Texas Health Insurance

Just a small delay in relaying medical information can cost the life of a patient. With nurses spending more time with patients than in the workstations, it is unavoidable that there would sometimes be a delay in getting information from the nurse to other health care providers. According to Myra Davis, the vice president of the information services at Texas Children’s Hospital (TCH), they are having trouble establishing an effective communication system. Since TCH understood how important communication can be, they started using the popular Apple iPhone to help.

TCH placed a community charging station where nurses get an iPhone at the start of every shift. Nurses need to update their work status whether they are busy or available. To inform the physicians about the current condition of the patient, they only need to send a text message. The alarm management system installed in the iPhone automatically prioritizes and delivers critical care alerts. It will also send a message if someone tries to text a user who is offline.

According to Davis, rules were given to prevent nurses from being flooded with alerts because that could desensitize them resulting in reduced effectiveness. The alerts need to be based on the severity of the case and what type of health care is required. They will only receive alerts that are pertinent to them based on the degree of severity. Davis hopes that this new project will result in faster and more effective communication so that patients will receive better health care.

While some of the life-and-death choices like how to relay critical information may be out of your hands as a patient, the life and debt choices are yours to make. Just as miscommunication in health care can be a matter of life and death, not realizing the limits of your Texas health insurance coverage can result in major medical debt.

TX health insurance plans come with a complicated mix of co-insurance, co-payments, one or more deductibles and sometimes multiple exclusions and limits. Not taking the limits of your coverage into account or not recognizing what may be excluded under your TX health insurance plan can leave you with a mountain of unexpected debt. Take the deductible, for instance.

A deductible is the amount of money that you have to pay out-of-pocket before your health insurance coverage starts. Basically this is an annual amount that you need to be spend on health care in a given year before your coverage starts. This year, states that didn’t get a waiver allowing them to delay meeting federal health care reform standards, offer plans that pay for preventive health care without charging anything beyond the premium. That means it doesn’t matter what the plan’s deductible is. You can get free preventive care before the deductible is met as long as you use a provider within the plans’ provider network.

For services beyond preventive care, you still need to meet the plans’ deductible before coverage begins. And, that’s where you could really get into trouble if you don’t clarify how the deductible is being applied. One family, for example, believed their plan had a $5,000 deductible, but they could have ended up spending four times that amount to meet the plan’s deductible. It was actually per person rather than per year. A couple with two children could, in a very bad year, need to spend $5,000 per family member before coverage was available for services beyond preventive health care.

Even after the deductibe has been met, you could still have out-of-pocket costs. Co-insurance is the amount of a medical claim that you need to pay if your coverage is less than 100 percent. For instance, it is common for Texas health insurance policies to have an 80/20 split, but other splits exist, like 70/30. Depending on your TX health insurance policy, you may have to pay for a percentage of charges after you’ve spent enough to cover the deductible.

Not all policies are created equal, at least until the Texas health insurance exchange is available in 2014. At that time, plans will be more standardized to help the public figure out what they’re buying. Right now, you still need to watch out for exclusions and limits on benefits. For example, a policy with a $500 limit on hospital expenses per day would surely be a ticket to bankruptcy for many people in the event they needed prolonged hospital care. Until the state exchange is available, it might be a good idea to get a second on any policy that looks good on the surface. Unlike company insurance agents, independent health insurance brokers can compare policies from different Texas health insurance companies. Looking them up online may be your best bet to get help comparing your coverage options.