Tex. Ins. Code Section 1366.055
Coverage for Inpatient Care Required

(a)

Except as provided by Subsection (b), a health benefit plan that provides maternity benefits, including benefits for childbirth, must provide to a woman who has given birth to a child and the newborn child coverage for inpatient care in a health care facility for not less than:

(1)

48 hours after an uncomplicated vaginal delivery; and

(2)

96 hours after an uncomplicated delivery by cesarean section.

(b)

A health benefit plan that provides to a woman who has given birth to a child and the newborn child coverage for in-home postdelivery care is not required to provide the coverage required under Subsection (a) unless:

(1)

the attending physician determines that inpatient care is medically necessary; or

(2)

the woman requests inpatient care.

(c)

For purposes of Subsection (a), the attending physician shall determine whether a delivery is complicated.

(d)

This section does not require a woman who is eligible for coverage under a health benefit plan to:

(1)

give birth to a child in a hospital or other health care facility; or

(2)

remain under inpatient care in a hospital or other health care facility for any fixed term following the birth of a child.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Source: Section 1366.055 — Coverage for Inpatient Care Required, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­1366.­htm#1366.­055 (accessed May 4, 2024).

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Accessed:
May 4, 2024

§ 1366.055’s source at texas​.gov