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Health and life

May 30, 2024

Your insurance might pay for at-home COVID-19 tests

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The federal government no longer mails free COVID-19 tests to your home. But you can buy your own tests.

  • Some health plans will pay you back for COVID-19 tests you buy at the store or online. Save your receipts.
  • Ask your health plan:
    • If it will pay to reimburse you for COVID-19 tests and for how many.
    • What steps you have to take to get paid back (reimbursement).

 


March 26, 2024

Insurance tips for new graduates

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If you’re graduating and moving into your own house or apartment, there’s a lot to consider. Here’s what you need to know about insurance.

a group of new graduates throwing caps into the air

Protect your stuff: Renters insurance pays for your clothes, furniture, electronics, and other belongings if they’re stolen or damaged by a fire or other cause. Most renters policies also pay for your belongings if they’re stolen from your car.

Shop for auto insurance: If you need your own auto insurance, use TDI’s HelpInsure.com to compare rates and policies. Then ask several companies for quotes. Also ask if you qualify for any discounts.

Finding health insurance: If you have a job that offers health insurance, that’s great. Be sure to ask if your doctors are in its network to avoid a big bill. Also look at the plan’s website to find hospitals and urgent care centers near you for when you need a doctor after hours.

Learn more


March 13, 2024

Did your Marketplace plan change without your consent?

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Woman in front of computer.

Open Enrollment to apply for, renew, or change a Marketplace health plan ended January 16. But some consumers are now learning they were enrolled in a Marketplace plan without their knowledge.

If you have this issue, report a complaint to the Department of Health and Human Service’s Marketplace.

Contact HealthCare.gov’s Marketplace Call Center at 800-318-2596. You can reach Marketplace representatives 24 hours a day, 7 days a week (except holidays).

HealthCare.gov resources


August 28, 2023

Do you know the difference between a copay and coinsurance?

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copay vs. coinsurance

Twenty five percent of Americans with health insurance recently told a pollster they find terms such as “copay” and “coinsurance” hard to understand.

We get it.

After all, the words sound alike.

And both relate to your paying money out of pocket when you get health care.

But there are differences:

  • You get charged a copay when getting treatment covered by your health plan.
  • Your copay is a fixed amount. It varies based on the service you get. For instance, your plan might charge a $15 copay for a generic prescription drug, $30 to visit your primary care doctor, or $50 to see a specialist.
  • Coinsurance kicks in after you have met your plan’s annual deductible, which is what you pay out of pocket before your plan starts picking up a share of medical expenses.
  • What you pay in coinsurance for a health care service is a percentage of what your plan pays the doctor or medical provider. Example: If your plan’s allowed amount for a treatment is $100, your coinsurance payment of 20% would be $20. Your plan pays the remaining $80.

Learn more


December 1, 2022

It’s health insurance shopping season—but watch for red flags

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Across America, it’s sign-up season for health insurance—a chance to shop for coverage that fits your health and budget needs.

You have until Jan. 15 to browse insurance options on HealthCare.gov. Read more in our Tips to buying a health plan—and getting what you want.

Warning: You should also watch for signs that something might not be right.

Some red flags:

  • You get a call from someone you didn’t contact first. You should be in control of when you shop, what you’re shopping for, and who you ask for help.
  • If an agent can’t answer basic questions—such as a plan’s copays, deductible or premium amounts, or give you specific plan information in writing—that’s a red flag; and it might be a scam.
  • If you feel pressured to commit to a plan right away, just say no. No legitimate plan changes its price or other terms during enrollment season.
  • If you see coverage that costs far less than other plans, hold off. There may be catches that cost you, like fewer benefits. If a deal sounds too good to be true, it probably isn’t true.

Listen to more on red flags and questions to ask while shopping in our Texas Insurance Podcast.

View podcast Q&A: Can you shop around for health insurance?

Learn more

Use these tips to shop smart for health coverage.

November 17, 2022

Open enrollment for Medicare runs through December 7

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It’s that season, time to shop for what you want in Medicare.

Medicare, federally-funded health insurance, is open to Americans 65 or older, younger people with disabilities, and people with end stage renal disease.

You have until Dec. 7 to change your Medicare health or drug coverage for 2023. The open enrollment period lets you join, switch, or drop a Medicare Advantage Plan or a Medicare drug plan.

A Medicare Advantage plan provides Medicare through a private company.

Sometimes a plan offers additional benefits. For instance, you may not need a separate drug plan if your Medicare Advantage plan has drug coverage.

Any changes you make take effect January 1.

In our Texas Insurance Podcast, we spoke with the Area Agency on Aging of the Capital Area about tips to find a plan that works best for you.

View podcast Q&A: What’s Medicare open enrollment?

Learn more

How to pick the right Medicare plan


October 20, 2022

Your mental health: What to know about getting help.

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If you have a fever or body aches, you’d go to the doctor. If you think you’ve broken a bone or have heart flutters, you might go to the ER.

