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Affordable Texas health insurance  Texas health reform   Texas Exclusion Riders

Exclusion Riders Will Be Riding Straight Into the Sunset

If you've never had to worry about what a "rider" is, you're lucky. But if you're one of the thousands of Texans who were denied certain aspects of healthcare coverage in the past, keep reading to find out what's changing on January 1st.


Applying for an Insurance Policy in the Past

Before the Affordable Care Act (ACA) was signed into law on March 23, 2010, applications for individual health insurance policies in Texas were subject to a standard underwriting review process. You would apply online, answer a lot of personal questions about your health and prescription drug history, and then wait to hear if the carrier approved you. The waiting period was anywhere from one day to two weeks while providers scrutinized your information. Ultimately, they could decline your application altogether. But they want your business, so they get creative about ways to provide coverage that will work for their bottom line and your basic needs.

When Coverage Does Not Provide Full Coverage

In many cases, the carrier would approve the application with a catch - assigning either a permanent or temporary exclusion of benefits, which is also referred to as a rider.  The rider might exclude services related to a specific medical condition you have, or exclude treatment for a specific organ, system, or body part affected.

Coverage without Exclusions

Riders...exclusions...modifications...these tweaks to health insurance policies will no longer be a factor on January 1, 2014.  The Affordable Care Act requires that policies offered to U.S. citizens be issued with no exclusions or riders. Benefits must be made available - in full - to all

What to Do About Your Rider

Are you one of the thousands of Texans with a rider right now?

Your current policy can be terminated, and you can secure a new policy for January 1st that accommodates any medical condition.  Plans with all of the mandated essential benefits will be available to you, regardless of health history.  Whether an applicant has a condition from the distant past or is currently being treated, coverage is guaranteed. 

Cancer, leukemia, arthritis, high blood pressure, diabetes, Crohn's disease, lupus, AIDS, ALS, cystic fibrosis, Parkinson, multiple sclerosis, sickle cell anemia, or even news of an unexpected pregnancy -  these medical issues are no longer barriers to coverage.

Benefits for Texans Right Around the Corner

  • Are you suffering from a chronic condition that requires ongoing medical attention

  • Have you been diagnosed with cancer recently?

  • Are you planning to start or expand your family in 2014, but don't have maternity coverage?

The important thing to remember is that beginning October 1st, these new all-inclusive policies can be quoted - without riders! - for a January 1, 2014 policy effective date.  Texas consumers can begin to evaluate their options now, and Stateside would like to help. In addition to eliminating riders, the Affordable Care Act also mandates that premiums cannot be rated up due to these medical conditions. In other words, carriers cannot charge you more because of your condition, whatever it may be.

Contact Stateside to Review Your Current Coverage

Call us for a review of your current coverage, whether you secured it through Stateside Insurance Services or not. We may be able to identify cost saving opportunities for you and your family, without compromising on strong coverage options.

You can contact Stateside Insurance Services in whichever way is most convenient for you:

Toll Free: (866) 444-3332
Austin Local: (512) 542-9760
Email: info@texasplans.com
Toll Free Fax: (800) 349-2730

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