Physicians are facing important decisions about health insurance coverage for the year ahead. Many small practice owners and independent physicians without employees might assume their coverage options are limited to individual health insurance—either an HMO plan or a short-term plan that only provides very limited and temporary coverage. However, there may be more options available than you think.
Even if you don’t have employees, you may still qualify for group PPO health insurance just for yourself and your family.
Explore Your Special Group Health Insurance Options
TMA Insurance Trust has uncovered special group health options available during Open Enrollment that could help improve your coverage for 2025. If you're looking to explore what options are available to you, here are some opportunities to consider:
- Practice owners looking for group coverage for their practice - there are initial enrollment opportunities available only during Open Enrollment to help practices manage the cost and be able to offer your employee’s group health insurance – including a mix of group PPO and HMO plans.
- Practice owners with staff on their own health coverage (spouse’s plan or another provider) may be able to get PPO coverage just for themselves and their family.
- Partners with no W-2 employees may be eligible for group coverage only for yourself. You’ll need to provide partnership documentation and the company’s SS4 or recent K-1 (Form 1065).
- Physicians who own a business with their spouse, or their spouse is a W-2 wage employee, you may qualify for group coverage even without partnership documentation.
- Establish a Health Savings Account (HSA), If you select a high deductible health plan to manage costs better, you can open an HSA. These accounts offer tax advantages, spending flexibility and ongoing saving and investment opportunities.
- Physicians opening your own practice, TMA Insurance Trust can help you with starting your own group plan.
Group PPO plans provide wider network access and more flexibility than individual HMO plans. With a group PPO plan, you’re not restricted to a narrow network of providers, and even small practices or independent physicians may qualify through special options. If you meet the criteria above, you will likely be eligible for group PPO coverage and the opportunity to secure more comprehensive insurance for yourself and your family.
Short-term health insurance has risks. While short-term health insurance might seem appealing due to its lower costs, these plans often come with limitations. They usually don’t cover essential healthcare services such as maternity care, mental health support, or treatment for pre-existing conditions. If you have pre-existing conditions, short-term plans may even deny you coverage altogether, unlike ACA-compliant plans, which provide full protection. Although short-term plans might save you money upfront, they could expose you to higher costs in the long run.
Given the complexity and risks, it's important to rely on a licensed agent who can explain the pros and cons of various health insurance choices.
Let TMA Insurance Trust Do the Work for You
Researching health insurance plans can be time-consuming; many physicians don’t have time to dive into the details. Our TMA Insurance Trust advisors provide one-on-one support, exploring various coverage options tailored to your needs. We’ll compare policies to find the best fit and handle securing quotes and paperwork on your behalf—all at no cost or obligation. With professional guidance, you can ensure you're making the best decision for your health and financial security.
Lock in Your Coverage for the Year Ahead
To secure coverage for 2025, all documents must be submitted by Wednesday, December 11, 2024. Don’t miss out on these special group health insurance options available for you, your family, and your practice.
Contact TMA Insurance Trust today, and let our advisors help relieve the stress of finding group coverage. Click below or call us at 800-880-8181, Monday through Friday, 8:00 AM to 5:00 PM CST.
For over 65 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 the highest-rated plans in the industry.