Are you taking the same care of your mental health? Or are you worried about the cost or don’t know where you’d go for help?

Texas and the federal government have laws to protect consumers and guarantee that health plans give you the same level of mental health benefits as your medical benefits, such as the number of office visits. This is known as “mental health parity.”

The laws require mental health parity for:

  • Payment limits. Some plans have limits on how much it will pay over your lifetime or over a year. If your plan has a limit for medical benefits, the limit should be the same for mental health benefits.
  • Out of pocket expenses. Your plan should have the same copayments, deductibles, or coinsurance for mental health and medical benefits.
  • Provider availability. Your plan should have a network of mental health providers and facilities, like it does for medical health.
  • Treatment limits. Your plan shouldn’t limit the number of visits for mental health treatment if it doesn’t for medical health.

All of that may seem complicated.

But basically, your health coverage should have a mind-body connection. And that connection should be all the time, not just when there’s an emergency.

Don’t delay or deny yourself care because you don’t think your plan covers it. Contact your health plan first for information and a list of providers in their network.

The Texas Department of Insurance is here to help. If you have insurance questions or want to file a complaint, call our Help Line at 800-252-3439.

View podcast Q&A: Your mental health: What to know about getting help.

Learn more


September 19, 2022

Am I covered by insurance when I rent a scooter?

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Scooter

Before you rent or jump on one of those cute zippy scooters, remember these tips.

  • Scooter rental companies don’t cover you in case of accident or injury. Rental agreements give you all liability. That means you could be paying for any damages and injuries, not just your own.
  • Home policies usually don’t cover damage from motorized vehicles and your auto policy probably won’t extend to an electric scooter.
  • Don’t forget to read your scooter rental agreement before you ride. And to be safe, wear a helmet.

So, what covers scooter accidents? Your health insurance probably will cover your injuries—though it won’t cover anyone in your path.

Learn more


August 4, 2022

Safety and savings tips when you go back to college

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Many college students live off campus.

Freedom, right?

But you need to watch out for yourself.

Some money-saving and safety tips:

  • Call your health plan to find nearby urgent care centers that are in your plan’s network. This could save you money when you need care.
  • Look for the fire alarms and exits in your apartment complex. Some alarms sound a bell. Others have a voice feature telling you where to go if there’s a fire.
  • Consider renters insurance. At less than $200 a year, a renters policy can pay to replace your things after a fire or other disaster. It might also pay for you to live somewhere else while repairs are being made.
  • Let your auto insurance agent know that you’re back at school. This might save you money.

Hear more expert advice about going back to school in the latest Texas Insurance Podcast.

View podcast Q&A: How college students can stay healthy, safe, and protect their stuff

Learn more


February 24, 2022

Did you get a surprise medical bill? You might not have to pay.

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Nobody likes getting a medical bill they weren’t expecting.

Good news: You might not have to pay it.

A new federal law and a 2019 state law bans out-of-network doctors, hospitals, and other health care providers from billing you in emergencies or when you didn’t have a choice of doctors. These bills are called “surprise bills.”

Federal law also protects you from surprise bills from air ambulance services.

We have tips about what to do with a surprise bill. Visit our webpage, How to get help with a surprise medical bill.

Learn more


January 6, 2022

New year, new you—and your health plan could help

Are you resolving to shape up in 2022?

Your health insurance plan could help.

Check your plan’s website or call your agent to see if your plan offers:

  • Free or discounted weight loss or wellness programs.
  • Free or discounted programs to help quit cigarettes and other tobacco products.
  • Discounts on gym memberships or fitness equipment.
  • A free app to help you count steps and track your fitness.

In TDI’s latest Texas Insurance podcast, Department of State Health Service’s Statewide Wellness Coordinator Lesley Jimenez offers fitness advice. Also, TDI’s Cindy Wright talks about insurance coverage of mental health benefits.

Listen to our podcast, Ways to help make healthy New Year’s resolutions stick.


December 9, 2021

How can I find the best health care insurance for my needs?

When shopping for health insurance, there’s a lot to consider. In this video, we share tips for how to shop smart:

  • Be aware of the deadlines to enroll if you’re shopping for health insurance through HealthCare.gov:
    • You have until December 15 to get coverage on January 1.
    • You have until January 15 to get coverage on February 1.
  • If you have a medical issue or a doctor you like seeing, make sure that plan covers treatment, and your provider is in the plan’s network. If you take a medication, make sure it is covered. Call the insurance company if you have questions about what’s covered.
  • Review out-of-pocket costs including deductibles and co-pays, which can increase depending on the cost of the plan.
  • If costs have you worried, find out if you can get a tax credit. “Premium tax credits” or subsidies are based on your income. More people are expected to get subsidies than in past enrollment periods.

Use our checklist to help you decide on health coverage. Health plan shopping guide.

Make sure you weigh your options when it comes to health care insurance coverage. The Health care coverage guide has answers about how coverage works or if you need help understanding your rights.

