: Free Articles from ArticlesFactory.com

ABOUT THE AUTHOR


The Harrin Group, LLC is one of the leading insurance agencies in San Antonio, Texas providing a range of insurance services like health insurance for individuals, life insurance, business insurance, burial insurance, dental insurance, silver sneakers, telemedicine, Medicare advantage and supplement plans. To know more, visit harringroup.com.



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