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If you need insurance, and you live in Texas, this is the place for the lowest rates on health insurance. We can help you choose the right policy. You may not know about the Texas Health Insurance Pool. It has selected a top rated network as the Pool's Preferred Provider Organization (PPO). Although you may choose any medical provider or hospital, you will save money by using providers from the 'Network'.
If you choose one of these Texas providers, the Policy will pay a greater coinsurance rate. The provider's rate will be based on the contract rate of the network. If you choose a Non- Preferred Provider, the Policy will pay a lower coinsurance rate and there is no coinsurance maximum. Also, Covered Expenses for a Non-Preferred Provider will be based on the Allowable Amount, which may be less than the provider's billed rate and which could result in a greater expense to you.
If you choose not to use one of these Texas state providers, it is still beneficial to use a "ParPlan" provider. While not a network preferred provider, a ParPlan provider will not bill you for the difference between covered expenses and the provider's billed charges.
There are other advantages to using our Texas health insurance service. We handle the initial paperwork so you do not have to file claims. We also precertify benefits for you, although it is ultimately your responsibility to ensure that your services have been authorized by the Pool.
If there are no providers available to you, you must contact the Administrator's precertification referral department at its toll free number. Generally, a provider will be considered to be unavailable to you if you reside more than 30 miles from a provider, which is most of us here in Texas... If there are no providers available to you and you contact the Administrator before obtaining services from a Non Preferred Provider, Covered Expenses for treatment or services by the Non Preferred Provider will be paid at the Preferred Provider coinsurance level.
If you need insurance, and you live in Texas, this is the place for the lowest rates on health insurance. We can help you choose the right policy. You may not know about the Texas Health Insurance Pool. It has selected a top rated network as the Pool's Preferred Provider Organization (PPO). Although you may choose any medical provider or hospital, you will save money by using providers from the 'Network'.
If you choose one of these Texas providers, the Policy will pay a greater coinsurance rate. The provider's rate will be based on the contract rate of the network. If you choose a Non- Preferred Provider, the Policy will pay a lower coinsurance rate and there is no coinsurance maximum. Also, Covered Expenses for a Non-Preferred Provider will be based on the Allowable Amount, which may be less than the provider's billed rate and which could result in a greater expense to you.
If you choose not to use one of these Texas state providers, it is still beneficial to use a "ParPlan" provider. While not a network preferred provider, a ParPlan provider will not bill you for the difference between covered expenses and the provider's billed charges.
There are other advantages to using our Texas health insurance service. We handle the initial paperwork so you do not have to file claims. We also precertify benefits for you, although it is ultimately your responsibility to ensure that your services have been authorized by the Pool.
If there are no providers available to you, you must contact the Administrator's precertification referral department at its toll free number. Generally, a provider will be considered to be unavailable to you if you reside more than 30 miles from a provider, which is most of us here in Texas... If there are no providers available to you and you contact the Administrator before obtaining services from a Non Preferred Provider, Covered Expenses for treatment or services by the Non Preferred Provider will be paid at the Preferred Provider coinsurance level.
