Health Insurance in Texas (mortgage, to buy, deductible)

[triscan]

Are there are individuals that have had to buy health insurance for themselves and their family (vs getting through employer)? If so, please share your experience. We are thinking about moving from MA and our health insurance here is very nice. We do go to the doctor 8-10 times a year with 2 kids. Ofcourse ER visits too...

Is paying a co-insurance a standard here, in both employer and private plans?

What do your annual costs run for health related expenditure for a family?

Which is the most widely accepted insurance plan/company. It is Harvard, BCBS and Tufts in MA.


Thank you!

[ChristieP]

MassCare is pretty unique in the USA, and you aren't going to find anything like that here.

The best way to get privately purchased insurance here is through the Exchange. I will have to let someone else comment on the prices/costs since I get my insurance through an employer. I can warn you that the Exchange plans have VERY narrow networks, and many hospitals and most physicians won't accept them.

[Trainwreck20]

Is paying a co-insurance a standard here, in both employer and private plans?

Coinsurance and copays are used quite often in various combinations, so I don't know that there is a most common example. I pay nothing for well-checks, a $15 copay for visits, and have co-insurance (20/80) up until I hit my deductible. I could have skipped the coinsurance part if I wanted to pay a slightly higher co-pay and a higher premium. Insurance is through my business.

[triscan]

Thanks Christie. If I may ask, how do you know the insurance have narrow networks when bought through Obamacare...do you know anyone that had trouble finding a doctor to accept them. I ask because a cursory look at available plans lists good ones like BCBS that we may be able to afford. BSBS is widely accepted by practises/hospitals I presume.

Thaks Trainwreck20. Is insurance through your own business? What is the name of the plan?

Anyone with Obamacare and health exchange experience, please respond.

[Trainwreck20]

Mine is through my work (employee owned business) and is BCBSTx.

[ChristieP]

I work in human resources at a local hospital, so I deal with my own employees' insurance, and I also sit in on meetings where patients' insurance information is discussed.

BCBS is a very common carrier, but the networks for all of their plans are NOT the same! One of the ways that the Exchange plans are less expensive is that they have a "narrow network" which means there are not as many "in network" hospitals and doctors as would normally be found on other BCBS plans. For example, there are very few specialists in DFW who are in network on those plans.

YMMV, but again, you aren't going to find private insurance here that compares with MassCare.

[KathrynAragon]

Originally Posted by triscan

Are there are individuals that have had to buy health insurance for themselves and their family (vs getting through employer)? If so, please share your experience. We are thinking about moving from MA and our health insurance here is very nice. We do go to the doctor 8-10 times a year with 2 kids. Ofcourse ER visits too...

Is paying a co-insurance a standard here, in both employer and private plans?

What do your annual costs run for health related expenditure for a family?

Which is the most widely accepted insurance plan/company. It is Harvard, BCBS and Tufts in MA.


Thank you!

My husband and I are in our fifties and are self employed. We do not qualify for any ACA subsidies. Our health insurance costs us $1137 a month - with a $6000 EACH deductible. We do get a wide range of preventive care services included in that at no charge, but still...dang, that's a lot of money each month.

(By the way, we had basically the same plan last year and the year before - and the monthly premiums were $575 - In January they more than doubled due to additional ACA requirements.)

Ours is Blue Cross Blue Shield of Texas. The sad thing is - believe it or not, this was the least expensive plan we could find. It is a PPO and has wide coverage and a pretty low co pay. So it has it's positives, in spite of being the equivalent of our mortgage payment each month. You can bet your sweet bippy that I take advantage of EVERY preventive care service they offer.

I can say one thing positive - their service has been good. They process claims quickly and there's been no drama.

Our average costs per year have been, not including premiums, about $8k to $11k. One year I tore my achilles tendon, the next year my husband had to have an emergency appendectomy, and then the next year I tore my OTHER achilles tendon! So thank goodness for health insurance...sort of. I guess.

[lonestar2007]

Ah, socialized medicine. People wanted it, people got it. Oh, happy day.

[Aceraceae]

Originally Posted by KathrynAragon

My husband and I are in our fifties and are self employed. We do not qualify for any ACA subsidies. Our health insurance costs us $1137 a month - with a $6000 EACH deductible. We do get a wide range of preventive care services included in that at no charge, but still...dang, that's a lot of money each month.

(By the way, we had basically the same plan last year and the year before - and the monthly premiums were $575 - In January they more than doubled due to additional ACA requirements.)

Ours is Blue Cross Blue Shield of Texas. The sad thing is - believe it or not, this was the least expensive plan we could find. It is a PPO and has wide coverage and a pretty low co pay. So it has it's positives, in spite of being the equivalent of our mortgage payment each month. You can bet your sweet bippy that I take advantage of EVERY preventive care service they offer.

I can say one thing positive - their service has been good. They process claims quickly and there's been no drama.

Our average costs per year have been, not including premiums, about $8k to $11k. One year I tore my achilles tendon, the next year my husband had to have an emergency appendectomy, and then the next year I tore my OTHER achilles tendon! So thank goodness for health insurance...sort of. I guess.

6,000 deductible! Affordable

[triscan]

Thanks for your replies!

Was looking at BCBSTx plans, without applying any federal subsidies for healthcare....i am guessing this would get me the best networks, correct Christie?

In general do companies offer all kinds of plans, bronze, silver and gold? looks like it would be best to take a low premium plan and pay as you go...does not look like there are major benefits to the higher premium plans...