Delaware Health Insurance - Health Plan One

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Health Insurance for the Well Informed

Individual health insurance plans are much more limited than group insurance plans in their ability to spread risk, therefore, the laws concerning individual health insurance are different in most states. In Delaware, medical underwriting is allowed without restriction. Medical underwriting is the process of selecting risks for insurance in respect of a plan and classifying members according to their degrees of insurability so that the appropriate premium may be charged and the terms offered may be reviewed. There are no preexisting condition exclusions for people eligible for HIPAA rights.

There is no state high-risk plan for uninsurable individuals. However, those utilizing their HIPAA rights are guaranteed health insurance coverage through any Delaware insurance carrier.

Group health insurance coverage is a policy that is purchased by an employer and is offered to eligible employees (and their dependents) of the company as a benefit of working for that company. In Delaware, medical underwriting is allowed. Rates may vary plus or minus 35% of the indexed rate based on the health status of the group. For preexisting condition requirements the carrier may look back in a consumer’s medical history 6 months and impose a 12 month exclusionary period for those that did not have prior medical coverage.

COBRA, the Consolidate Omnibus Budget Reconciliation Act of 1985, is offered in Delaware. COBRA provides continuation of group health coverage that might otherwise be terminated with an employee’s employment due to job loss, reduction in hours worked, death, or divorce.

Medicaid is a state and federal program for public assistance to eligible people, regardless of age, whose income and resources are insufficient to pay for health care. These individuals must meet certain income and other requirements and generally consists of low income pregnant women, children, certain people on Medicare, disabled individuals and nursing home residents.

Income Requirements

Children
Ages 1-5: 133% of the Federal Poverty Level
Ages 6-19: 100% of the Federal Poverty Level

Covered Services

Clinic services, inpatient and outpatient hospital services, rehabilitation, nurse midwife, optometrist, physician, and podiatrist services, prescription drugs, physical therapy, medical equipment, prosthetics, ambulance services, laboratory and x-ray, home health services, hospice, and institutional care.

Co-pays vary for different services. There are no co-payments if you are under 18, pregnant, living in a nursing home, or receiving family planning services.

You may learn more about Delaware Medicaid at http://www.dhss.delaware.gov/dhss/dss/medicaid.html.

Delaware offers the Delaware Healthy Children Program to children under the age of 19 who are U.S. citizens, residents of Delaware, not covered by any other insurance, and not a dependent of a state of Delaware employee. Please visit the Delaware Healthy Children Program for more detailed information at http://www.dhss.delaware.gov/dhss/dss/dhcp.html.

DPAP (Delaware Prescription Assistance Program) provides prescription assistance to elderly and/or disabled individuals currently without prescription coverage who have incomes below 200% of the poverty level or have prescription costs exceeding 40% of their income.

Delaware Health Insurance Quotes

Delaware Health Insurance Companies

Delaware Individual Health Insurance 411

Delaware Group & Small Business (1-50 employees) Health Insurance

Delaware COBRA Health Coverage

Medicaid in Delaware

Other Delaware Health Insurance Programs