The Texas Department of Insurance (TDI) wants consumers to look closely before buying alternative health plans. These plans might not be state regulated and don’t have to follow federal rules.
Health plans with limited benefits might look attractive because of the price. Before you buy one, ask questions to know what it provides and how much it will cost when you see a doctor.
Unlike plans you buy on HealthCare.gov, alternative plans:
- Might not cover all injuries or illnesses, including preexisting and chronic conditions.
- Might have waiting periods to join, pay less for each service, and limit total payments.
- Don’t allow you to get federal subsidies to lower your premiums and out-of-pocket costs.
Some of the most common alternative health plans are:
- Short-term plans that last three months or less. When a plan ends, you have to buy a new plan.
- Limited benefit health plans pay part of your bills for some injuries or a specific illness, like cancer.
- Discount health plans charge members monthly fees to get reduced rates on specific health care services, like vision, hearing, or medicine.
- Subscription health plans often charge members monthly fees to visit a primary care doctor or use telemedicine. They don't cover hospital care.
TDI has a health plan shopping guide to learn what questions to ask when choosing a plan. Check a plan’s consumer reviews to make sure it has a good record on paying claims and providing service.