Arlington Health Insurance
Shopping for affordable health insurance in Arlington TX doesn't have to be difficult. In fact, it should be a rewarding experience for you and your family. We are here to demystify the process and information for you so that you can get what you came for-- low-cost insurance plans that are specific for your situation and needs. The Arlington Texas Insurance Agent's job is to find the right policy for you and your family, and arm you with the information you need to use all of your benefits. We will go out of our way to make sure that you are satisfied with your healthcare coverage, and help you compare the rates from multiple companies. And... we can further protect your assets with Life Insurance.
Click Here for a free consultation with an Insurance Agent in Arlington who cares!
Click Here for a free consultation with an Insurance Agent in Arlington who cares!
Individual Health Insurance Texas
What does Individual Health Insurance mean?
Individual Health Insurance is Insurance for one person or it can be for a person's dependents. This would not be insurance that is offered by your employer, but Insurance coverage that you get for yourself or loved ones. A great method for finding the best coverage possible is to have your Insurance Agent or Broker research the best and available options for you. At Royalty Life and Health, we are committed to finding the best plan for you as well as explain your coverage in great detail preparing you for doctor's office visits and dealing with the companies directly.
Individual Health Insurance is Insurance for one person or it can be for a person's dependents. This would not be insurance that is offered by your employer, but Insurance coverage that you get for yourself or loved ones. A great method for finding the best coverage possible is to have your Insurance Agent or Broker research the best and available options for you. At Royalty Life and Health, we are committed to finding the best plan for you as well as explain your coverage in great detail preparing you for doctor's office visits and dealing with the companies directly.
Types of Individual Health Insurance
There are many different types of Insurance options out there and each is tailored for a person's individual situations or healthcare needs. There are different choices with multiple ranges of out-of-pocket costs for services, payment options, special benefits, and more from different healthcare providers. Though it can be technical and sometimes tricky, it all has to do with what is right for you. That's why at Royalty Life and Health, we stress the fact that you should always talk to someone who is experienced so that you can find the right Insurance Plan and don't miss out on options that aren't easily understood or blatantly advertised.
There are two groups that most Individual Health Insurance can be placed in: Indemnity Plans and Managed Care Plans.
Indemnity plans meant that the insurance company has set up a percentage that they will pay for services and the rest of the cost is paid by the insured individual. With this, there is not a Provider Network, so an individual can make their own choice for their doctor or hospital. However, the medical provider, such as a hospital or other health care provider, can bill the individual for the remaining balance of what the Indemnity Plan did not pay. For example, if your medical costs equal $4,000 and your Indemnity plan covers $3,500, then you will be billed for the remaining $500.
Managed Care Plans, more popular today, are of a system designed to help manage the costs and quality of care a person can receive. These Managed Care systems include PPO, HMO, and POS which we do a break-down of each meaning below. Managed care plans can have limitations on out-of-network care providers, limits on the amount of care providers that an individual can choose from, and whether or not they are required to use a primary care physician. Though they may sometimes have these limitations they can be cost-effective, and are known to emphasize disease prevention and the improvement of overall health.
There are two groups that most Individual Health Insurance can be placed in: Indemnity Plans and Managed Care Plans.
Indemnity plans meant that the insurance company has set up a percentage that they will pay for services and the rest of the cost is paid by the insured individual. With this, there is not a Provider Network, so an individual can make their own choice for their doctor or hospital. However, the medical provider, such as a hospital or other health care provider, can bill the individual for the remaining balance of what the Indemnity Plan did not pay. For example, if your medical costs equal $4,000 and your Indemnity plan covers $3,500, then you will be billed for the remaining $500.
Managed Care Plans, more popular today, are of a system designed to help manage the costs and quality of care a person can receive. These Managed Care systems include PPO, HMO, and POS which we do a break-down of each meaning below. Managed care plans can have limitations on out-of-network care providers, limits on the amount of care providers that an individual can choose from, and whether or not they are required to use a primary care physician. Though they may sometimes have these limitations they can be cost-effective, and are known to emphasize disease prevention and the improvement of overall health.
Indemnity Plans
Indemnity plans offer the greatest flexibility in choosing your doctor or healthcare provider. Your premium is set monthly and allows you to go to any doctor, hospital, or another type of healthcare provider of your choice. You can choose to go to a specific doctor for all of your needs but the plan will not require you to go to a primary care doctor.
