Delaware Individual Health Insurance
Health insurance can prove to be blessing in case of an accident or severe illness accompanied by costly medical expenses. If you are currently uninsured, looking into a Delaware individual health insurance policy is a smart choice. Since you are considering private health insurance, you may want to know more about the Delaware laws regulating individual policies.
Eligibility: How Am I Evaluated?
The state of Delaware has no regulations regarding how individual health insurance applicants are evaluated and leaves the decision up to each individual insurer. Most insurers choose to use popular factors, such as health status, gender, lifestyle and age, when determining whether or not to approve or deny an applicant for a private policy. There also are no laws or regulations on why an applicant can be turned down by an insurer. You can basically be denied for any reason as determined by the insurer. However, in accordance with HIPPA Group-to-Individual Portability Coverage regulations, Delaware requires all private insurers to offer at least two policies to those who are HIPPA eligible. These two health policies must be comparable to other policies on the market.
Delaware Guaranteed Benefits & Pre-Existing Conditions
The state of Delaware does not require insurers to carry standardized policies, but they must have at least 2 state approved policies for HIPPA eligible consumers to choose from. These policies must be similar to those offered to non-HIPPA customers. HIPPA eligible consumers cannot have exclusion periods imposed on their policy. Pre-existing conditions can be included in an elimination rider attached to your policy, which will exclude them from coverage under the policy forever. The state has not mandated the limit for exclusion of pre-existing conditions, thereby, authorizing the health insurers to impose the exclusionary period for unregulated length of time. To determine what is a pre-existing condition, insurers can look back in your medical files up to 5 years (60 months) prior to your application. Any condition that you did or should have sought medical advice or treatment for can be considered a pre-existing condition. .If, within the first 2 years of your policy, you make a claim regarding a condition that was not listed as pre-existing, your insurer can check back 5 years prior to your application to see if it is something that should have been listed as pre-existing. If so, then your claim can be denied.
However, individual Delaware health insurance plans must cover certain medical service such as routine care for clinical trials for serious health conditions, cancer screening for breast, cervical, prostate, and colorectal cancer, continuity of care for pregnant women, care for certain diabetes treatments and vaccinations for children.
Delaware Individual Health Insurance Premiums
Premiums are determined based on many individual factors, including age, gender, residential location, health care costs in that area, lifestyle habits and health status, and there is no limit to how much one can be charged for a policy. The health insurer has the right to increase your premiums at any point of time. Nonetheless, your policy cannot be cancelled because of a change in your health status, even when it is time to renew, but you may be charged a higher premium for the changed health status.
It is important to remember health insurance is your only protection against high medical expenses and the well-being of your family. Consult with a qualified broker/agent near you to avail the benefits of health insurance alternatives.