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Preexisting conditions
Health insurance companies cannot deny you coverage or charge you more because of an existing health condition or disability. When deciding how much to charge you, companies can only use your age, where you live, whether you smoke or use tobacco, and whether the coverage you're buying is for an individual or a family.
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Children included
Children may stay on their parents' plans until age 26. They don't have to live at home, be enrolled in school, or be claimed as a dependent on their parents’ tax return. Children with disabilities may continue to get coverage after age 26. And Texas law requires insurers to provide coverage for dependent grandchildren up to age 25.
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How to appeal
Most plans have a process to appeal if a claim is denied. If you appealed with your health plan, and you're not satisfied, you may be able to request an external review by an independent group. To learn more about that process, visit the Federal External Review Process website.
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No dollar limits
Insurance companies cannot put dollar limits on the amount they will pay for the covered health care you receive in a year or over your lifetime.
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Filing a complaint
TDI regulates individual and some employer health insurance and can help you with complaints about those plans. If your health plan ID card has “TDI” or “DOI” on it (see examples), you can file a complaint with us. Learn more about how to file a complaint or call 800-252-3439 for help.
If you want to find more information about other types of health coverage visit the Health care coverage guide.
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