Insurance Mandate

Many of you have asked about the State Mandate regarding therapies for children with Developmental Delays. What I did was searched for Texas State Insurance mandate children. It took me to the following page Texas Department of Insurance which stated:

Developmental Delays:

Citation: TIC Chapter 1367, Subchapter E

A health benefit plan that provides coverage for rehabilitative and habilitative therapies must offer coverage of certain therapies for children with developmental delays.
I then searched for that citation and it took me to the actual text of the Texas Insurance code, found here.

Texas Insurance Code Chapter 1367 Subchapter E


If you live in Texas and your child had the diagnosis of Developmental Delay and you are having trouble getting therapies you should be able to just call your insurance company and ask them to read the TIC chap. 1367 Subchap E and that should clear things up. If they still fight you you can get your agent involved and they can help sort through the details.

I am amazed at how many people don't know about this. I have actually made copies of it and sent it to our pediatrician, therapy company and therapist. Not to mention every time I call into my insurance I have to inform them all over again and ask them to read notes from previous calls. Pain? yes but definitely worth it.

If you don't live in Texas and wonder if your state has something similar just search as I did with your state instead of Texas. I REALLY hope this helps!!!