Texas Child Health Insurance
Insurance for Little Ones: Child Health Insurance

Texans are very serious about the health of their children. Organizations like the Texas Health and Human Services Commission sponsor many programs which are designed to ensure health children within the state. It is consequently no surprise that health insurance for children is a big issue.

There are several different health plans offered which are conducive to children’s needs, but by far the two most popular plans is an HMO (Health Maintenance Organization) plan and a PPO (Preferred Provider Program) plan. Both plans involve monthly premiums, deductibles, and co-pays, but the big differences arise when people compare the cost between the two different plans and also with the flexibility each one provides. There are pros and cons to each plan, and parents must make the decision as to which plan works best for their family.

An HMO plan is a little more restrictive than other health insurance plans. Patients must utilize doctors who are on an approved listing with the HMO, so this means that families who have used the same family doctor for years will notice a big change when joining an HMO. This particular plan is a pretty popular one with employers because it is generally much less expensive than any other plan. This allows employers to either pick up most of the tab for the monthly insurance premiums or to actually pay the full cost as a benefit to the employees. Even if employers choose to not kick in a good amount of money for the monthly premiums an HMO plan is still generally affordable, at least much more so than any other health insurance plan.

Problems arise with HMO plans when parents have children with special needs. HMOs require that patients receive a referral from their primary care physician prior to receiving any sort of specialty treatment. This can be a lengthy and tedious process for a family waiting to have their child seen by a specialist for a specific need. Usually the only reason families stay within an HMO plan is simply because of the inexpensive premiums.

A PPO plan has much greater flexibility than an HMO. Parents can take their children to go see whatever doctor they choose, which means if they find a doctor the kids love then it doesn’t matter if the doctor is not on an approved list. A PPO plan also works much better for families who have children with special needs. Unlike an HMO there is not usually a lengthy wait to receive approval for specialty care, and PPO plans also allow for a bit more preventative and routine care than an HMO does. So why isn’t everyone enrolled in a PPO plan? Quite simply, the cost is more restrictive for some people. While HMOs pride themselves in being inexpensive, PPOs have pride in the fact that their coverage is more comprehensive. Monthly premiums, deductibles, and co-pays are all more expensive with a PPO than with an HMO. Parents need to decide which insurance plan works best for their kids and family, both in the terms of coverage and cost.