Compare all ACA Plans here:
Quick Quotes & ON-Exchange Enrollments Here
Lots of Changes are coming for 2022
We have several NEW Insurance Companies entering the Texas Market in 2022.
They'll have low prices.
Why?
Their networks are much smaller than we've seen in the past.
When you run-a-quote on my Quick Quotes & Enrollments Engine be sure to add your preferred Doctors & Hospitals....so that you'll see which plans include them & which plans do not.
We're still in Insurance Company meetings...finding out about the new companies, plans & networks......as well as changes to existing plans.....until November 22nd.
Every 2021 plan will automatically renew if you "do nothing"....just like they did last year.
We have plenty of time to compare the many choices for 2022.
As always, it's best to wait until Thanksgiving (or shortly thereafter) to make your final decision about coverage for next year.
Many of the 2022 plans & networks are still being updated.
Several of the old (2021) companies will be adding new & smaller networks. They won't remove their old (larger) networks (that you're using right now) for 2022.
But, they'll have new, cheaper plans that will use those smaller networks.
...BCBS did this last year with their 400-Series (Sanitas) Plans in the DFW & Houston areas.
I'll update this blog by mid-to late November....when I have all of the facts from the companies....so that you can make the best decision for your 2022 coverage.
Watch for:
- Virtual Care Visits
.......These are TeleMedicine Visits (over the phone or computer) with a Dr IN the Virtual Care Network that's provided by the insurance company (contracted with your insurance company).....NOT a visit over-the-phone with YOUR chosen PCP.
Like: TelaDoc or Doctors-on-Demand
- Value Plans
.......Many companies are adding NEW plans that will use SMALLER networks if you pick one of their Value Plans.
You'll have fewer doctors in your network & ONLY a FEW hospitals in some areas that might have a HUGE network if you picked one of their traditional ACA plans... that you used/had in 2021.
Each company has names for their plans & networks...that are DIFFERENT than the next company.
They are NOT all called Value Plans...but they're the CHEAPER plans with a DIFFERENT name than the plans they offered to you in 2021.
If your Renewal Plan for 2022 has a DIFFERENT NAME than your 2021 plan, that's a clue that you're getting a SMALLER network for 2022.
Important for 2022:
When you run-a-quote on my Quick Quotes & Enrollments Engine be sure to add your preferred Doctors & Hospitals....so that you'll see which plans include them & which plans do not.
I will not be ready to review all Renewal Plans until our meetings with the insurance companies are over.....after Nov 22nd.
It's more important this year than ever that I KNOW all of the "secrets" for 2022 plans & networks...so that I can share that with you.
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2021 Special Open Enrollment
...from April 1st to August 15th...
For On-Exchange applications ONLY
Anyone can enroll in a health plan that is currently uninsured ...
... without having to show documentation of a qualifying event.
Just run a Quick Quote HERE
For those who already own an ACA Plan:
You can change benefit plans......or.......keep the same plan you bought in late 2020 (for 2021 coverage)....& get:
- Higher Tax Credits
- Lower Monthly Premiums
Those in high income brackets can even apply...to see if you can now get a
- Tax Credit for OnExchange coverage.
...Monthly Premiums will be capped at 8.5% of Household Income!
For Unemployment-Benefit Recipients:
- People that receive unemployment in 2021 will be treated as earning no more than 133% FPL, unless otherwise eligible for Medicaid: For 2021, individuals receiving or approved to receive unemployment for at least 1 week will be eligible for fully subsidized ACA coverage, if they are not eligible for Medicaid. You will need to attest to & provide documentation.
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2021 Open Enrollment
Our Quick Quoting & Enrollment Engine is directly tied into the ACA computer system....but it's much faster & easier to use than the govt system.
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Networks
All 2021 plans will be HMOs or EPOs.
EPOs are hybrid HMOs.
There is no coverage for out-of-network treatment!
....except for serious emergencies!
These networks are much smaller than the old PPO Plans
(Grandfathered Plans) offer.
Grandfathered Plans:
If you still own a Grandfathered Plan, you can (& probably should) keep it.
If you cancel it, you can never go back!!!
Many have been sorry that they dropped their old Grandfathered Plan when they needed to use their coverage for a large claim!!!
