Health Insurance Mandates in Texas
Health insurance mandates are state laws requiring the inclusion of specific coverage in health insurance policies. The laws vary from state to state and are sometimes referred to under different terminology but have the same effect. Texas insurance mandates make health insurance more comprehensive but also raise the cost of health insurance. Some types of health insurance including short term medical insurance, supplemental insurance and international travel insurance are exempt from many state mandates and are therefore able to keep premium costs lower. Short term medical insurance and supplemental insurance policies are usually exempt from these requirements but even the low cost renewable major medical policies like Golden Rule Insurance and Celtic Insurance must comply with these mandates. See your own policy for specifics about your own coverage.
Texas health insurance policies cover acupuncture, brain injuries, chiropractors*, dentists+, dieticians, first nurse assistant, marriage therapists, nurse midwives, nurse practitioners, occupational therapists*, optometrists*, osteopaths*, physical therapists*, physician assistants, podiatrists, professional counselors, psychologists*, public facilities, social workers*, speech and hearing therapists*, adopted children, continuation coverage for dependents and employees, conversion to non-group coverage*, extension of coverage for handicapped dependents*, newborns* and grandchildren.
Each of these individual mandated coverage items accounts for less than 1% of the total cost of insurance with the exception of those coverage items marked with an * or a +. Those marked with an * account for more than 1% but less than 3% of the total cost of a health insurance policy that provides these benefits. Those marked with a + account for more than 3% but less than 5% of the total cost of a health insurance policy that provides these benefits.
Texas has 54 total health insurance mandates. The mean number of health insurance mandates for all of the states is 38. Generally, states that have a higher number of mandates have higher cost of health insurance in comparison to states with a lower number of health insurance mandates.
Most major medical health insurance policies contain a provision in the contract that specifies that they will cover state mandated benefits regardless of the specific wording in their policy. Major health insurance companies typically provide benefits in addition to those required by state law. Check with your own policy for details.
This information is obtained from the Council for Affordable Health Insurance report published in 2008. Information was based on 2006 laws. Since mandate change frequently, it is possible that the state's health insurance mandates have changed.