What are the laws governing health insurance coverage?

In Texas, the laws governing health insurance coverage are determined by the Texas Department of Insurance. Health insurance policies must cover medically necessary health care services that have been determined to be medically necessary by a physician and are typically delivered in a hospital or outpatient setting. Insurance providers must also provide coverage for preventive services, such as vaccinations, screenings, and physicals. Insurance providers must also adhere to the Affordable Care Act. Through the ACA, insurance providers must offer a range of plans and fee structures to meet the needs of their customers. All plans must include coverage for certain essential health benefits, such as mental health and substance use disorder services, maternity and newborn care, and prescription drug coverage. Additionally, insurance providers are not allowed to deny coverage to people with pre-existing health conditions. Finally, Texas also has an individual mandate requiring individuals to purchase health coverage or pay a penalty. This mandate helps ensure that all Texans have access to health insurance coverage. Overall, Texas health insurance laws are designed to protect consumers, ensuring that they have access to adequate and affordable health insurance coverage. It is important for Texans to understand what their coverage includes and to take the time to shop around for the best plan for their individual needs.

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What are the laws governing health insurance coverage?

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