Whether you live in Dover or Seaford, it's impossible to escape the constant news about health insurance these days. As old laws are replaced with new reforms, this complex set of insurance protection has only become more confusing and time consuming for those searching for answers. The importance of finding comprehensive, affordable medical insurance has never before been at the center of Delaware and national debate.
Before you search for health insurance quotes, there are several things to consider.
How Delaware Has Handled Health Insurance So Far
According to statistics:
- In 2007, nearly 10 percent of adults in Delaware reported they were unable to see a doctor when necessary due to cost.
- Between 2003 and 2009, Delaware families saw their insurance premiums increase by 21 percent, to an average annual cost of $12,682. Individual policyholders saw a rate increase of 29 percent over the same period.
- Of the Delaware residents who do have health insurance, 53 percent are insured through employment, 4 percent purchase individual policies, and 32 percent are covered through public programs such as Medicaid and Medicare. This leaves 11 percent of the Delaware population, or approximately 96,000 people, lacking health insurance.
Who Are the Uninsured in Delaware?
- Children (18 years old and younger) are uninsured at a rate of 6 percent in Delaware.
- This figure rises to 8 percent among children in households with an income less than 139 percent of the Federal Poverty Level.
- At this income level, non-elderly adults (19 to 64 years old) are uninsured at a rate of 29 percent.
- Nearly one-third of the non-elderly Hispanic population in Delaware lacks health insurance.
- Among the non-elderly white population, 10 percent are uninsured, while 9 percent of the non-elderly black population in Delaware has no health insurance.
How Does the ACA Affect Delaware Residents?
The Affordable Care Act (ACA) requires each state, including Delaware, to offer its citizens access to a health insurance marketplace where they can shop for and enroll in quality health plans. Each states has the option of creating their own exchange, turning operation of an exchange over to the federal government, or running an exchange in cooperation with the federal government. In November 2012, Governor Jack Markell informed the Department of Health and Human Services (HHS) that Delaware plans to implement the partnership model for its exchange.
Under the ACA, all new policies and in-force policies (upon renewal) must cover a package of essential health benefits, including hospitalization, emergency services, and mental health treatments. Annual wellness check-ups and other preventative screenings must be covered with no co-payments or deductibles. Insurers may not place a lifetime cap on benefits and residents may not be denied health insurance for pre-existing health conditions. Households with incomes at or below 400 percent of the Federal Poverty Level may be eligible for tax credits to offset premium costs.
What Does Health Insurance Cover?
Health insurance can cover a number of things, from regular checkups and family care, to major medical events. It is vital to determine your health care needs carefully, as plans and coverage options vary depending on the Delaware insurance company you choose and the policies you pick.
Doctor office visits are one of the most common things that health insurance covers. Other services commonly covered include hospital room and board, emergency room visits, and inpatient substance abuse treatment. Some things that you might think would be covered under a majority of policies may not be, including maternity care and diabetes care management.
Some insurance policies will cover vision services and surgeries, while others will not. Special tests may not be covered, and all services may not be covered 100 percent. There is normally an out-of-pocket expense through a co-pay, coinsurance, or deductible.
Make sure that you know what your policy covers, whether all of your family members are covered, and how it will be paid for. Some health insurance policies, like HMOs (health maintenance organizations), will only cover procedures performed by certain professionals in a network. A PPO (preferred provider organization) will allow you to choose your provider and then pay based on that provider’s preferred status.
How Does Health Insurance Work?
As the health insurance policy holder, you will pay a premium based on your plan and coverage, whether you get your health insurance through your employer or privately. Depending on the type of your plan, you may have co-pays, deductibles, and coinsurance.
- Co-payments: Your Delaware insurance company agrees to pay for a service, but you must cover a pre-set cost. This cost applies every time you receive that service, and co-pays typically run about $25.
- Deductibles: A deductible is the amount of money that you are required to pay before your insurance begins to cover services. Normally, you will either need to meet a deductible or pay a co-pay amount. It is important to choose a deductible you can comfortably afford to pay.
- Coinsurance: Some policies may have coinsurance, requiring you to pay a certain percentage of services rendered. Your coinsurance may be an amount you pay in addition to your co-pay, and may apply towards your deductible.
Choosing the best plan depends primarily on your personal circumstances. When choosing your plan, it is very helpful to work with an insurance agent who specializes in medical coverage.
What Will My Health Insurance Quote Look Like?
The quotes you receive from Delaware insurance companies for medical coverage depends on a number factors. Quotes vary based on your plan type, whether you have insurance through an employer or private insurer, and how much of the insurance you cover.
On average, individual policy quotes can range from $150 to $200 per month, and a family policy can cost $350 to $425 per month. With some plans, you will pay these premiums entirely out of pocket and for others, the majority of premiums are covered by an employer. You can adjust your quote based on your coverage, as well as your deductible amount. Depending on your income, you may be eligible for subsidies to help pay your health insurance quote through the ACA.
How Can I Find Health Insurance?
As one of the first states to set up a health insurance exchange, there is a lot of information out there and many options to choose from in Delaware. Knowledgeable, independent insurance agents on the Trusted Choice network are always here to help answer any questions you may have about health insurance, suggest coverage options, and even help you file a claim. The agents' years of experience working with Delaware insurance companies enable them to gather a variety of quotes from a number of providers, ensuring that you will receive only those quotes offering the most comprehensive coverage at the most affordable price.
Contact a Trusted Choice member agent in your area to find out how you can be better protected with a health insurance policy that is right for you.