Austin Texas Health Insurance Companies - Austin, TX, October 25, 2016 // - Millions of people are gearing up for open enrollment, the year when people can choose a new health plan. This is a difficult task for many people. In fact, many polls show that Americans are dissatisfied with a health care system in which insurance plays a large role.
Vista360health, an Austin-based HMO, aims to change that sentiment by changing the way individuals, entrepreneurs and small businesses view the health care system. One of the ways they do this is by "going local".
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Vista360health was first founded in the 1990s in Austin, Texas. They have once again capitalized on the growing need for quality coverage and attentive customer service.
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"For many individuals and business owners, the changing health plan market is a challenge," explained Sharon Alvis, president of Vista360Health. As national carriers sell products or exit the market, people are left with fewer options. Many companies that remain in the individual market have responded with double-digit rate increases, higher franchises, narrower networks and limited-plan projects.
Serving the Entrepreneur, Small Business It's no secret that Austin has become one of the fastest growing hubs for entrepreneurs in the US. Austin was ranked No. 1 on CNBC's Metro 20: America's Best Places to Start a Business. In 2013, there were 44,163 small businesses in Austin. According to a study by the American City Business Journals, that translates to a population of 2,342,100,000.
Unlike giant national insurance companies, Vista360health is very local, currently serving only Central Texas residents. All Vista360Health services are located in Austin, including customer service representatives, claims department, medical providers, telemedicine physicians and medical management.
"People know the name of their coffee shop barista, but they don't really associate it with their health plan," says Alvis. "Our model is simple – we offer a broad network of high-quality providers, affordable health plans and a focus on our members."
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Free Telemedicine Adds Convenience, Manages Costs To help members advance their healthcare, Vista360health offers free 24/7 access to a physician through eMD Access, a telemedicine service. Members can call anytime, anywhere and always talk to a local doctor about their health concerns.
Patients often incur unnecessary out-of-pocket costs by making unnecessarily intensive and expensive emergency room or urgent care visits when a call to a telemedicine doctor could have solved the problem for free and in the comfort of their office or home, Alvis said.
"Our telemedicine doctors navigate members through the maze of care. Should I see a doctor about this problem? Does it need stitches? Do I need a prescription? Our telemedicine doctors answer those questions," explained Sharon.
These doctors can treat common ailments, write prescriptions and, if necessary, refer people to their primary care physician's office or an urgent care center for further medical care. This is all done via secure text messages, phone calls and/or video chats without any payment or fees.
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Alvis said, "A quality health plan also means providing resources that people actually use. What's better than free 24/7 access to a doctor?"
About Vista360health: Vista360health was first created in 1994. And was reincarnated as an Austin-based home-grown HMO plan. Unlike giant insurance companies, they offer regular benefit plans to help meet the needs of their customers and a "right-sized" plan to fit their budget. As a non-federal exchange, Vista360health's mission is to keep our customers healthy and support their health care in three ways: by making quality medical care convenient, personalized and simple. For more information about Vista360health, click here. Learn how America's bailout damaged the health of the market. Insurance costs for Texans from Dallas-Fort Worth to Houston, Austin, San Antonio and beyond. Learn about the ongoing opportunity for low-income residents to enroll at a $0 premium. Enroll during open enrollment (November 1 through January 15 in most states) or during a special enrollment period if you experience a life event that qualifies you.
Short-term health insurance in Texas is available to individuals and families who meet coverage guidelines set by insurers.
Texas did not expand Medicaid eligibility under the Affordable Care Act (ACA). As a result, Texas has the largest coverage gap in the nation, with an estimated 771,000 residents ineligible for Medicaid and even premium subsidies to offset the cost of private coverage on the exchange.
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More than 4.4 million people in Texas have Medicare plans, just 14% of the state's population. About half of Texas Medicare beneficiaries have Medicare Advantage plans. Medicare Advantage plan availability ranges from 12 plans to 108 plans depending on the county.
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Texas uses a federally managed marketplace (exchange) at HealthCare.gov and has one of the largest exchange enrollments in the nation. Only Florida and California record more conversions.
The insurance marketplace offers health insurance plans for individuals and families who need to purchase their own health insurance. This includes early retirees (who switch to Medicare when they turn 65), self-employed residents, and people who work for a small business that does not offer employer-sponsored health benefits.
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Market use is optional; Individuals and families in Texas can choose to purchase coverage directly from a health insurance company. However, the Marketplace is the only place where Texas residents can receive financial aid payments based on their household income. These include premium subsidies (offsetting monthly insurance costs) and cost-sharing discounts (reducing medical costs associated with deductibles, coinsurance and premiums).
In Texas, open enrollment for individual and family health insurance begins November 1. Except for open enrollment through January 15, you need a qualifying event (triggering a special enrollment period) to sign up for coverage or change your plan.
Three insurers entered the Texas market in 2023 and two more exited. Plan availability varies from region to region, but in the Texas market, a total of 15 insurers will offer coverage through 2023.
And in 2023 Cigna and Ascension will join the personalized care Texas market. Plans in 2023 will be available from 2022 onwards. November 1
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The ACA expanded Medicaid to cover all legal Texas residents with incomes up to 138% of the federal poverty level, but in 2012. The Supreme Court ruling allowed states to halt Medicaid expansion. Texas continues to oppose Medicaid expansion as the number of states continues to decline (there are 12 states that will not expand Medicaid in 2022).
As a result of the state's refusal to expand Medicaid, 771,000 Texans are uninsured and without access to financial assistance for health insurance. That's more than any other state that hasn't expanded Medicaid — the next largest is Florida, which has about 415,000 people.
March 2013 to 2017. Despite the state's very strict eligibility guidelines, the Texas Medicaid/CHIP program grew by nearly 13%. As of 2019, the number of students has actually decreased as compared to 2013.
However, by 2022 March. The total Texas Medicaid/CHIP patient population is 27% higher than in 2013. The COVID pandemic has increased Medicaid enrollment nationwide due to widespread job losses and reduced incomes. This is true even in states like Texas that did not expand Medicaid under the ACA. And families' first response to the coronavirus law has been delaying changes to Medicaid eligibility across the country. This will continue until the end of the COVID public health emergency. Thus, Medicaid enrollment continues to rise during the pandemic.
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Medicaid eligibility rules are particularly strict in Texas: Disabled adults without children are ineligible regardless of income, and parents with dependent children are eligible only if their household income is very low ($230 a month or less for a parent with two children).
Texas rules on the definition and duration of short-term health plans are consistent with the new federal short-term rules. As a result, short-term health insurance plans in Texas have initial terms of up to 364 days and can be extended for a total of 36 months.
By mid-2022, 4.4 million people signed up for Medicare were Texas residents. That's about 14% of the state's population, the U.S. 19% of the population is enrolled in Medicare. Most Medicare beneficiaries in the state are eligible for coverage because of their age (at least 65), but about 12% are under 65 and eligible for Medicare because of a disability.
More than 2.25 million Texas residents are enrolled in Original Medicare (Part A, hospital coverage and Part B, outpatient coverage) and more than 2.19 million are enrolled in private Medicare Advantage plans. Medicare Advantage enrollment has grown faster than overall Medicare enrollment growth.
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You can read more about Medicare in Texas, including the state rule for Medigap plans, as well as the availability of Optional Medicare Advantage and Medicare Part D prescription drug plans.
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