Texas Health Insurance Information
Family or Individual (Houston, TX Area)
(HMO, PPO, POS or Major Medical Coverage)
Individual or family health insurance can provide the
important protection needed in the event of illness and
for regular preventive care. Using the strength and
experience of our health insurance markets, Texans
Insurance & Financial Group of Sugar Land, TX offers
affordable Texas HMO, PPO, POS, and Major Medical
Health Insurance policy coverages throughout the Lone
Star state.
Health insurance plans that allow you the most choices
in doctors and hospitals also tend to cost more than
plans that limit choices. Individual and family health
insurance plans that help to manage the care you
receive, such as PPO and POS plans, usually cost you
less, but you must give up some freedom of choice.
Learn more about Texas HMO, PPO, and POS managed
health care insurance policies we offer throughout Texas
by clicking on a link below or click on the link for
information on Major Medical health insurance.
Click on the link below to fill out a secure quote request form for a Texas
health insurance policy that provides excellent health insurance coverage
and services at an affordable cost. Or you can speak with our Texas
Health Insurance agent specialist toll free at (800) 747-6140 to discuss
the insurance policy features in more detail.
We are a Sugar Land, TX insurance agency offering affordable Texas health insurance
policy premiums in the following towns, cities and counties in southeast Texas:
Meadows, Town West, Four Corners, Crabb, Booth, Thompsons, Fresno, Manvel,
Pleak, Kendleton, Eagle Lake, Sandy Point, Beasley, Rosenberg, Richmond,
Orchard, Fulshear, Juliff, Arcola, Needville, Frydek, Rosharon, Bonney, East Bernard,
Lissie, Elm Grove, Spanish Camp, Wharton, Guy, Bellville, Wallis, Pasadena, Deer
Park, Houston, Pearland, Galena Park, Jacinto City, La Porte, Bellaire, West
University Place, Cloverleaf, Beaumont Place, Spring Valley, South Houston, Iowa
Colony, Hilshire Village, Humble, Houmont Park, Friendswood, League City, Alvin,
Mission Bend, Stafford, Missouri City, Texas City, Webster, Dickinson, Baytown,
Channelview, Highlands, Seabrook, Bacliff, La Marque, Jersey Village, Lake Jackson,
Surfside Beach, Algoa, Santa Fe, Barker, Katy, Sealy, Dayton, Angleton, Freeport,
Bammel, Kohrville, Bay City, Brenham, Addicks, Brookshire, San Felipe, Hockley,
Waller, Prairie View, New Caney, Beach City, Nassau Bay, North Houston,
Hempstead, Tomball, The Woodlands, Burr, Iago, Boling, Peters, Cat Spring,
Burleigh, Waller County, Wharton County, Brazoria County, Harris County, and Fort
Bend County, TX. We can also offer less expensive Texas health insurance policy
premiums throughout the Lone Star state, including in Beaumont, Austin, Waco, Fort
Worth, Dallas, and San Antonio, TX.
Major medical health insurance provides benefits up to a high limit for
most types of medical expenses incurred, subject to a deductible.
Once you meet the deductible, Texas Major Medical Insurance plans
pay a percentage of what is considered the "Usual and Customary"
charge for covered services. The insurance company generally pays
80% of the Usual and Customary costs and you pay the other 20%,
which is known as co-insurance. If the insurance company charges
more than the Usual and Customary rates, you will need to pay both
the co-insurance and the difference.
With Texas Major Medical Insurance plans you can choose your doctor
and any hospital for your medical services. You or your doctor send the
bill to the insurance company, which pays part of it. Usually, you have a
deductible such as $250 or more to pay each year before the insurer
starts paying. The plan will pay for charges such as medical tests and
prescriptions as well as from doctors and hospitals.
Major medical insurance coverages offer more choice of doctors
(including specialists, such as cardiologists and surgeons), hospitals,
and other health care providers than managed care plans, such as HMO,
PPO, and POS. Texas Major Medical Insurance may not pay for some
preventive care, such as check-ups, and is usually a more expensive
health insurance coverage than utilizing a Texas HMO, PPO, or POS
plan.
Click on the link below to fill out a secure quote request form for a Texas
family or individual Fee-for-Service / Major Medical health insurance
policy that provides excellent health insurance coverage and services at
an affordable cost. Or you can speak with our Texas Health Insurance
agent specialist toll free at (800) 747-6140 to discuss the features.
Learn more about the other types of Texas Health Insurance polices
we offer in the Lone Star state by clicking on a link below!
* Preventive care emphasis
* Primary care physician (PCP) coordinates your total care
* Must get a referral from your PCP to visit a specialist
* Fixed monthly fee
HMO Health Insurance Policy Overview - Texas
Subscribers to an HMO receive medical services from participating
physicians, clinics and hospitals. You choose a primary care physician
(PCP) from a list of participating doctors from where you live in Texas.
That doctor is used for typical circumstances such as annual exams
and usual health issues. If you need to see a specialist, be
hospitalized, or have lab or X-ray work, your doctor will refer you to a
provider or facility within the HMO system. Your doctor must give
authorization for those services to be covered by your HMO. In other
words, you must see HMO approved physicians and use HMO
approved facilities or pay the entire cost of the visit yourself.

Similar to Point-of Service (POS) and PPO's, HMO's have made
arrangements for lower fees with a network of health care providers
and give their policyholders a financial incentive to stay within that
network.

