Self-employed and sole-proprietor small businesses may feel like they have limited options for health insurance coverage in Texas. Often times, they won’t qualify for a short term health insurance plan in Texas due to pre-existing conditions. For husband and wife teams with pre-existing limitations, their options are limited. Here are the two main choices:
- ACA/Obamacare Plans (HMO plans on the marketplace – more about HMO and PPO below) – Not the best choice due to limited HMO network!
- Group Health Insurance – most self-employed individuals don’t realize that coverage like this exists for a group of two
Thankfully there are plans available which are not only affordable, but provide great coverage on nationwide PPO’s. This option requires you to have a corporation in good standing in the state of Texas, does not have any qualifying medical questions, and is roughly comparable to an ACA plan while being on a far better network. This ensures you will be able to find providers, as they aren’t as limited as a regional HMO, and generally don’t require gatekeepers to see a specialist. These plans have no medial questions and are guaranteed issue no matter what your pre-exisitng condition is, and provide rich benefits such as 100% preventive coverage, unlimited doctor visits, maternity, and mental health. They are also fully ACA-compliant.
Group Health Insurance for A Group of Two
While the process itself is somewhat complicated, a Texas Health Insurance Broker will be able to help you navigate the way. Most importantly, the process involves ensuring your “group” meets the state requirements for coverage. Once this hurdle is cleared, you and your spouse will be able to enjoy comparable coverage to a large W2 employer without the added expense. As an added bonus, most of your plan options are also tax-friendly.
PPO and HMO Explained
A PPO plan (preferred provider organization) is a nationwide network, which also provides coverage out of network. PPO plans are widely accepted all across the country.
An HMO (health maintenance organization) is more limited, usually only regional, and doesn’t provide any coverage outside of its own network.
Of special note is that the group plan options that use PPO’s for coverage are generally also not exceptionally more expensive than their far more restrictive HMO counterparts.
With that in mind, there really is no reason to go with a plan you’re paying for that won’t cover you for most medical expenses! A group health PPO plan will still save you a bundle compared to an on-exchange Obamacare plan, as well.
Get The Process Started
The most important step to finding affordable Texas group health insurance is contacting a Texas health insurance broker today to discuss your plan options. The specialists at Custom Health Plans are experienced in finding affordable coverage for groups of all sizes, from multinational firms all the way down to husband and wife teams. The one thing these groups have in common is a need for cost-effective coverage, and Custom Health Plans has a proven track record of delivering.