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Texas Statutes (Last Updated: January 4, 2014) |
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INSURANCE CODE |
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Title 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES |
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Subtitle E. BENEFITS PAYABLE UNDER HEALTH COVERAGES |
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Chapter 1369. BENEFITS RELATED TO PRESCRIPTION DRUGS AND DEVICES AND RELATED SERVICES |
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Subchapter E. COVERAGE FOR ORALLY ADMINISTERED ANTICANCER MEDICATIONS |
Sec. 1369.203. EXCEPTION
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(a) This subchapter does not apply to:
(1) a plan that provides coverage:
(A) only for fixed indemnity benefits for a specified disease or diseases;
(B) only for accidental death or dismemberment;
(C) for wages or payments in lieu of wages for a period during which an employee is absent from work because of sickness or injury;
(D) as a supplement to a liability insurance policy;
(E) only for dental or vision care; or
(F) only for indemnity for hospital confinement;
(2) a Medicare supplemental policy as defined by Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
(3) a workers' compensation insurance policy;
(4) medical payment insurance coverage provided under an automobile insurance policy;
(5) a credit insurance policy;
(6) a limited benefit policy that does not provide coverage for physical examinations or wellness exams;
(7) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; or
(8) a long-term care insurance policy, including a nursing home fixed indemnity policy, unless the commissioner determines that the policy provides benefit coverage so comprehensive that the policy is a health benefit plan as described by Section 1369.201.
(b) This subchapter does not apply to a qualified health plan offered through a health benefit exchange.