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Texas

Texas Health Insurance

Texas has fewer health insurance regulations than most states. Still, it's important to familiarize yourself with them, so you're more confident and wise in your purchase.

This guide:

  • Describes important Texas health insurance policy regulations

  • Lists rules Texas health insurance companies must follow

Health insurance policies are regulated by each state's own health insurance laws. Texas health insurance companies and policyholders alike must abide by established insurance laws.

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Do You Qualify For A Subsidy?


Find out if you qualify for a government subsidy under Obamacare. Millions of Americans will have their insurance rates reduced under the new health care law. Learn how much you could save with our simple calculator.

Texas health insurance provisions

Some of the most important Texas health insurance laws are the ones that influence the health insurance policy itself.

Texas health insurance laws require that all Texas health insurance policies include a clause called the guaranteed renewability provison. This mandatory provision gaurantees that, at the end your Texas health insurance policy's term, you will be able to renew that same policy for another year.

Texas health insurance laws regulate policy exclusion periods too. Medical conditions can be excluded from your Texas health insurance coverage for a period of time if they are considered to be pre-existing conditions.

State laws define the term “pre-existing” differently. Texas health insurance regulations consider conditions to be pre-existing if you received medical treatment for, or were diagnosed with, the condition anytime in the 5 years before the beginning of the health insurance policy.

Legally, Texas health insurance companies are allowed to include exclusion periods for pre-existing condition for up to 2 years. However, Texas health insurance companies can also exclude coverage for a pre-existing condition permanently by attaching an elimination rider to the policy.

If you switch health insurance companies, your old policy can be used to credit your new Texas health insurance policy's pre-existing exclusion period.

Regulating Texas health insurance companies

Health insurance laws in some states strictly regulate the cost and availability of health insurance policies, instead of letting insurance companies have complete freedom. Texas health insurance laws are rather relaxed in this area, which means you have to be more aware of what liberties your Texas health insurance company are allowed.

For one, the availability and cost of Texas health insurance is determined by your health status. This means that any Texas health insurance company is free to initially refuse you coverage or to increase your premiums due to your health status.

However, once you purchase a health insurance policy, it is illegal for a Texas health insurance company to deny you continued coverage on the basis of declining health.

Considering the relaxed protection Texas residents receive from your state government, it is very highly recommended that you purchase your Texas health insurance policy while you are young and healthy, then continue to maintain that policy. By doing so you avoid the possibility of being denied Taxas health insurance when you need it most.

More TX health insurance help

If you want more help getting a good health insurance policy, read our guide to health insurance.

Also see the guide to Texas small business health insurance.


To find out more about TX health insurance laws and regulations, visit the official website of the Texas Department of Insurance.





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This internet site provides information of a general nature for educational purposes only and is not intended to be legal advice. We make no guarantees as to the validity of the information presented. Your particular facts and circumstances, and changes in the law, must be considered when applying insurance law. You should always consult with a competent insurance professional licensed in your state with respect to your particular situation.