Whether you’re new to the Austin, Texas area or you’re just looking for a new health insurance agency in Austin to manage your health care needs, there are a few things you should know before you begin.
Affordable Care Act (ACA) coverage in Texas
During the first year of the ACA, the health care exchange facilitated over one million health insurance purchases. More than 80 percent of those enrollees received subsidies to lower their monthly premiums.
The ACA has also spawned an industry. Blue Cross Blue Shield of Texas has launched a texting campaign, a website, and a social media presence to help consumers make informed decisions. The company engaged community clinics, churches, and nonprofits to help educate Texans on the ACA. In addition to its usual suite of health plan offerings, it has tapped into its resources to offer assistance to enrollees via the ACA Reporting and Tracking Service.
The aforementioned ACA has spurred the creation of a state-based rate review program, which will allow Texas to better determine the best and worst plans available in the market. This will result in more premium subsidies for Texans, especially those in need.
HMO or PPO health insurance plan
Choosing between an HMO or PPO health insurance plan can be a personal decision. Some people prefer the flexibility of a PPO while others don’t mind the restrictions of an HMO. When you are selecting a health plan, consider your healthcare needs and your budget. You should also consider your provider’s network.
PPO is a type of health insurance that offers a wider network of doctors. However, these plans typically have higher premiums and out-of-pocket costs.
One of the most important differences between an HMO and a PPO plan is the size of the network of providers. In addition, HMOs usually offer fewer out-of-network care options. This may be a good choice if you are a patient who only sees a handful of doctors and doesn’t anticipate a lot of doctor visits.
Mandating telehealth options for routine issues
Using telehealth for routine medical appointments has become a popular practice, so why not make the experience better for both the patient and the healthcare provider? A well designed telehealth program can reduce a patient’s stress and overall experience in a way that a trip to the emergency room might not. As a result, patients are less likely to make a hospital visit which means less time in the hospital and more time at home, thereby reducing overall healthcare costs. For this reason, it’s no surprise that many hospitals are now implementing telehealth programs for routine appointments. As a result, nurses are now able to provide better patient care while avoiding the hassles and expenses associated with the actual visit. To help boost morale, telehealth programs are also offering financial incentives to eligible nurses.
Paying sick leave and vacation time
Depending on your employer, you may be able to accrue paid sick and vacation time. These leave benefits can be used for a variety of reasons, including pregnancy, an injury, or a child’s illness. Some states have enacted or proposed temporary regulations to ensure that workers are able to receive the time off they need.
Texas has enacted a job-protected medical leave law, which allows employees to take up to twelve weeks of unpaid leave for a family member’s illness or to care for a family member who has a serious health condition. The law also requires that the employee return to the same or equivalent position after the leave.
In addition to sick leave, employees can contribute to a Sick Leave Pool. This pool is available to employees who have catastrophic illnesses.
Reporting non-licensed insurance agents to Texas Department of Insurance
TDI has issued a stern warning about insurance agents who aren’t licensed. One of the easiest ways to find out whether your insurance agent is licensed is by checking out the company’s website. You can also check out their financial statements filed with the National Association of Insurance Commissioners. If they aren’t in business, they may be writing fraudulent policies.
The Texas Department of Insurance is the official state agency responsible for regulating the state’s insurance industry. The department has the capacity to revoke licenses and sanction insurers for misdeeds.
The department has a Consumer Protection Division that reviews and investigates complaints. It is also tasked with the task of identifying and educating the public about insurance fraud. The department’s website features information on discount programs, insurance scams, and other insurance related topics.
