From Frustrated to Covered: One Doctor’s Health Plan Discovery

Dr. Daniel Lal* started his day the same way most solo physicians do—juggling charts, patient care, and practice demands. He wore every hat: clinician, business owner, husband, dad.

He ran a growing internal medicine practice in Austin, taking pride in caring for his patients. But when it came to taking care of himself, specifically his health coverage, he was running into roadblocks.

Dr. Lal had always assumed the best health plans were reserved for large practices. As a solo practitioner, he’d tried to make the most of his options on the open market, but the rising costs, narrow networks, and limited flexibility left him frustrated year after year.

Then, something changed.

When His Health Shifted, His Coverage Couldn’t Keep Up

When Dr. Lal’s Crohn’s symptoms worsened, life outside the exam room got harder. Every flare-up meant more referrals, more delays, more frustration, and less time for the people counting on him.

The limitations of his coverage began to affect his quality of life. Prescription costs were adding up. Out-of-pocket expenses piled on. And trying to get consistent specialist care through his current plan? Nearly impossible.

That’s when a colleague suggested he reach out to TMA Insurance Trust. Just to explore other options.

What he found was something he didn’t expect.

Group PPO Coverage for One

Dr. Lal learned that because he operated as an independent physician, he could be eligible for group health insurance, even if he didn’t have a large staff. In fact, with his spouse serving as an office manager and handling his practice’s bookkeeping, he had what he needed to qualify.

Through TMA Insurance Trust, he was able to access group PPO coverage he thought was out of reach: broader networks with more choices for specialists, no requirements for referrals, and fewer restrictions on where and how he got care.

And the best part? There was no cost to get help from a TMA Insurance Trust advisor. No pressure. Just guidance.

Dr. Lal’s experience isn’t unique, and with guidance from TMA Insurance Trust, better coverage may be in your reach as well:

• We offer group and individual plans from leading carriers.
• For practice owners with existing group coverage, we help manage costs while offering your employees a combination of group PPO and HMO plans.
• If your staff are already covered elsewhere (such as a spouse’s plan), you may still qualify for group PPO coverage just for yourself and your family.
• Partners without W-2 employees can qualify for individual group coverage by providing partnership documentation and the company’s SS4 or recent K-1 (Form 1065).
• Physicians owning a business with their spouse as the only employee can often qualify for group coverage without additional documentation.
• We can assist you with high-deductible health plans so you can qualify for a Health Savings Account (HSA). These accounts provide tax advantages, spending flexibility, and ongoing saving opportunities.
• For physicians opening a new practice, TMA Insurance Trust simplifies starting your own group plan, supporting your professional growth from the outset.

Every physician’s situation is different, but if you’ve ever felt uncertain about your coverage options, you’re not alone. Dr. Lal’s experience is a reminder that with the right support, real change is possible. If you’re an independent physician in Texas, TMA Insurance Trust is here to help you explore your options and find a path forward that offers greater peace of mind for your practice and your family.

Explore Your Options

Whether you’ve just started your practice or you’ve been in solo practice for years, the coverage you need might be more accessible than you think. Now is the time to ask.

TMA Insurance Trust was created to help Texas physicians find better solutions—without commissions, without sales pressure. Just support.

Let us help you see what’s possible for you. Call 800-880-8181 Monday through Friday, 8:00 a.m. to 5:00 p.m. CST to speak with a TMA Insurance Trust advisor.

For over 70 years, TMA Insurance Trust advisors have been serving Texas physicians, their families and staff. TMA Insurance Trust prides itself on offering unbiased information and strategies to members, along with exclusive group rates on a range of quality insurance plans.