With this type of plan, you or your healthcare provider may be reimbursed by the insurance carrier. You may be required to pay a deductible or a percentage of each bill. However, there is usually an annual out-of-pocket limit for these plans, and once you spend up to that limit, all other expenses for that year can be completely covered by the insurance.
Sometimes, the insurance carrier may pay only a percentage of the UCR Rate which means "usual, customary, and reasonable". This rate is the average rate that healthcare providers in your area typically charge. There could be restrictions on what is covered and what is not with your Indemnity Plan. Hospital stays, procedures, equipment, and other expensive services may require prior authorization by your insurance carrier.
Is an Indemnity Plan right for me?
You may benefit from an Indemnity Plan if :
With this type of plan, you or your healthcare provider may be reimbursed by the insurance carrier. You may be required to pay a deductible or a percentage of each bill. However, there is usually an annual out-of-pocket limit for these plans, and once you spend up to that limit, all other expenses for that year can be completely covered by the insurance.
Sometimes, the insurance carrier may pay only a percentage of the UCR Rate which means "usual, customary, and reasonable". This rate is the average rate that healthcare providers in your area typically charge. There could be restrictions on what is covered and what is not with your Indemnity Plan. Hospital stays, procedures, equipment, and other expensive services may require prior authorization by your insurance carrier.
Is an Indemnity Plan right for me?
You may benefit from an Indemnity Plan if :
- You want to have the freedom of choosing which doctor or healthcare provider that you visit
- You don't want to have to designate a Primary Care Physician, or have to get referrals for visiting a Healthcare Specialist
- You want control over your or your family's Physician
Managed Care Plans
Managed Care plans have the hopes of reducing the cost of for profit health care simultaneously improving the quality of that care. The following is a summary of the main types of Managed Care options.
POS- Point of Service Plans offers some flexibility. With this plan, you have a Primary Care Physician who can make referrals to other doctors within the network provided by the insurance provider. If you choose to have healthcare services from an out-of-network doctor or specialist, the service may be covered by the plan but you may have to pay a co-pay. However, if your doctor makes a referral out-of-network, the insurance plan pays for most or all of the bill.
HMO- Health Maintenance Organizations provide a good amount of in-network doctors and healthcare providers. A Primary Care Provider is also required under this type of coverage. You will have the majority of your care under one Physician, although you may be referred to a specialist by your Primary Care Doctor.
PPO- Preferred Provider Organizations can offer a lower cost if you choose to go with an in-network doctor but you do have the flexibility of going with an out of network doctor as well, sometimes at higher costs. These plans are under contract with doctors, hospitals, and other healthcare providers to offer service at a pre-determined rate, and can be more affordable and offer more flexibility than other plans.
POS- Point of Service Plans offers some flexibility. With this plan, you have a Primary Care Physician who can make referrals to other doctors within the network provided by the insurance provider. If you choose to have healthcare services from an out-of-network doctor or specialist, the service may be covered by the plan but you may have to pay a co-pay. However, if your doctor makes a referral out-of-network, the insurance plan pays for most or all of the bill.
HMO- Health Maintenance Organizations provide a good amount of in-network doctors and healthcare providers. A Primary Care Provider is also required under this type of coverage. You will have the majority of your care under one Physician, although you may be referred to a specialist by your Primary Care Doctor.
PPO- Preferred Provider Organizations can offer a lower cost if you choose to go with an in-network doctor but you do have the flexibility of going with an out of network doctor as well, sometimes at higher costs. These plans are under contract with doctors, hospitals, and other healthcare providers to offer service at a pre-determined rate, and can be more affordable and offer more flexibility than other plans.
Other Healthcare Plans
Another form of Health Care Coverage is that which comes from and is paid by the government. These can be considered Individual but are technically in their own category. For more information on these you can click the link provided below to be taken to the detailed page.
Medicare
Part D Medicare
Medicare Supplement Coverage
Medicare
Part D Medicare
Medicare Supplement Coverage
*Definitions and terms may vary between different plans and insurance providers. You can find the details of your specific plan in their Summary of Benefits. It is recommended that you speak to a qualified agent to have all of the benefits explained.
MARLENE LEEPER, CEO
ROYALTY LIFE AND HEALTH
Principal Office - Arlington, Texas
507 Baylor Dr.
Arlington TX 76010
marlene@royaltylifeandhealth.com
214.437.3262