Largest to Smallest Provider Networks:
1- CHC (Community Health Choice) in SouthEast Texas areas
Most hospitals are in this network!
It's easy to find a good doctor in their network!
Most hospitals are in this network!
It's easy to find a good doctor in their network!
CHC will let you visit any doctor in their network at any time!
2 - BCBS-Tx ... will offer coverage in ALL Texas Counties
Just be sure that you can live with their Dr & Hospital Network...
Blue Advantage HMO Network
St Luke's Hospitals are leaving the network for 2021!
Note:
If your doctor says that they "accept" BlueCross coverage, this does not mean that they'll "accept" YOUR BC-Advantage HMO Network!!!
Almost all of the BCBS-Tx Plans use the Advantage HMO Network!
It's a much smaller network...for ACA Plans...than their other plans use.
Note:
If your doctor says that they "accept" BlueCross coverage, this does not mean that they'll "accept" YOUR BC-Advantage HMO Network!!!
Almost all of the BCBS-Tx Plans use the Advantage HMO Network!
It's a much smaller network...for ACA Plans...than their other plans use.
Their 400-Series (Sanitas) Plans...only available in the DFW & Houston areas...will use an even SMALLER HMO Network ...built around their Sanitas Clinics ...in DFW & Houston areas!
Referrals are required to see a specialist!
With BCBS-Tx, your PCP (Primary Care Physician) must coordinate all of your care!
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BlueCross Provider Finder Search Engines:
IF you see that BCBS-Tx is the lowest quoted price in the Quote Engines:
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Beware!!!
It could be a Sanitas Network Plan...the 400-series plans...with very
limited doctors & hospitals in your area!...(DFW & Houston areas only)
Great rates....IF you can live with the SMALL network.
3 - Oscar Insurance Company:
Central Texas - Austin & San Antonio areas
Austin Hospitals
San Antonio Hospitals Here
North Texas - DFW areas
DFW Hospitals Here
Southeast Texas - Houston areas
Southeast Texas Hospitals Here
West Texas - El Paso
El Paso Hospitals Here
No referral is required to see a specialist IN the network.
Just use the link below to find doctors IN the Oscar EPO network:
4 - Ambetter
A long-time MediCaid (Government) Insurer.
Financially strong.
Excellent hospital network
But, their doctor selection can be limited in many areas.
No referrals are required to see a specialist IN their network.
Ambetter will have the best prices & benefits for those with lower
incomes...in most areas of Texas!
They do have good doctors in their network
But, if you have a favorite doctor, they may not be in the network.
Ambetter's network is continuing to grow in Texas & expand.
If you want Baylor Scott & White Hospitals...IN the DFW
They do have good doctors in their network
But, if you have a favorite doctor, they may not be in the network.
Ambetter's network is continuing to grow in Texas & expand.
If you want Baylor Scott & White Hospitals...IN the DFW
Only HMO Plans for 2021 !
Scott & White has just re-entered the ACA Market for 2021...
.....in North & Central Texas areas.
Most of their hospitals will be the Baylor Scott & White Hospitals
Most doctors will be Baylor Scott & White doctors
Choose the following options at link below:
- Commercial
- BSW Preferred HMO - Individual Marketplace
6 - Molina
Another long-time Medicaid (Government) Insurer
Financially stable.
They have a decent hospital network.
But, their doctor network can be limited in many areas.
No referrals are required to see a specialist IN their network.
Molina will have the BEST rates in MANY areas for 2021.
Just be sure that you can live with the doctor network.
New to the Texas market for 2021.
Friday's rates look excellent in many areas of Texas!
Just check the network before choosing Friday Health Plans.
