Does Texas Health Insurance Cover Pre-Existing Conditions?

Pre-Existing Conditions

Insurance plans are meant to be there for unfortunate and unpredictable events, whether it is simple health insurance or with pre-existing conditions or any other insurance in Texas, it serves as a backup plan. It is important to have a complete understanding of the insurance policies you are planning to avail. Different companies offer different insurance plans and have different coverage and exclusions.

What Are Pre-existing Conditions?

This term is used in Health insurance and is a part of it. It includes diseases and illnesses that are critical, have symptoms, or are diagnosed before the coverage date of your insurance plan. Pre-existing conditions include both acute and chronic conditions. Examples of acute conditions include broken bones and pneumonia, whereas chronic conditions are those conditions that are ongoing and can be controlled but not cured, including:

  • Heart Strokes
  • Brain hemorrhage
  • Hypertension
  • Cancer
  • Arthritis
  • Asthma

Can You Get Covered by Texas Health Insurance if You Have Pre-existing Condition?

Companies often avoid offering health insurance coverage for individuals with pre-existing medical conditions due to the higher likelihood of insurance claims. However, it’s important to note that while it may pose a challenge, finding suitable coverage for those with pre-existing conditions is not an insurmountable task.
When seeking insurance protection, it is crucial to find a trusted Insurance broker like Insurance Brokerage Of Texas and other step is to be transparent about your specific needs and forthright regarding your existing health condition and medical history.

Affordable Care Act

“Under the Affordable Care Act, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. They also can’t charge women more than men.
These rules went into effect for plan years beginning on or after January 1, 2014.”

It is prohibited for insurance providers to impose higher premiums or refuse coverage for individuals and children, based on pre-existing conditions. Furthermore, they are not allowed to place restrictions on benefits related to those conditions. Once you have obtained insurance, insurers are obligated to provide coverage for treatments without the option to deny such coverage.

How to make a claim?

It is best to talk to an insurance broker they are linked with insurance providers who can provide you best solutions. Texas Medicare insurance can help you find insurance plans according to your health condition.
Here we’ll discuss briefly the steps of claiming:

  • Find the information you need
  • Your policy or membership number.
  • Make sure to record the following essential information to communicate with your insurer effectively.
  • Details regarding your illness or symptoms and their onset.
  • Any relevant conversations or consultations with your healthcare provider.
  • The treatment recommendations provided by your doctor.
  • Start your claim via phone, book an online appointment, or talk to your GP.

So, now Texans can get relief that they’ll get coverage even with pre-existing health conditions.


In conclusion, while there are safeguards in place to provide coverage for pre-existing conditions in Texas, it is essential for individuals to make informed decisions and choose the right insurance plan that best meets their healthcare needs. It’s important to note that the availability and specifics of health insurance coverage can vary depending on the type of plan and the insurance provider. It’s essential to review the specific terms and conditions of any health insurance plan also any changes in regulations.

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