Well here we are again. The Affordable Care Act, even with the showdown in Washington, looks to be here to stay for at least another year. I realize that Trumpito is trying to let it die a natural death, but that would be very unlikely given the fact that many of you would have zero options for insurance if you’re self-employed. A move like that would have far reaching consequences and would make it unlikely that a solid “Federal fix” would stabilize the insurance market for the remainder of participants.
Either way, let’s specifically talk about the health insurance market in Houston. Currently, there are four insurance carriers offering plans in the area including Memorial Hermann Health Plans, BCBS of Texas, Community Health Choice and Molina Healthcare. At this point, come 2018, only three will be available as Memorial Hermann has recently announced they will no longer offer health insurance coverage for individuals and families in 2018, but who cares. Memorial Hermann is the most expensive carrier in Greater Houston and you can get access to most all of their docs and hospitals them from Community Health Choice for a fraction of the price.
Bear in mind, I’m not speaking about the small group health insurance market for Houston; only the individual family market. Our Houston small group plans for businesses are mostly unaffected by the back and forth in D.C., so if you can transition to one of those, you need to do exactly that.
In the words of Dr. Dre, back to the lecture at hand. Of three most likely options for 2018, here are the pros and cons of each:
BCBS of Texas: Pro: They offer an HMO network of doctors and hospitals and you have access to all in-network providers with Texas. This product is available both on and off exchange meaning you can use a federal subsidy if you qualify for one. Con(s): You must get a referral from your Primary Care Physician in order to see a Specialist and this is the most expensive carrier in Texas.
Molina Healthcare: Pro: They are the least expensive carrier in Texas, but…. Con: Not many doctors or hospitals are in their network. Same as BCBS of Texas, this is available both on and off exchange, so you can use your federal subsidy.
Community Health Choice: Pro: They are just slightly more expensive than Molina, but way, way less than BCBS of Texas. While you must name a primary care physician, you do not need a referral to see an in-network specialist. This is huge if you just had an emergency whereby you don’t have time to screw around with getting a referral. Also, this plan is available both on and off-exchange, so you can use a subsidy. Cons: None in my book.
Since the 2018 rates will not be released until late October, I can’t say if those pros and cons will remain constant, but they should. A simple drive to Richardson, Texas to the BCBS of Texas headquarters and you can see one reason why rates are so high. The buildings and amenities are amazing, if you work there. Not so hot if you’re buying their insurance policies. In comparison, take a drive along 610 South in Houston, next to Reliant Stadium (Go Texans!), and you’ll see the Community Health Choice headquarters. They are the definition of “no frills” which is what I want to see in my choice health insurance carriers. I firmly believe they know how to control both the cost of their progress and of their internal business.
Anyway, as always, just reach out to us for all of your local Houston health insurance needs at either 713.621.1440 or firstname.lastname@example.org