Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
Subchapter Y - STANDARDS FOR LONG-TERM CARE INSURANCE, NON-PARTNERSHIP AND PARTNERSHIP LONG-TERM CARE INSURANCE COVERAGE UNDER INDIVIDUAL AND GROUP POLICIES AND ANNUITY CONTRACTS, AND LIFE INSURANCE POLICIES THAT PROVIDE LONG-TERM CARE BENEFITS WITHIN THE POLICY
Division 2 - NON-PARTNERSHIP AND PARTNERSHIP LONG-TERM CARE INSURANCE
Section 3.3825 - Prior Hospitalization or Institutionalization

(a) No long-term care insurance policy or certificate may be delivered or issued for delivery in this state which conditions the eligibility for benefits on prior hospitalization.

(b) No long-term care insurance policy or certificate may be delivered or issued for delivery in this state if such policy conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care.

(c) No long-term care insurance policy or certificate may be delivered or issued for delivery in this state which conditions eligibility for any benefits other than waiver of premium, post-confinement, post-acute care, or recuperative benefits on a prior institutionalization requirement.

(d) Any long-term care insurance policy or certificate containing post-confinement, post-acute care, or recuperative benefits, which are subject to any limitations or conditions for eligibility, including any required number of days of confinement, shall clearly label such limitations or conditions, including any required number of days of confinement, in a separate paragraph of the policy or certificate, entitled "Limitations or Conditions on Eligibility for Benefits."