Health Insurance
Health Insurance Overview
- The Health Coverage Tax Credit - The HCTC is a new federal tax credit program established to help eligible individuals pay for health care coverage for themselves and qualified family members. Eligible individuals primarily consist of certain groups of displaced workers and pension recipients. The HCTC is expected to help an increasing number of eligible Texas individuals and their family members pay for health coverage they might otherwise not be able to afford. | More on the Health Coverage Tax Credit
- State Planning Grant (SPG) - A two-year study of Texans without health insurance. The study was designed to develop statewide strategies to significantly reduce the number of uninsured Texans. | More on the State Planning Grant
Online Brochure
Your Health Care Coverage
This brochure provides a general understanding of health care coverage available in Texas. It is not a replacement for the detailed information found in a policy or benefits booklet. Yet, it can help you evaluate health care coverage, ask the right questions, avoid some common mistakes, and solve some of your health coverage problems.
Certain terms are defined in a section entitled "Basic Health Coverage Terms." Please review the definitions for a better understanding of some of the information provided.
Information in this booklet also briefly covers:
Special health plans for small employers (two to 50 eligible employees)
High-risk individuals who may obtain coverage through the Texas Health Insurance Risk Pool
Children´s health policies from the Children´s Health Insurance Program (CHIP)
Texans covered by an employer´s self-funded ERISA health plan
This booklet does not include information on long-term care or Medicare supplement (Medigap) coverage. For publications regarding Medicare Supplement or long-tern care insurance, call the Texas Department of Insurance´s Publications Order Line at 1-800-599-SHOP (7467) or visit our Web site for more information.
Introduction | Health Plan Basics
Group vs. Individual Coverage | Health Plan Benefits
Limitations of Coverage | Shopping for Coverage
Losing Coverage | Filing Claims
For More Information
More Health Care Brochures
En Español
- Long-Term Care Insurance Rate Guide - Information about companies that sell long-term care insurance in Texas, including the rates companies charge. "Long-term care" refers to the type of medical or personal care services you need if you become unable to care for yourself because of chronic illness, disability, loss of functional capacity, or cognitive impairment. Long-term care is different from traditional medical care. Traditional medical care treats physical problems directly in an attempt to permanently cure or control them. Long-term care helps a person maintain his or her ability to function, perform normal daily activities, or maintain a normal lifestyle. | More on Long-Term Care Insurance
Complaints
- Health Insurance Online Complaint Form - Information disclosed in this form helps us resolve your complaint. Complaints requiring supporting documents should be mailed or faxed. If you file on-line, print a copy of your completed complaint form before using the "submit" button at the bottom of the form. Add that copy to any supporting documents you mail or fax. It will help speed up the process. You can expect an acknowledgement letter once your complaint form has been received.
- Helping You With Your Insurance Complaint - Each year TDI assists consumers with more than 18,000 insurance-related complaints. Because of TDI´s efforts, consumers receive millions of dollars a year in additional claim payments and refunds. This online brochure explains how we can help you with your insurance problem and how you can file a consumer complaint.
- Consumer Complaint Information/Data - Search TDI´s Internet Complaint Information System (ICIS) by (1) Summary Complaint Information by Quarter (2) Region Complaint Information by Quarter or (3) Line of Insurance.
Understanding Health Care Discount Cards
Consumers and small employers often contact the Texas Department of Insurance to ask about health care discount programs. Their questions indicate that some people confuse these programs - sometimes called "referral plans" - with true health insurance policies, which they are not. Typically, the attraction of a discount plan is a very low price compared to the premium for a major medical insurance policy.
Find out more.
More Consumer Advice About Health Care Coverage
Helpful Lists
Related Web Links for Health Coverage
For more information, contact: ConsumerProtection@tdi.state.tx.us
Texas Department of Insurance
