Health Insurance Options
Choose the Plan that Covers the Provider and Hospital You Trust.
Trinity Mother Frances providers and hospitals are NOT in-network for the Public Exchange/Health Insurance marketplace products.
But, there are a number of other coverage options in which TMFHC is in-network, including your employer's Blue Cross Blue Shield PPO plan. Other alternatives can be accessed through numerous trusted independent insurance agents/brokers across East Texas.
Please read the commonly asked questions below to help you make an informed decision about your healthcare.
Q: With which health insurance plans is Trinity Mother Frances in-network?
Contracted Insurance Plans
Trinity Mother Frances Hospitals and Clinics accept most major insurance plans providing health care coverage. The following is a list of health insurance companies and PPO networks with which Trinity Mother Frances is currently contracted as a participating provider.
Trinity Mother Frances Hospitals and Clinics’ participation with any product or insurance plan is subject to change without notice. Additionally, insurance companies offer a variety of plans and may change the names and benefits at any point. A patient’s level of coverage and access to Trinity Mother Frances depends on the specific benefits outlined in their plan.
To ensure that Trinity Mother Frances hospitals and physicians are in-network, it is the patient’s responsibility to verify that Trinity Mother Frances is a participating provider and their benefit plan allows them access as of the day of a visit and/or admission.
Q: What is a public exchange/Health Insurance Marketplace?
A: A provision of the Affordable Care Act calls for the government to create public exchanges, an online Marketplace that will allow both uninsured and insured consumers the opportunity to shop for insurance coverage that best fits their budget and individual needs. In addition, there are cost sharing subsidies available to individuals and families who meet eligibility requirements. December 15, 2015 is the last date to enroll for coverage that starts on January 1, 2016.
Q: Will the plan I purchase on the public exchange/Health Insurance Marketplace allow me to continue to seek care at Trinity Mother Frances Hospitals and Clinics?
A: It’s important to note that as of January 1, 2016 TMFHC is not included in the insurance products offered through the online public exchange/Health Insurance Marketplace.
If you have a Trinity Mother Frances physician and want to continue to use Trinity Mother Frances Hospitals & Clinics, you will need to choose a plan outside the public exchange/Health Insurance Marketplace. By choosing an “off the market” in-network plan you will have access to all Trinity Mother Frances hospitals and providers. If you choose a plan that does not include Trinity Mother Frances Hospitals and Clinics, you could be responsible for up to 100 percent of costs.
Q: How will a public exchange/Health Insurance Marketplace affect my coverage if I have Medicare?
A: There will be no effect to you if you are on Medicare. You already have coverage through Medicare, and you do not need to make any changes.
Q: How will the public exchange/Health Insurance Marketplace know whether I am eligible for Medicaid?
A: The public exchange/Health Insurance Marketplace is equipped to evaluate the eligibility of individuals for Medicaid or financial assistance. Once eligibility is determined, the public exchange/Health Insurance Marketplace will help direct individuals to health insurance plans that meet their needs.
Q: How can I determine if I am eligible for Medicaid or financial assistance?
A: Individuals can determine if they are eligible for Medicaid or financial assistance in four ways: online at www.HealthCare.gov, by phone at (800) 318-2596, by mail, or in-person with the help of a trained assistant or navigator. Additional information is available by visiting www.HealthCare.gov or calling (800) 318-2596.
Q: Will there be out-of-pocket costs and co-pays for plans offered on the public exchange/Health Insurance Marketplace?
A: As with all health insurance plans, there will be different levels of out-of-pocket expenses and co-pays based on the type of insurance selected. Typically, if an individual has a higher monthly premium, he/she usually pays less out-of-pocket costs. A person may find it beneficial to select a higher premium insurance to avoid large out-of-pocket expenses and to minimize any pre-service deposit requirements for non-emergency care.
Q: Where can I find more information?