Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 357 - INDEPENDENT LIVING SERVICES
Subchapter D - CONSUMER PARTICIPATION
Section 357.405 - Insurance Payments
Current through Reg. 49, No. 38; September 20, 2024
(a) If the consumer has medical and dental insurance that covers an independent living service received by the consumer and the agreement for in-network services made between the insurance company and the service provider or service provider's subcontractor requires that the service provider or subcontractor accept as payment in full the deductible, copayment, or coinsurance and insurance reimbursement, then the consumer's fee for service is either the deductible, copayment, or coinsurance, or the amount calculated by the DARS fee schedule, whichever is less.
(b) The consumer pays the premiums for medical and dental insurance. Neither DARS nor the service provider pays the premiums.
(c) The premiums for medical and dental insurance do not count toward meeting the consumer's fee for service.
