Deciding on a health insurance plan is a yearly dilemma most people face. While affordability is an understandable consideration, it’s just as important to choose a plan that’s practical enough to meet your current and anticipated health care needs.
If you have younger kids or teens in your family or if you regularly participate in sports and physically demanding activities yourself, coverage for emergency care is something you’ll definitely want to consider as you make your decision.
There are plenty of health insurance options available throughout the Houston area and each available plan includes access to some type of emergency care. Here’s a closer look at the top five plans for ER visits and what emergency and urgent care services each company offers.
There are many things to consider and comparing health insurance plans is not as easy as comparing nutrients of different dishes…but bear with me for a while as we go through the most important points.
Aetna’s Texas Health Insurance Plans
Aetna’s Texas health insurance plans include an assortment of PPO and HMO plans. Medicare plans are also available. And surprise, surprise…the company offers metallic level plans. With Aetna’s bronze level plans, you’ll pay about 80 percent of covered health care costs. It’s 70 percent for the silver level plans and 60 percent for gold level plans.
Urgent care from an in-network provider includes co-pays starting at $10 per visit. Aetna has a blanket policy of providing access to emergency care 24 hours a day, seven days a week wherever a policyholder happens to be at the time of the emergency.
ER visit co-pays with any Aetna plan do not apply if you or someone covered under your plan is admitted for an overnight hospital stay. If you do need to seek emergency care from non-participating provider, you’ll need to notify your primary care physician and Aetna within 48 hours of the emergency.
Urgent care outside of your local area is covered. Any emergency care co-pays specific to your plan still apply regardless of where you receive medical care. Any don’t forget that follow-up care must be provided by your regular doctor or an approved specialist.
How to Compare Health Insurance Plans in Texas
Emergency care and urgent care options for all five of these plans are very similar in structure. With most plans, you’ll pay a copay or a percentage of the cost in what’s referred to as cost-sharing. Your monthly premiums will depend on factors such as your age and whether or not you use tobacco products (the two most common questions asked on quote forms). Whether or not you qualify for a tax credit will depend on your income. In order to select a plan that best fits your needs, consider:
If the monthly premium is something you can comfortably afford
How often you’re likely to need emergency or urgent care services
Whether or not you would be able to afford the cost-sharing expenses or co-pay if you did need to seek emergency medical assistance
Ultimately, you want to make a decision that’s right for your budget and your needs. If you don’t have any pre-existing conditions or other health issues likely to contribute to your insurance costs, pay more attention to services you’re more likely to use.
For new parents and college students, this typically means urgent care and emergency room coverage. Each of the five companies mentioned here will provide quotes before you make a commitment to signing up for coverage. It also doesn’t hurt to do your own comparison shopping. Consider scheduling a phone interview with an agent after you get some quotes.
The more informed you are, the better your odds are of finding coverage that meets your needs and works within your available budget.