Medical insurance is necessary to protect your family's health
against unfortunate circumstances of sickness or injury. Before
opting for health coverage, you need to assess through your
family's medical needs and your budget. Being a Washington D.C.
resident, you can choose from various product alternatives. The DC
Department of Insurance, Securities and Banking supervises the
regulations under which the Washington D.C. health insurers can
sell private health plans to individuals and families. The
individual health insurance market in the District of Columbia is
unique to other states because they have laws that affect one
insurance company differently than all the rest. Carefirst Blue
Cross and Blue Shield is the only insurance company in the state is
that is required to sell individual health plans on a "guaranteed
issue" basis, meaning they are not able to deny an application,
regardless of the health history of that applicant. Not all
individual health plans that are offered through Carefirst are
available to applicants on a guaranteed issue basis and a
pre-existing condition waiting period may be placed on the policy
of any applicant that is not HIPAA eligible. CareFirst is not
required to credit your prior health coverage toward preexisting
condition exclusion periods.
The state has not mandated the period for exclusion of pre-existing conditions and the look back period for the determination of those medical conditions. All other insurance carriers in the District of Columbia are permitted to medically underwrite your application, unless you are HIPAA eligible, in which case they must offer you one of two plan options in their portfolio. Insurance premiums are not regulated in this state and there is no limit or guidelines as to how much you may be charged by the insurance companies. Premiums are based on your age, gender, health status, health history and residence.
Search for plans and the costs associated with them using the search box above. We provide individual, family, Medicare supplemental, group and student health plan quotes for you to compare on all states and zip codes. Remember that having coverage leads to a healthier lifestyle as you are able to get regular doctor checkups.
A small employer in Washington DC is defined as any employer with 2-50 employees. Companies that fall into this classification will be guaranteed issue of coverage for any health plan they apply for in the state. The insurance companies may ask health questions of new small groups wishing to enroll in a health plan. The answers to these questions will be used by the insurance company to determine the premium that will be charged for the group health plan. Groups with a higher percentage of employees with pre-existing medical conditions may be charged a higher rate than heath groups. The state does place maximum increase restrictions on the insurance company for any small group at annual renewal. The health insurers may look back into your 6-month medical history to determine the presence of pre-existing health conditions. For employees that do not have creditable coverage, as defined under federal HIPAA law, the insurance company may place a 12- month exclusionary period on pre-existing medical conditions.
Employees of groups with more than 20 employees are entitled to
18 months of COBRA coverage under federal law. Under special
circumstances, dependents and permanently disabled persons may
remain on COBRA for up to 36 months. Your COBRA option must be
accepted within 63 days of the termination date of your group
health plan. The District of Columbia has a mini-COBRA law that
requires small employers with 2-19 employees to offer COBRA
coverage to their departing employees for a period of 3 months,
unless they were terminated due to gross misconduct. The
ex-employee will be responsible for paying the premium, plus a
possible 2% surcharge. If the health insurer raises the premium on
your employer's group plan, you will also be subject to those
higher rates. For persons that have exhausted their COBRA option,
some insurance companies may offer a conversion policy, but these
are not mandatory for all types of group health plans in the
District of Columbia. Guaranteed issue coverage is also made
available through private health insurance companies offering an
individual health plan in Washington D.C. For any person that has
had 18 months of continuous coverage, most recently under a group
health plan, the insurance companies must offer at least two of
their health plan choices without medical underwriting.
For those persons who have exhausted their COBRA benefits, guaranteed issue coverage under federal HIPAA regulations is available through Carefirst Blue Cross Blue Shield.