Is the premium payment the first thing you look at when shopping for health insurance coverage? There is a lot more to consider when selecting a health insurance plan than just the premium pricing. The lowest priced plan may not always meet your needs. As the saying goes, you get what you pay for so understanding the guidelines and familiarizing yourself with common health insurance terms can help you choose wisely when your Texas insurance agent presents you with a number of plan options.


HMO, which stands for health management organization, provides coverage within a network of doctors. You typically select a primary care physician (PCP) in the network to be your regular doctor. If you need to see a specialist, your PCP will need to issue a referral. This is usually the least expensive option because there are no deductibles and most routine procedures are 100 percent covered after the copay. HMOs are useful if your preferred doctors are within the network; however, it will likely cost you a great deal to see a doctor who isn’t part of the network.


PPO, which stands for preferred provider organization, is made up of a network of doctors who have arranged a negotiated rate with your insurance company. This type of plan is more flexible because you have more freedom in seeing the doctor of your choosing and you don’t need referrals. PPOs usually have more expensive costs, including the premium, deductible and copays.

High Deductible Plan

Also sometimes known as a catastrophic or safety net plan, the high-deductible option offers the lowest premiums. This plan is best for those who have minimal medical needs or can’t afford an HMO or PPO. In exchange for the low premiums, you must pay a high deductible, usually around $2,500, in order to receive care. A typical PPO deductible is only $250. However, once you have reached the deductible, you will be covered fully.

Factors to Consider

Once you understand the difference between the major health plan options, it’s time to think about your unique medical needs and the needs of your family. Consider your family’s current and prior health history, such as any ongoing illnesses or conditions. Don’t forget to also check out the prescription coverage with any plan you are evaluating. When it comes to selecting health insurance coverage, think about what’s most important to you. Is it the overall cost? Is it the ability to see any doctor you want and not worry about needing referrals? Once you have determined what’s most important, it will be easier for independent insurance agents of Dallas to assist you in finding the best plan for your needs. If you are looking for a Texas insurance agent to help you set up health insurance coverage, contact us. Our independent agents can help you find the best coverage at the best price.

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