Washington DC Medical Insurance

Medical insurance is an important thing to have to protect your physical, mental and financial health. Illness and injury can wreck havoc on the individual or family that is uninsured. In Washington, DC there is a long list of medical insurance options available to people and these are overseen by the DC Department of Insurance, Securities and Banking.  Insurers are subject to the regulations set by this department.

Individual Medical Insurance in DC

There are many things that set DC apart from other states. In fact, even its treatment of individual health insurance is unique. Washington, DC requires Carefirst Blue Cross and Blue Shield to sell "guaranteed issue" individual medical insurance. This is the only company that must do so and they must accept all applications regardless of pre-existing conditions. However, there are some Carefirst plans that are not available to certain applicants because of medical issues and waiting periods may apply. Other DC insurance companies can underwrite your application medically, however if you are eligible according to HIPAA, you must be offered at least 2 plans to choose from.

In DC, there is no policy limiting the length of pre-existing condition exclusion periods. There is also no policy on how far back an insurer can go into an individual's health history when making decisions on policies. Rates are not capped in DC, so insurers can charge any premium they set based on your present health, health history, gender, age, and where you live.

Small Group Medical Insurance in DC

Small group medical insurance is available for companies that have between 2 and 50 employees. Such policies are guaranteed issue, meaning they must accept all employees at the company into the plan regardless of health. However, if an employee has no creditable HIPAA coverage, the new insurer can exclude pre-existing conditions for that person for up to 1 year. Companies eligible for DC small group medical insurance are questioned regarding the health of their employees. If a company has a large percentage of employees having pre-existing conditions, their premiums will be higher than other companies whose percentage is lower. DC places limitations on annual premium increases.

Coverage Continuation in DC

If your employment ends with a company which has more than 20 employees, you are eligible for COBRA coverage for 18 to 36 months depending on your circumstances. You have 63 days following the termination to activate COBRA. There is also a mini-COBRA plan in DC for companies with 2 to 19 employees but it only provides coverage for 3 months. With COBRA, the entire premium and a 2% administration fee must be paid by the individual. There are also conversion policies available through certain insurance companies for those who have used up all their COBRA eligibility.

In Washington, DC, almost 90% of people have health insurance according to 2008 statistics. In fact this number is substantially higher than 2004 statistics. DC has succeeded in implementing a system where very few people need to fall through the cracks of the medical insurance system.

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