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Delaware Health Insurance

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Delaware Health Insurance

Shopping for health insurance in the state of Delaware might seem like a daunting task. Thankfully, there are many options open to Delaware residents who are uninsured or underinsured. Whether you're healthy or not, this page can provide you with valuable information for obtaining health coverage. Read on to learn about the difference between group and individual coverage, and COBRA. If you're healthy enough to obtain coverage on the individual market or if you have a small business and qualify for small group, Health Plan One can help in choosing a plan that best fits your needs and your price range. If not, review the information on this page about Delaware Medicaid, Healthy Kids Program, and the BCBS HIPAA plan high risk pool alternative. All of these government programs can help those who are medically uninsurable or who cannot afford private coverage obtain basic health coverage.

What Every Delaware Resident Should Know About Health Insurance

The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not medically underwritten, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.

Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through Health Plan One. Simply visit our Short-Term information page for your free quotes. It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.

What If I'm Between Jobs?

As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government, you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs to invest in an individual/family insurance policy through Health Plan One.

With individual coverage you choose the health insurance carrier and benefits you want with the help of Health Plan One. We will quote plans for you and your family from all the different carriers available in Delaware so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs a plan on the individual market through Health Plan One could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Delaware each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months.

If you're healthy and are unhappy with the health insurance offered by your employer, are between jobs, or are not offered benefits by your company, enter your zip code into the Health Plan One quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat (see the button to the right) or toll-free at (877) 567-5267 to answer any questions.

Sole Proprietor and Small Group Plans

If you own your own business your first option is to see whether you qualify for a sole proprietor plan. A sole proprietor is someone who is the sole owner and only employee of their company. If you are self-employed and this is your situation, you could qualify for a sole proprietor plan in Delaware. There is medical underwriting when applying for a sole proprietorship, but it's not as stringent as the underwriting on the individual plans.

If you own a small business but are not a sole proprietor, you can apply for a small group plan. You must have 2 or more eligible employees who each work at least 30 hours per week. Small groups which meet these requirements cannot be denied for coverage by carriers to the plan they apply for. This means that though no one in the group can be denied coverage, the carrier can increase the rates based on the health history of employees enrolling.

Health Plan One can help you by quoting plans for both sole proprietors and small groups. Simply call our toll-free number at (877) 567-5267.

If you're not healthy there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.

To view small business group plans in Delaware, visit our Delaware Small Business Group page.

Delaware Medicaid and Medicare

Medicaid is a federal-state cooperative program which provides basic health coverage to eligible low-income families as well as the aged, blind and disabled. Medicaid works in practice much like private health insurance, and the benefits are largely the same. Coverage includes doctor visits, hospital care, lab work, prescription drugs, immunizations for children, mental health services and much more. There are several eligibility categories one could fall into which would qualify one for Medicaid. For example, low-income uninsured adults between 19 and 65 years of age, low-income pregnant women, and women of child bearing age requiring family planning services are all eligible for full or partial coverage under the program. For full eligibility requirements and program details, visit the Medicaid website athttp://www.dhss.delaware.gov/dss/medicaid.html

Click here for information regarding Delaware Medicare plans and pricing.

Delaware Healthy Children Program - SCHIP

The Delaware Healthy Children Program is Delaware's version of the federally-mandated SCHIP program. It is meant to provide low-cost health insurance for the state's uninsured children whose parents' income is too high to qualify them for Medicaid, but too low to afford private insurance. Children may qualify if they are:

  • Uninsured
  • Under age 19 and residents of Delaware
  • US citizens or qualified noncitizens
  • Dependents of a Delaware state employee
  • Meet income eligibility (fall below 200% of the federal poverty level)

Total family income and the number of people in your family determine the premium cost for your family. Benefits of the program include: routine doctor checkups, eye exams, hospital services, physical therapy, lab work, prescription drugs, and much more. For full eligibility requirements and plan details, click here http://www.dhss.delaware.gov/dss/dhcp.html

Blue Cross Blue Shield's HIPAA Plan - Delaware's High Risk Pool Alternative

For residents who find themselves medically uninsurable on the individual market due to a preexisting condition, the insurer of last resort in Delaware is Blue Cross Blue Shield's HIPAA plan. The HIPAA plan from Blue Cross Blue Shield of DE is offered in lieu of a state high risk pool option to residents considered “HIPAA eligible”: have had 18 or more months of prior creditable coverage which ended not more than 63 days ago, were most recently covered under a group plan, have no other health coverage in force, and are not eligible for Medicare/Medicaid/group insurance/COBRA continuation plan. If HIPAA eligible, one cannot be denied for the HIPAA plan. If you have had 18 months of prior creditable coverage, BCBS will not impose a waiting period for preexisting conditions. You need not have been denied from another individual plan in order to enroll in the HIPAA plan.

For more information, check out our HIPAA Insurance page.