Here are the Texas Hospitals that will be in the network on Jan 1st:
....as well as all associated doctors, labs & imaging facilities
San Antonio - Bexar County
Methodist Children's Hospital 7700 Floyd Curl Dr San Antonio
Methodist Hospital 7700 Floyd Curl Drive San Antonio
Methodist South 1905 Highway 97 East Jourdanton
Methodist Specialty/Transplant Hospital 8026 Floyd Curl Dr San Antonio
Methodist Stone Oak Hospital 1139 E Sonterra Blvd. San Antonio
Methodist Texan Hospital 6700 IH 10 West San Antonio
Metropolitan Methodist Hospital 1310 McCullough Ave San Antonio
Northeast Methodist Hospital 12412 Judson Road Live Oak
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Dallas / Fort Worth
Collin County
Medical City Plano 3901 West 15th St Plano
Medical City Frisco 5500 Frisco Square Blvd Frisco
Medical City McKinney 4500 Medical Center Dr McKinney
Medical City McKinney - Wysong Campus 130 S Central Exp McKinney
Dallas County
Medical City Children's Hospital 7777 Forest Lane Dallas
Medical City Dallas 7777 Forest Ln Dallas
Medical City Green Oaks Hosp Dallas 7808 Clodus Fields Dr Dallas
Medical City Las Colinas 6800 N MacArthur Blvd Las Colinas
Crescent Medical Center Lancaster 2600 W Pleasant Run Rd Lancaster
Denton Medical City Denton 3535 S Interstate 35 Denton
Denton Medical City Lewisville 500 W Main St Lewisville
Parker
Med City Weatherford 713 East Anderson Street Weatherford
Tarrant
Cook Children's Medical Center 801 7th Avenue Fort Worth
Medical City Alliance 3101 N Tarrant Pkwy Fort Worth
Medical City Arlington 3301 Matlock Rd Arlington
Medical City Fort Worth 900 Eighth Ave Fort Worth
Medical City North Hills 4401 Booth Calloway Rd No Richland Hills
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El Paso
Del Sol Medical Center 10301 Gateway Blvd W El Paso
Las Palmas Medical Center 1801 N Oregon St El Paso
Del Sol Rehabilitation Hospital 10301 Gateway West El Paso
Las Palmas Rehabilitation Hosp 300 Waymore El Paso
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Houston - Harris County
HCA Bayshore Medical Center 4000 Spencer Highway Pasadena
HCA Clear Lake Medical Center-Webster500 Medical Center Blvd Webster
HCA Cypress Fairbanks Med Ctr Hospital10655 Steepletop Dr Houston
HCA Houston NW Med Cente 710 Cypress Creek Parkway Houston
HCA Kingwood Medical Center 22999 Hwy 59N Kingwood
HCA North Cypress Medical Center 21214 NW Freeway Cypress
HCA Park Plaza Hospital 1313 Hermann Dr Houston
HCA Texas Orthopedic Hosp 7401 South Main Houston
The Woman's Hospital of Texas 7600 Fannin Houston
HCA Tomball Regional Medical Center 605 Holderrieth Tomball
HCA West Houston Medical Center 12141 Richmond Ave Houston
Texas Children's Hospital - Main Campus 6621 Fannin Houston
Texas Children's Hospital - Pavillion for Women 6651 Main St Houston
Texas Children's Hospital - West Campus 18200 Katy Fwy Houston
Montgomery County
HCA Conroe Regional Med Center 504 Medical Center Blvd Conroe
Texas Children's Hospital - Woodlands Campus 17600 I-45 So Woodlands
Galveston
HCA Mainland Medical Center 6801 Emmett F. Lowry Exp Tx City
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Austin - Travis County
Heart Hospital of Austin 3801 N Lamar Blvd Austin
St. David's Medical Center 919 E 32nd St Austin
St. David's No Austin Med Ctr 12221 MoPac Expressway No Austin
St. David's Rehabilitation Hosp 1005 East 32nd Street Austin
St. David's So Austin Med Ctr 901 W. Ben White Blvd Austin
St. David's Surgical Hosp 1201 W. Louis Henna Dr Austin
St. David's Childrens Hospital 919 E 32nd St Austin
St. David's Rehab - No Austin Med Ctr 12221 MoPac ExpresswayNo Austin
Williamson County
St. David's Georgetown Hosp 2000 Scenic Dr Georgetown
St. David's Round Rock Med Ctr 2400 Round Rock Ave Round Rock
Round Rock Med Ctr Rehab 2400 Round Rock Ave Round Rock
St. David's Rehab - St. David's Georgetown Hosp 2000 Scenic Dr Georgetown
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Lubbock
Lubbock University Medical Center
Lubbock UMC Harnar Burn Center
Lubbock UMC Children's Hospital
Lubbock UMC Heart Center
Carefully check the Provider Networks!
The same networks are used for On-Exchange plans and for Off-Exchange plans.
