Tejas health care is a comprehensive healthcare system that serves the people of Texas. It provides access to quality healthcare services, including primary care, specialty care, and mental health services. Tejas Health Care also provides access to affordable health insurance plans, including Medicare and Medicaid.
Tejas Health Care was created in 2003 as part of the Texas Health Care Reform Act. The goal of Tejas Health Care is to make sure that all Texans have access to quality health care. It is an individual-centric system that emphasizes prevention and early intervention, rather than treatment of chronic diseases.
Tejas Health Care is dedicated to providing access to quality care, regardless of a person’s income or insurance status. The system is designed to ensure that all Texans can access the care they need. It also provides access to a wide range of specialty care services, such as mental health, substance abuse, and home health services.
Tejas Health Care also provides access to affordable health insurance plans. These plans are designed to give Texans the coverage they need at a price they can afford. Tejas Health Care also offers subsidies to those who qualify for assistance.
Health insurance plans
Health insurance plans are contracts between a health insurance company and an individual or group, which provides coverage for some or all of the costs associated with healthcare. There are several types of health insurance plans available, each with its own benefits, costs, and coverage levels. Some of the most common types of health insurance plans include:
- Private health insurance plans, which are purchased by individuals or provided by employers. These plans typically include a network of participating providers and have copays, deductibles, and out-of-pocket maximums.
- Medicare, which is a federal health insurance program for individuals age 65 and over, as well as certain younger individuals with disabilities. It covers hospitalization, doctor visits, and other medical services.
- Medicaid, which is a joint federal and state program that provides health coverage for individuals and families with low incomes. It’s available to those who meets the eligibility criteria set by each state.
- Public health insurance plans, such as the Affordable Care Act (ACA) marketplace plans, which are available to individuals who do not have access to health insurance through their employer or the government.
All plans must cover certain essential health benefits, such as emergency services, hospitalization, prescription drugs, and mental health services. The cost and coverage of the plans vary depending on the type, provider and the state.
It’s important to note that the knowledge cut off is 2021, and there might have been some changes or updates in the health insurance plans and related policies.
Essential health benefits
The Affordable Care Act (ACA) requires all individual and small group health insurance plans offered in the United States to cover certain essential health benefits (EHBs). These benefits are intended to ensure that all Americans have access to a basic level of healthcare coverage, regardless of their health status or income. The EHBs include:
- Ambulatory patient services: Outpatient care that doesn’t require an overnight stay in the hospital.
- Emergency services: Care in the event of an unexpected illness or injury, including transportation to a hospital.
- Hospitalization: Care that requires an overnight stay in the hospital, such as surgery.
- Maternity and newborn care: Care for pregnant women and their newborns, including prenatal and postpartum care.
- Mental health and substance use disorder services: Treatment for mental health conditions and substance use disorders.
- Prescription drugs: Medications prescribed by a doctor.
- Rehabilitative and habilitative services and devices: Services and devices that help individuals recover from an illness or injury, or that help them learn, recover, or improve mental and physical functions.
- Laboratory services: Tests that help diagnose and monitor certain medical conditions.
- Preventive and wellness services and chronic disease management: Services that help individuals stay healthy, such as vaccinations and screenings, as well as care for individuals with chronic conditions such as diabetes and heart disease.
It’s important to note that some services may have limitations or exclusions, and the coverage may vary by plan. The EHBs are the minimum requirement that the plan must cover, but the plan may cover additional services.