You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call: 1-800-MEDICARE (800-633-4227). TTY or TDD users should call 877-486-2048, 24 hours a day/7 days a week; The Social Security Office at 800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY or TDD users should call, 800-325-0778; or Your State Medical Assistance (Medicaid) Office.
There are premium subsidies available in the exchange, but you're not eligible for them if the plan offered by your employer is considered affordable and provides minimum value (this is true for your family members as well, if they have access to your employer-sponsored plan, even if the employer-sponsored plan is only affordable for the employee's portion of the coverage; this is known as the family glitch). Most employer-sponsored plans are affordable and do provide minimum value. So if you're shopping for an individual market plan instead, chances are high that you'll have to pay full price for it, without any subsidies.
For those who don’t have access to employer-sponsored plans, coverage on the individual market is an option. This market has changed dramatically as a result of the Affordable Care Act. Prior to 2014, in most states, individual coverage was medically underwritten, which meant that coverage was only available for purchase if the applicant was at least fairly healthy, as the insurance companies would closely scrutinize your complete medical history when you applied. Coverage in the individual market was typically not as robust as employer-sponsored health insurance; maternity care, prescription drugs, and mental health care were often missing from the coverage. And people who purchased individual market coverage prior to 2014 had to pay the whole premium themselves.
Depending on the health insurance company, Texas individual and family health insurance rates for couples can be based on the age of the youngest person on the policy. Some couples with an age difference of several years may find they save money by applying for the same plan rather than individually. Couples that are only a few years apart might be able to reduce their total costs by applying for separate health insurance plans. If you decide to apply for a health insurance plan as a couple, make sure the plan you choose covers the benefits both of you need.
These plans meet all the requirements of the health care law, including covering pre-existing conditions, providing free preventive care, and not capping annual benefits. If you have one of these plans, you won’t have to pay the fee that people without coverage must pay through the 2018 plan year. (Note: Starting with the 2019 plan year (for which you’ll file taxes in April 2020), the fee no longer applies.)
HealthMarkets can help you find options that meet your needs, whether it is for a private plan, a health plan on the new government exchange, or even a Medicare Advantage plan. We offer a broad portfolio of health plans from 180 recognized companies nationwide. From platinum level metal plans to catastrophic only, we’re ready to help you find a plan to fit your lifestyle.
There are other plans available year-round that are not individual major medical coverage. Most of these plans are not recommended as stand-alone coverage (with the exception of short-term plans, which can be adequate stand-alone coverage if you're healthy and you know that you need the coverage for only a short time; they are usually not at all adequate for longer-term coverage). These plans are not regulated by the Affordable Care Act, which means they can exclude pre-existing conditions, impose dollar caps on your coverage, and don't have to cover the ACA's essential health benefits. In most cases, these plans cannot really be compared with an employer-sponsored plan, since the coverage will be so much lower quality. If an insurance offer sounds too good to be true, read the fine print carefully. It may end up being a poor substitute for real health insurance, and you don't want to learn those details after you have a major claim.
For those who don’t have access to employer-sponsored plans, coverage on the individual market is an option. This market has changed dramatically as a result of the Affordable Care Act. Prior to 2014, in most states, individual coverage was medically underwritten, which meant that coverage was only available for purchase if the applicant was at least fairly healthy, as the insurance companies would closely scrutinize your complete medical history when you applied. Coverage in the individual market was typically not as robust as employer-sponsored health insurance; maternity care, prescription drugs, and mental health care were often missing from the coverage. And people who purchased individual market coverage prior to 2014 had to pay the whole premium themselves.
Humana group medical plans are offered by Humana Medical Plan, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Health Plan of Ohio, Inc., Humana Health Plans of Puerto Rico, Inc. License # 00235-0008, Humana Wisconsin Health Organization Insurance Corporation, or Humana Health Plan of Texas, Inc., or insured by Humana Health Insurance Company of Florida, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Insurance Company, Humana Insurance Company of Kentucky, or Humana Insurance of Puerto Rico, Inc. License # 00187-0009, or administered by Humana Insurance Company or Humana Health Plan, Inc. For Arizona residents, plans are offered by Humana Health Plan, Inc. or insured by Humana Insurance Company. Administered by Humana Insurance Company.
Anthem Blue Cross Life and Health Insurance Company is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross Life and Health Insurance Company depends on contract renewal. Anthem Blue Cross Life and Health Insurance Company (Anthem) has contracted with the Centers for Medicare & Medicaid Services (CMS) to offer the Medicare Prescription Drug Plans (PDPs) noted above or herein. Anthem is the state-licensed, risk-bearing entity offering these plans. Anthem has retained the services of its related companies and authorized agents/brokers/producers to provide administrative services and/or to make the PDPs available in this region. Anthem Blue Cross Life and Health Insurance Company is an independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.
However, they might still be able to find a less expensive plan in the individual/family market, even paying full price for the premiums. It would almost certainly have a higher deductible and out-of-pocket exposure than the plan Doug's employer offers, but that might be a trade-off that the family considers worthwhile. Doug might find that his employer-sponsored coverage for just himself is very affordable, since employers often pay more towards the employee's premiums than they pay towards additional family members' premiums. So Doug's family might opt to keep Doug on the employer-sponsored plan and get an individual market plan for his wife and kids.
Humana group dental plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, Humana Health Benefit Plan of Louisiana, The Dental Concern, Inc., Humana Medical Plan of Utah, CompBenefits Company, CompBenefits Insurance Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., or DentiCare, Inc. (DBA CompBenefits).
The Texas health insurance market has turned shopping for affordable health insurance quotes in Texas into a maze. Although there is no single “best” plan, there are some Texas health plans that will be better than others for you and your family’s health care needs. Plans differ, both in price and in access to service. To ensure you make the right decision in choosing an affordable health insurance plan in Texas for you and your family, contact Custom Health Plans. A Texas health insurance agent will be able to provide personalized attention and a health insurance quote in Texas to find the perfect plan for you.
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