Finding Health Insurance

The Texas Department of Insurance’s online resource, Your Health Care Coverage, also briefly covers special health plans for small employers, coverage available through the Texas Health Insurance Risk Pool, the Children’s Health Insurance Program and employers’ self-funded health plans.

Private Insurance Coverage

Self-employed individuals and workers who do not have access to health insurance through their employers may purchase individual and/or group health policies. The following resources may help you:

•  A Consumer Guide for Getting and Keeping Health Insurance - State-by-state information on your rights under federal and state law that will protect you when you seek to buy, keep, or switch your health insurance (Georgetown University Health Policy Institute)
• Questions and Answers About Health Insurance - Describes the different kinds of health insurance plans available. (America’s Health Insurance Plans)
• Managed Care Answer Guide - Guide to assist you in choosing, understanding, and utilizing your health plan. (Patient Advocate Foundation)

TDI’s Web site may help you understand health insurance options. TDI has lists of:

• Companies authorized to offer consumer choice benefit plans;
• Companies offering small employer accident and health coverage;
• Insurance companies authorized to sell individual health policies;
• Insurance companies authorized to offer Preferred Provider Organization health plans;
• Insurance companies authorized to offer medical savings accounts; and
• Insurance companies authorized to offer dental plans.

If you cannot obtain health insurance as a result of a pre-existing medical condition, or qualify as a “Federally Eligible” individual, you may be able to purchase insurance through the Texas Health Insurance Risk Pool.

If you have insurance through your employer and leave the company, a federal law allows you to continue your insurance coverage through your former employer for up to 18 months, although you will have to pay the entire premium. Get more information about COBRA continuation of coverage.

Government Programs

Medicare is a federal health insurance program that covers those age 65 and older, as well as disabled individuals. Supplemental insurance may be purchased to help offset the costs not covered by Medicare. These resources will help you learn more about Medicare coverage:

• Medicare Personal Plan Finder - Allows you to identify and compare Medicare health plans that are available in your area. (Centers for Medicare & Medicaid Services)
• Understand Your Health Insurance and Medicare Options - Information to help you understand Medicare, Medicare supplemental insurance (Medigap), managed care, and other health insurance options. (American Association of Retired Persons)
• Your Medicare Coverage and Frequently Asked Questions
  Provide information about health care benefits in the Original Medicare plan. (Centers for Medicare & Medicaid Services)

Medicaid provides access to health care for qualified low-income pregnant women and children as well as people who are elderly or who have a disability. Applications for Medicaid and other services for low-income families are taken at local Medicaid offices, or may be made online. Call the toll-free Texas Medicaid Hotline at 800/252-8263 between 7:30 a.m. and 5:30 p.m., Monday through Friday for assistance, or visit the Texas Medicaid Web. Additional information is available here.

The Children’s Health Insurance Program provides coverage for children whose family income exceeds the amount to qualify for Medicaid but do not earn enough to buy private health insurance. Families pay premiums and share the cost of services based on their income for doctor visits, prescription drugs and emergency care. To find out more, call toll-free 800/647-6558 or visit the CHIP Web site. Additional information is available here.