Felix Said:

What is a good health insurance company for individuals in Texas?

We Answered:

There are several very good health insurance companies for individual in Texas. However, they all underwrite their policies, which means if you have a health condition that requires an MRI it at least won't be covered and at most would result in them declining to offer you a policy. Your only viable option would be a group plan through an employer, which will cover the MRI after you go through the waiting period.

Francis Said:

Will a family doctor prescribing anxiety medication be covered by my insurance?

We Answered:

I really find it odd that Aetna doesn't cover mental health. Are you positive that they don't cover it at all or do they only cover it with certain providers (ones that are in a different network).

As far as if the insurance company gives you a discount on the meds, well, you'd have to check with them, to see if the med you are looking for is in their formulary. It doesn't matter WHO prescribes it for you. It only matters if it is in their formulary.
AND...does your plan have a prescription program?


EDIT...

It is unlikely that your insurance company will deny it if it is coming from you GP. However, your GP may only prescribe you a small amount and refer you to a psychiatrist for further evaluation, then, according to your plan that you state, may have coverage issues. Mental health coverage is usually for people who seek treatment for an ongoing issue. Are they covering your therapist that you are currently seeing? Because that would be classified under mental health. The only way to be absolutely sure is to call Aetna and ask them specifically what you are asking us. If need be, ask for confirmation numbers (prior authorization) and names of /dates/time of day of people that you spoke to.

And again, Check the formulary of the meds that are in your plan's coverage.

Enrique Said:

Texas Group Health Insurance, any experts?

We Answered:

The only way the employees are REQUIRED to join the group health plan for work, is if the employer pays 100% of the premium.

On average, that's $350 per person, per month.

Otherwise, you can't make the employee join the group health plan. Sorry.

Constance Said:

Pregnancy and health insurance?

We Answered:

Hi. I'm 34 weeks pregnant and have worked in the health insurance industry for 12 years and recently left that field for a different job. I currently have an individual insurance policy since my employer does not offer health insurance. If you are planning on getting pregnant you will need the maternity rider on your individual health policy. This will cost you more due to the added cost of services the insurance company will have to pay for as a result of you being pregnant. In addition, make sure that the insurance company will cover you when you are pregnant and that the plan does not have a "Maternity Waiting Period" on it. Some individual health insurance policies have a 12 month waiting period where they will not pay for any maternity related services until after you are insured with that company for a full 12 months after your effective date.
If you are pregnant when you take the policy, there is a chance your insurance company will consider this a pre-existing condition and will not cover your pregnancy. They have a right to request medical office notes from your physician to determine the date you conceived if they receive a claim from your doctor's office for maternity/pregnancy related services and then deny the claim as pre-existing if you were pregnant before your policy's effective date.
It is frustrating since the time when you need insurance the most, if you have or want to get an individual plan that covers maternity services, you have to make sure the plan doesn't have a maternity waiting period and that you are not pregnant before the plan's effective date.
Some states have state-sponsored health plans that will pay for maternity coverage even if you are already pregnant, however, there are eligibility requirements and limitations.
My recommendation is this: if you are thinking about getting pregnant (and are not pregnant already) then I would get the health insurance plan with the maternity rider and verify that it does not have a 12 month Maternity waiting period and that it will cover maternity services should you become pregnant in the months following your effective date. Good luck!

Ida Said:

Individual Health Insurance for Texas Diabetics?

We Answered:

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