What You Should Know About Individual Health Insurance in Texas When You Have Pre-Existing ConditionsHMO plans are more favorable health insurance options for those seeking individual health insurance in Texas. If you purchase an HMO plan, you will not face an exclusion period. State law prohibits HMOs from requiring pre-existing condition exclusion periods. If you purchase a different type of individual health insurance plan, such as PPO, the provider can exclude your pre-existing condition. One way they can exclude your existing condition is with an elimination rider - an amendment to your insurance contract that temporarily or permanently excludes your condition, body part or body system from coverage. Providers can also impose exclusion periods for up to 24 months. Even after you have purchased health insurance, a provider can exclude a condition at a later time. For example, if you file a claim for a condition within the first two years of your contract, the provider can look five years back into your medical history and determine if treatment was sought and impose limits on the condition in your individual health insurance plan. Pregnancy may be considered a pre-existing condition under your individual health insurance plan if you are pregnant at the time of the contract. Texas self-employed persons with pre-existing health conditions should take these and other factors into consideration when considering an individual health insurance purchase. To learn more about pre-existing health condition limits imposed by individual health insurance providers, please visit HealthInsuranceInfo.net. You can also contact your Texas insurance commissioner.
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