A limited service HMO may not:

1. (1) exclude services required for preexisting conditions which would otherwise be covered under the plan;
2. (2) establish waiting periods for coverage of preexisting conditions;
3. (3) impose a lifetime coverage maximum for any covered service or benefit;
4. (4) limit or otherwise interfere with an enrollee's right to terminate his or her membership in the plan before the end of the enrollment year;
5. (5) limit coverage for emergency services under a limited health care service plan;
6. (6) charge an emergency fee in addition to a copayment for emergency services; or
7. (7) count medication-related services and services provided by telephone toward the annual outpatient visit total for either serious or nonserious mental illness.

Source Note:The provisions of this §11.2403 adopted to be effective August 1, 2017, 42 TexReg 2169.