[ Knowing the Differences | Consumer Protections | Sample Complaint Form | Frequently Asked Questions | Healthplan Checklist ]
The foundation of quality health care is the exchange of information and trust between you and your physician. That's why finding the right physician, then building a relationship based on mutual trust and shared knowledge, is such an important part of taking care of your medical needs.
In today's health care marketplace, many people depend on their employers to provide health insurance. They must limit their choice of a physician to those doctors who contract with the employers' health plans. Nonetheless, many employers provide several choices for coverage within each group insurance plan. They frequently offer health maintenance organizations (HMOs) that require you to see only the doctors signed on with the HMO. Another common option is preferred provider organizations (PPOs) that allow you to visit doctors of your choice, but reward you for seeing doctors within the plan's network.
If you must buy your own health insurance, the choices are just as confusing. You must weigh the costs against how well the policy will cover expected and unexpected illnesses and treatments, and whether your existing doctors are available through the insurer's network.
Whether you are covered by an employer's group health policy or you want to buy an individual policy, making the right choices to fit your family's needs can be confusing. Sometimes, you are asked to make those choices based on either incomplete summaries of the health plan or on contracts full of legalese. The physicians of the Texas Medical Association recognize the difficult language and the complex structure of health insurance, and offer this guide in hopes that it will help you make the right choices in buying health insurance.
Tom B. Hancher, MD