Delaware Individual Health Insurance
Health insurance is an important safety net that will be there for you in the 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 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 and the decision is up to the sole discretion of 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.
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. If an insurer fails to designate two specific policies, then the consumer is free to choose from any of their policies.
The following regulations apply to pre-existing conditions:
- 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.
- Pre-existing conditions can also be included in an exclusionary period of unregulated length. To determine what is a pre-existing condition, insurers can look back in your medical files up to 5 years 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.
Delaware Individual Health Insurance Premiums
Premiums are determined based on many individual factors, including health status, and there is no limit to how much one can be charged for a policy. These rates can even be based on your health status. So, if you have poor health, your rates will likely be much higher than the next person.
To conclude, 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 (as explained above). It is important to remember that even basic protection is better than no protection at all when one is suddenly hit with high medical expenses and large bills. Individual health insurance can be a life preserver in these situations.