Understanding Texas Health Insurance Categories

 In most cases, even minor diseases and injuries cost thousands of dollars for diagnosis and treatment. It is here that health insurance policies come into picture. They are meant to protect the subscribers and their families from financial losses in the event of health care necessities. He Texas Department of insurance offers a free information service to the residents of the State with respect to various health insurance options in the state at TexasHealthOptions.com. For more detailed information and to know the changes in the healthcare reforms from time to time, Texas residents can visit TDI’s Federal Health Care Reform Information Page at 
There are some health insurance basics that can help the Texas residents choose from a large number of health insurance plans. In return to the premiums paid by the subscribers, health insurance plans are meant to pay for most and sometimes all of the expenses incurred by them in the event of illnesses and injuries. Some of the most common types of health insurance plans include indemnity plans, fee for service plans and managed care plans.
Indemnity Plans permit the subscribers visit any doctor or hospital of their choice. However, in case of choosing the medical service from outside the preferred network of doctors and hospitals approved by the plan, the subscribers must first pay the full cost of the medical care and then file for a claim to the carrier for reimbursement. Over and above, the difference in the hospital charge and the amount covered by the policy must be borne by the subscriber. You can understand it this way. Consider your plan has $20 coverage for doctor visit and you incur a charge of $25. Now you will have to pay $25 and file for the claim. The insurance carrier will reimburse you $20.
Fee-for-Service Health Plans also enable the subscribers visit any hospital or doctor they choose. The doctor or hospital will bill the insurance company for the carrier’s share of the costs incurred during the treatment. The insurance company will pay only a fixed percentage of the treatment. In other words, if the policy states it will pay 70 percent of the cost incurred towards a medical service covered by the policy, then said percentage of the cost incurred in a treatment will be paid by the carrier while the subscriber must bear the remaining 30 percent. Though the percentage can vary from plan to plan, as a general rule, fee for service plans should pay not less than 50 percent of the cost of health care expenses once the deductible is met by the subscriber. 
Managed Care Health Plans have contractual agreement with a network of doctors and hospitals to provide health care to the subscribers. Some of these plans require that the subscribers use the doctors and hospitals within the carrier’s network for availing of the routine care. Other kinds of plans allow the subscribers to choose doctors and hospitals even from outside the approved network but feature some financial incentives when the care is availed of from within the network. The four kinds of Managed Care Health Plans include Health maintenance organizations (HMO), Preferred provider plans (PPP), Point-of-service (POS) and Exclusive provider organization plans (EPO). The choice of any one of these categories can depend on the typical situation and requirements of the buyer.