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Texas Health Insurance

Texas Family Health Insurance Regulations

(Also covers Child Health Insurance and Texas coverage for individuals)

Any Texas individual covered under a group or employer Texas health insurance plan cannot be denied or limited coverage under that plan. Individuals looking for individual Texas health insurance, however, can be denied or limited access to Texas health insurance because of age, health, or other factors. All Texas health insurance plans are guaranteed renewable which means that any individual is guaranteed the right to renew an existing Texas health insurance plan provided he or she has not given false information and has paid all premiums on time.

Pre-Existing Conditions

Some Texas health insurance companies can impose elimination riders and pre-existing condition exclusion periods. Elimination riders exclude a condition or body part from coverage for the duration of the health insurance policy. Pre-existing condition exclusion periods can exclude any disclosed condition for a period of up to 24 months. If the Texas health insurance company fails to ask about pre-existing conditions, then it can only exclude conditions for up to 12 months.

Texas health insurance companies can look back 5 years into an individual’s history to determine if any condition is pre-existing. Texas medical insurance has the right to research any claim during the first two years of a policy and determine if the condition was pre-existing. If so, it can impose the pre-existing condition clause.

HMOs in Texas cannot impose pre-existing exclusion periods. Pre-existing periods can also credit prior continuous coverage for pre-existing condition exclusion periods.


Pregnancy is considered a pre-existing condition under most plans. Any parent who has an individual Texas health insurance plan that covers dependents can keep disabled children under the plan past the age at which dependents are usually no longer covered. Newborns and adopted children are automatically covered under these individual plans as well for the first 31 days after birth or adoption.

Major Medical Insurance Rates - Texas

While there are many types of health coverage, most people’s research includes a request for major medical insurance rates. Texas health insurance rates vary depending on health, age, family size and other factors. Premiums can increase with each renewal of policies depending on changing age and health. These rate increases are not dependent on an individual’s change, but on all persons of similar age range and health. US Insurance Online offers free health insurance quotes. Texas residents seeking coverage rates can find what they need through our extensive quote research process and information resources.

Temporary Insurance

Some Texas health insurance companies sell temporary health insurance. Persons who are between plans or employers have an option to purchase temporary Texas individual health insurance to cover these periods.

Alternative Texas Health Insurance Options

For individuals who have difficulty obtaining Texas medical insurance or may be “uninsurable” there are some state programs that may help:

  • Texas Medicaid is available to qualifying individuals who meet eligibility criteria
  • Texas Health Insurance High Risk Pool is designed to help “uninsurable” individuals obtain health insurance through a group health insurance plan through the state of Texas. Pre-existing condition periods may apply.
  • Texas Children’s Health Insurance Program is designed to provide health insurance for children up to age 19 whose families do not qualify for Medicaid and who may not be able to afford Texas health insurance. Children must re-enroll every six months.

For other Texas Insurance Resources, See:

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