A pre-existing condition is a medical issue that you’ve had previously prior to getting health insurance. One example of a pre-existing condition is diabetes. In the state of Texas, that would fall under the definition for pre-existing conditions. If you have health insurance in Texas, you may have to wait several months or years before the insurance will pay for claims in regard to that condition.
According to the law, you cannot choose to keep any information from your insurer if it is requested when you apply for health insurance in Texas. If you are not completely honest, your insurer can cancel your policy and you may have to repay any expenses your insurance company incurred on your behalf.
Your health insurance company in Texas may consider a pre-existing condition to be one where you have received treatment and care prior to having your current health insurance plan. With health insurance in Texas, pre-existing conditions can also be determined with an individual health plan. If you have an individual plan, they will look at your medical history from the past to the present, starting five years back. If you have an employer-sponsored plan, they go back to the last six months. Other health insurance plans use the last twelve months.
By law, health insurance companies may decline to insure you on the grounds of the existence of a pre-existing medical condition. Those that choose to cover you may require a policy rider. A policy rider is a set of exclusions from the health care insurance coverage. This would mean that they would cover doctors’ visits, tests, procedures and medications for any other illness or accidents, but would not cover treatments or medications that are intended to treat the pre-existing condition. In other cases they may just require a waiting period and for most health insurance plans in Texas that waiting period is usually about two years.
In the state of Texas, regardless of whether or not you have a pre-existing condition, you may still have to go through a waiting period. If that happens to you, the waiting period for pre-existing conditions begins on the first day of the waiting period. If you have health insurance in Texas that is an HMO plan, then you can have a waiting period of no more than three months.
If you already have health insurance in Texas and you’re switching plans, then you may not have to wait as long. If there is a gap before you get new health care coverage it has to be within two months. If there are any lapses after that, you may have to wait longer to get health insurance.
It’s very important to know the facts and details about pre-existing coverage with health insurance in Texas. If you have a pre-existing condition, there are still ways that you can get around the loophole. You will definitely need to let your health insurance carrier know that you have a pre-existing condition. Otherwise, you may find yourself without insurance. You will also be putting your health in danger if you’re not able to pay for the treatments yourself. Just because you have a pre-existing condition does not mean that you are in danger of not having insurance at all. However, you do need to know what you could be faced with if you don’t comply.
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