Your Rights to Individual Health Insurance under Texas Law
In Texas, you have limited access to guaranteed individual health insurance.
Private providers can deny individual health insurance coverage for any reason.
If you have a pre-existing condition, HMOs cannot impose exclusions. However, PPOs and other providers can impose exclusions and raise your premiums. They can even impose exclusions after you have purchased insurance.
There are no limits on the premiums charged by providers. Premiums can be based on your health, age, family size, etc.
Individual health insurers have to give you credit for previous continuous coverage.
Your coverage cannot be cancelled because you get sick. This is guaranteed renewability. However, premiums can be raised during a coverage period.
If your employer, regardless of size, offers a fully insured group health plan, you may also be eligible for continuation coverage under some Texas laws that are similar to COBRA.
If you cannot obtain individual health insurance in Texas because of expensive health issues, you may qualify for the Texas Health Insurance Risk Pool (The Health Pool).
If you are self-employed, you are not eligible to buy a small employer group health plan on your own. Therefore, the laws that protect employers' access to group health plans do not apply to you. Your access to health coverage is protected by the laws that apply to individuals.
If you are self-employed and buy your own health coverage, you are eligible to deduct 100% of the cost of your premium from your federal income tax.