Texas Health Compare allows you to find and compare health insurance plans. If you have more questions, call the TDI Help Line at 800-252-3439.


October 28, 2021

Does insurance cover treatment for mental health and substance use disorders?

If you’re dealing with stress, depression, anxiety, or substance abuse issues, your insurance should help cover your treatment—just like it would with a medical issue.

In our latest video, we asked Cindy Wright in TDI’s Customer Operations what Texans should know about insurance coverage for mental health and substance use disorders.

  • Most health insurance plans cover services for mental health and substance use disorders. If you aren’t sure, check your policy or contact your insurance company.
  • The law guarantees “parity” for most health plans, which means health plans must cover mental health and substance abuse treatment the same as medical health. Learn more on our How to get help with a mental health issue
  • If your mental health insurance claim is denied, you may be able to file an appeal with your insurance company or ask for an external review.
  • Texas Health and Human Services has resources to help you get access to mental health and substance use treatment through your insurance plan.

If you have questions about appealing an insurance claim or the claims process, call the TDI Help Line at 800-252-3439.

For more information, see our webpage, Insurance coverage and parity for mental health and substance use disorder services.


October 14, 2021

Protect your information from scams during Medicare open enrollment

Did you get a phone call from someone offering a free COVID-19 vaccine or a gift if you give them your Medicare information? It’s probably a scam. A health plan will never call you out of the blue and ask for personal information.

Medicare open enrollment—the time of year you can sign up for or make changes to a Medicare plan—is from October 15 to December 7. Which also makes it prime time for scammers.

Never give your Medicare information to someone you didn’t expect to get a call from. If you aren’t sure, call 800-252-9240 to find your Area Agency on Aging, or check with your local State Health Insurance Assistance Program.

About 4 million Texans have health insurance coverage through Medicare. In our new video, we talked to Yvette McVeigh with the Area Agency on Aging. McVeigh explains what to do when your plan doesn’t cover the medications you need or let you see the specialist who’s right for you. She also had great advice for avoiding scams.


August 12, 2021

Got insurance? Questions to ask at a job interview

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Text on image: Job offer? Ask about a health plan.

Congrats, you got a job interview! After you talk about pay and telecommuting, don’t forget to ask about the benefits. And we don’t mean days off – we mean insurance.

On average, benefits make up a third of a company’s compensation package, according to the U.S. Bureau of Labor Statistics. Health insurance is a big part of that.

Ask if the company offers health insurance and how much of the premium you’ll pay. Also ask if they offer health insurance for your family. And look at the plan’s copays, deductibles, and coinsurance. Those are all amounts you’ll have to pay yourself.

If you already have health insurance, getting it through your job will probably cost less and offer more benefits. But always compare costs and benefits before you switch.

If a company doesn’t offer health insurance, ask if there’s a health savings plan. It’s a plan you pay into to help with the cost of health care.

Learn more about what to ask about insurance before you switch jobs.


July 1, 2021

Podcast: How to find a new health plan now

Shopping for health insurance podcast

Choosing the best health insurance is kind of like picking the perfect mix of streaming services. The choices are overwhelming and costs add up quickly. We can’t help with streaming, but we have tips on how to find the right insurance coverage and avoid scams.

From now until August 15, anyone can sign up for a health plan through Healthcare.gov. You may even qualify for subsidies to help pay for your coverage.

You also can buy health insurance from an insurance company or licensed agent. Or you may have options through your employer, a union, an association, or your church.

There are a lot of different plans, all with different costs. Listen to our podcast to learn how to find the right one for you. And our health plan shopping checklist has a list of questions to ask before you buy a plan.


June 2, 2021

Starting your financial future together

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Getting married soon? You’re not the only happy couple! Wedding planners report being booked through the year as couples reschedule weddings postponed due to the pandemic. We can’t help you find a caterer, but we do have an insurance checklist to get you off to a good financial start.

Renters insurance: The average renters policy in Texas costs about $20 a month. That’s a great way to protect those nice wedding gifts. It will pay to replace items damaged by a burst pipe or other cause. It will also cover personal items stolen from your home or car.

Auto policies: Combining your auto policies may save you money. Most insurance companies offer a discount if you have more than one vehicle, and rates are usually lower if you’re married.

Health coverage: You have several options for health coverage. If both of you have coverage through work, compare the policies. One may have better benefits, a lower deductible, or a lower cost to add a dependent. And check to see if there’s a deadline to add a spouse.

Life insurance: As your situation changes and your family grows, you may need life insurance. Consider how much income would need to be replaced to help with childcare, your mortgage, and other debts.


Texas Insurance Blog

Insurance tips and help

How to get help or file a complaint: We can answer insurance questions, help with problems, and explain how to file a complaint against an insurance company or agent.

Videos: Our video library has short tips and interviews with experts on dozens of topics.

Insurance tips: Use our tips to get the best deal on insurance, protect yourself from fraud, and learn what to do when you have a problem.


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