You may have to pay some portion of the cost (co-payment) for each
office or hospital visit, such as $20 - $30 per doctor visit, regardless
of what the services cost. Also, some services such as emergency
room, mental health and chemical dependency services, may carry
additional costs in a Texas HMO health maintenance plan.
Click on the link below to fill out a secure quote request form for a
Texas HMO health insurance policy that provides excellent health
insurance coverage and services at an affordable cost. Or speak
with our Texas Health Insurance agent specialist toll free at (800)
747-6140 to discuss the policy features.
* Convenient access to quality health care
* Large and diverse network available of primary care physicians,
specialists, hospitals & clinics.
* Pay for services as they are provided
PPO Health Insurance Policy Overview - Texas
You can see any health care professional in the network any time
you choose to make an appointment. You don't need referrals for
specialists or other services as you do in an HMO. You can see
doctors or specialists outside your PPO network, however, your
portion of the costs will be higher.
You may have to pay some portion of the cost (co-payment) for
each office or hospital visit, such as $20 - $30 per doctor visit,
regardless of what the services cost. Also, some services such as
emergency room, mental health and chemical dependency
services, may carry additional costs in a Texas PPO health
insurance plan.
Click on the link below to fill out a secure quote request form for a
Texas PPO health insurance policy that provides excellent health
insurance coverage and services at an affordable cost. Or you can
speak with our Texas Health Insurance agent specialist toll free at
(800) 747-6140 to discuss the features in more detail.
* Preventive care emphasis
* Pays benefits for out-of-network care, but at a lower level
POS Health Insurance Policy Overview - Texas
Less restrictive than an HMO or PPO, a (POS) or Point of Service
plan lets you see any licensed health care professional for anything
covered by the insurance. Care you receive from out-of-plan health
care professionals is reimbursed, but you must pay an often times
much higher co-payment or deductible amount. While you may
choose to see a physician outside the network, if you don't receive
permission from your (PCP) primary care physician, you're likely to
end up submitting the bills yourself and receiving only a small
reimbursement...if any.

Costs that exceed your deductible are covered by a co-insurance
plan in which you and the insurance company share the cost for
services covered by the policy.
Also, some services such as emergency room, mental health and
chemical dependency services, may carry additional costs in a Texas
POS health insurance plan.
Click on the link below to fill out a secure quote request form for a
Texas POS health insurance policy that provides excellent health
insurance coverage and services at an affordable cost. Or you can
speak with our Texas Health Insurance agent specialist toll free at
(800) 747-6140 to discuss the policy features.
Learn more about the other types of Texas Individual or Family
Health Insurance polices we offer by clicking on a link below!
Managed Health Care Plans:
Fee-for-Service Health Plan:
Learn more about the other types of Texas Individual or Family
Health Insurance polices we offer by clicking on a link below!
Managed Health Care Plans:
Fee-for-Service Health Plan:
Learn more about the other types of Individual or Family Health
Insurance polices we offer in Texas by clicking on a link below!
Managed Health Care Plans:
Fee-for-Service Health Plan:
Managed Health Care Plans:
**The information, pictures, and other content in this website about particular insurance
services is only provided for informational purposes. Any decisions regarding your
insurance needs should be discussed with a licensed insurance agent.
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Texans Insurance
& Financial Group
101 Southwestern Blvd.
Suite 230
Sugar Land, Texas 77478
Fort Bend County, TX
Office: (281) 277-7800
Toll Free: (800) 747-6140
Fax: (281) 277-7801

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Texas Health Insurance Policy Information
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TEXANS INSURANCE
Texas Health Insurance Information
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New National Healthcare Overview
Enrollment began October 1, 2013 and coverage
started January 1, 2014
Essential Health Benefits
The Affordable Care Act passed in 2010 requires
individual health insurance plans beginning on
January 1, 2014 to offer essential health benefits
services. Below is the list of minimum services
required under all health insurance plans.
1. hospitalization
2. maternity and newborn care
3. ambulatory patient services
4. emergency services
5. mental health and substance use disorder
services, including behavioral health treatment
6. prescription drugs
7. rehabilitative and habilitative services and devices
8. laboratory services
9. preventive and wellness services and chronic
disease management
10.pediatric services, including oral and vision care
Health Marketplace Insuranace Plans
You can choose the plan that is right for your budget and needs. All plans
offer the 10 essential health services mentioned above. The cost of each
plan will be different whether your state has set up its own Health
Marketplace or uses the National Health Marketplace. Speak with your
health insurance agent for specific costs and enrollment information.
Bronze Plan
Silver Plan
Gold Plan
Platinum Plan
The Bronze Plan has the lowest premium, but you'll pay a higher share
of costs when you get care. On the other end of the cost spectrum, the
Platinum Plan will have the highest monthly premiums and the lowest
out-of-pocket costs when care is needed.
Marketplace Health Plans Pricing
All insurance plans available through the Marketplace will be offered by
private insurance companies. Marketplace pricing will show any cost
savings you may be eligible for based on your income.
Pre-existing Conditions
An insurance company can't turn you down or charge you more
because of your health condition. It can't refuse to cover treatment for
pre-existing conditions.
The only exception is for grandfathered individual health insurance plans-
the kind you buy yourself, not through an employer. If you have one of
these plans you can switch to a Marketplace plan during open enrollment
and get coverage for your pre-existing condition.
The Marketplace will also tell you if you qualify for free or low-cost coverage
available through Medicaid or the Children's Health Insurance Program
(CHIP).
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