Sec. 1651.052. PREEXISTING CONDITIONS. (a) A long-term care benefit plan may not contain a provision that denies coverage for a claim for losses incurred more than six months after the effective date of coverage for a preexisting condition.
(b) A long-term care benefit plan may not define a preexisting condition more restrictively than as a condition for which medical advice was given or treatment was recommended by or received from a physician within six months before the effective date of coverage.
(c) The commissioner by rule may:
(1) establish additional reasonable regulation of preexisting conditions consistent with this section and Section 1651.051; and
(2) extend a limitation period specified in this section as to a specific age group category in a specific benefit plan form if the commissioner finds that the extension is in the best interest of the public.
(d) Rules adopted under this section must comply with Section 1651.051(e).
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 4, eff. April 1, 2005.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle I - Specialized Coverages
Chapter 1651 - Long-Term Care Benefit Plans
Subchapter B. Benefit Plan Standards
Section 1651.051. Minimum Standards
Section 1651.052. Preexisting Conditions
Section 1651.053. Loss Ratio Standards
Section 1651.054. Notice of Right to Refund
Section 1651.055. Rate Stabilization
Section 1651.056. Review; Approval or Disapproval of Premium Rates