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Temporary ShortTerm Plans
This market has become a magnet for junk coverage!!!
None of these plans are worth buying any longer!
They are full of gaps & limits!!!
Temp Plans do not cover:
- Pre-existing Medical Conditions
- Maternity/childbirth deliveries
- Most wellness check-ups
...They cover future things that might happen to you.
Limitations & Exclusions everywhere!!!
Like:
Low (insufficient) dollar limits & many things that just aren't covered on the policies.
Low (insufficient) dollar limits & many things that just aren't covered on the policies.
Yes, many of them are PPO Plans with large networks.
But, the coverage can be dangerous IF you need to USE it!!!
If your treatment is not covered, what good is the coverage?
If your claims are HIGH, you could run out of coverage!
One large claim could wipe you out financially!
If your treatment is not covered, what good is the coverage?
If your claims are HIGH, you could run out of coverage!
One large claim could wipe you out financially!
If you just can't afford more than a Temp Plan, here's a strong A+ rated company to buy from....with limited benefits...and lots of policy exclusions:
The highest maximum benefit they offer is $1 million.
These days, that's not a lot of coverage.
Carefully read the plan benefits, limits & exclusions before buying!!!
You can use any doctor or hospital with this plan!
Pick the highest maximum benefit available!!!
Pick the highest maximum benefit available!!!
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Small Business Association Plans
This is another Junk-Plan Market.....in Texas!
The insurance companies are not designing safe coverage for these plans!...not in Texas, anyway!
Yes, they are PPO Plans.
But, they're worthless to you if they won't cover your claims in their large PPO networks!
In Texas, they are ALL full of serious limitations & exclusions!!!
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Ruth's NPN (National Producer Number) for the govt:
1103110
When you run-a-quote, this number will appear at the top of your Quotes Screen. This number just keeps Ruth attached to your account (as your agent).
ACA:
Affordable Care Act (Obamacare Law)
On-Exchange:
Enrollments through the government system.
They also refer to this system as their Marketplace.
Our Quick Quote Engine is an On-Exchange Enrollment System.
Click HERE....to use our On-Exchange Quoting & Enrollment System
Off Exchange:
No tax credits are available from the govt!
Tax Credits are paid to your chosen Insurance Company...each month...on your behalf...to lower your monthly premium payments.
The government may refer to the Tax Credits as "subsidies" or "help paying your premiums".
These are insulting & misleading terms!
They mark it up...to mark it down!!!
They use your tax dollars to play their "subsidy" games...
...as well as for padding the pockets of our lawmakers & many others in high places.
Yes, healthcare is much too expensive!
But, it's not as expensive as they'd like for you to believe!
What's too expensive is "corruption" in high places.
You will be required to reconcile your 2021 Tax Credits when you file your Federal Tax Return (for 2021).
- If the govt paid too much (each month) to your insurance company, you'll owe them money back...with your Federal Tax Return.
- If the govt didn't pay enough (ea month), you'll get a refund with your Federal Tax Return.
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Off-Exchange Enrollment Links
Enroll directly with the Insurance Company of your choice
...with NO Tax Credits from the govt
Ambetter - Most Ambetter plans are On-Exchange Plans.
If you'll qualify for a Tax Credit, use our Quick Quoting & Enrollment Engine for Ambetter enrollments:
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Cheaper Off-Exchange Plans from Ambetter now available
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BCBS-Tx - Be sure that you have time to enroll in one sitting!
If you go back later, their antiquated system will malfunction!
You'll usually need at least 1 hour to enroll at the BCBS-Tx Enrollment Engine.
BCBS-Tx - Enroll HERE
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CHC - Community Health Choice ... in Southeast Texas
Current members: Re-enroll inside your
CHC Member Online Account - HERE
They entered many Major Metro areas in Texas on Jan 1st.
It looks like their doctor & hospital networks will not be sufficient for 2021.
They're just too small !
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Molina - All Molina Plans are On-Exchange Plans.
So, use our Quick Quoting & Enrollment Engine:
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Oscar Insurance Company - Enroll HERE
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Scott & White......and.....their sister company FirstCare - They will expand
their networks in 2021.
If you want to use the Baylor Scott & White network,
this will probably be your best choice:
Ruth's new telephone number at the river property:
979-964-3900
