Health Insurance Carriers in Texas (TX)
The health insurance regulations in Texas are different
than other states. To aid you in your quest for the perfect health
insurance plan, we have compiled a recommended list of Texas regulation
compliant companies, complete with links for more information.
Once you have looked these over, check out the section at the
bottom of the page which details some of the insurance regulations
that providers must abide by in Texas.
Get more information on health insurance >>
Health Insurance Carriers in Texas
Aetna
American Medical Security
Assurant Health (Formerly Fortis)
BlueCross BlueShield of Texas
Celtic
Clarendon National
Fairmont Specialty Group
Golden Rule
Guardian
PacifiCare
Security Life
UNICARE
Group Health Insurance in Texas
- Coverage may not be denied to qualified persons due to health
problems. Neither may they be charged more.
- New employer may withhold coverage for a period of time.
- Special opportunities may be available during life changes
dealing with marriage or job loss.
- Small business employer are required to include family members
under health coverage.
- Newborn, adopted, grand, and disabled children are offered
special consideration for health coverage.
- Except for HMOs, group providers may review medical history
for the six months immediately prior to new coverage.
- Providers may require an exclusion period for up to 12 months.
- HMOs may not impose exclusion periods but may require an
affiliation, or waiting, period.
- Creditable coverage for a pre-existing condition is available
when previous coverage was maintained without a break longer
than 63 days.
- Consult your employer for more information.
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Small Business Health Insurance in Texas
- Small businesses with fewer than 50 employees may not be
refused small group health coverage and may not be cancelled
due to illness within the employee group.
- There are limits on premium prices for businesses with fewer
than 50 employees.
- Insurance providers must offer policies with mandated benefits.
- Small businesses with fewer than 50 employees may join a
statewide and approved purchasing association for group health
insurance coverage.
- For rules on professional associations which offer group
health coverage, contact the Texas Department of Insurance.
The Texas Department of Insurance
333 Guadalupe
Austin, TX 78701
(512) 463-6169
www.tdi.state.tx.us
Self-Employed Health Insurance in Texas
The self-employed may not purchase small group health
insurance.
Individual Health Insurance in Texas
- Private insurance providers may deny individual insurance
due to health problems.
- Individual providers must offer low cost Consumer Choice
Benefit Plans.
- Those with pre-existing conditions may be subject to an
exclusion period unless the insurance is through an HMO.
- Insurance providers may attach an elimination rider to a
policy or require an exclusion period of up to 24 months.
- During the first two years of coverage, any claim allows
the provider the right to review medical records for the five
years previous to application.
- If a pre-existing condition is found, the provider may refuse
to pay the claim.
- Pregnancy may be considered a pre-existing condition, but
genetic information may not.
- Creditable coverage is available to those with pre-existing
conditions if continuous coverage was maintained without breaks
over 63 days.
- Insurance may not be cancelled because of sickness.
- Premium prices are not limited.
- For low income individuals and those who are HIPAA eligible,
Texas Health Insurance Risk Pool offers health insurance assistance
Texas Health Care Programs
Medicaid, Texcare Chip, and Breast and Cervical
Cancer Control Program provide assistance to low income families
and individuals.
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