Your Rights under Delaware Health Insurance Law
(Copyright 2005 All Rights Reserved)
Individual Delaware Health Insurance:
In Delaware, your health insurance opportunities may be dependent on your health status. However, once you obtain health insurance, it cannot be canceled because you become sick. All health insurance in Delaware is guaranteed renewable.
If you have low or moderate household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The Delaware Medicaid program offers free health coverage for pregnant women, families with children, the elderly, and people with disabilities who have low incomes.
In addition, through the Screening for Life Program, some women diagnosed with breast or cervical cancer may be eligible for medical care through Medicaid. In this case, the Delaware Cancer Treatment Program provides payment of medical expenses related to cancer treatment to qualified individuals. If you believe that you may be at risk for cancer but are uninsured or underinsured, you may be eligible for free screening and treatment. The Delaware Cancer Treatment Program is a state-funded program, which provides payment for medical services related to the treatment of cancer for qualified Delaware residents.
If your children are 18 years old or younger, do not have health insurance, are a US citizen and a Delaware resident, then you may be able to buy insurance for them through the Delaware Healthy Children Program. The program is also for pregnant women who are ineligible for Medicaid.
If you lost your health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program, you may be eligible for a federal income tax credit to help pay for new health coverage.
If you are a retiree aged 55-65 and receiving benefits from Pension Benefit Guarantee Corporation, then you may be eligible for the HCTC.
Under Delaware law, newborns, adopted children and children placed for adoption are automatically covered under the parent’s fully insured health plan for the first 31 days, if the plan covers dependents.
After you purchase your individual health insurance policy, insurers can still exclude coverage for a pre-existing condition, even if it wasn’t specifically excluded by the terms of the policy.
Pregnancy can be considered a pre-existing condition in an individual health insurance policy.
If you are self-employed and buy your own health coverage, you are eligible to deduct 100% of the cost of your premium from your federal income tax
Families and children under the age of 18 participating in Delaware’s cash assistance program are automatically covered. However, parents who receive benefits under Temporary Assistance for Needy Families (TANF) should know that when you get a job and your TANF benefits would normally end.
A federal income tax credit is available to help certain trade-dislocated workers and early retirees, and their dependents, buy qualified health insurance coverage.
For more information on Delaware Individual Health Insurance visit the Delaware Department of Insurance website at
www.state.de.us/inscom or call (800) 282-8611.
Group Delaware Health Insurance:
If you leave your job, you may be able to remain in you old job group health plan for a certain length of time. This is called COBRA continuation coverage.
If you are a small employer applying for a group health plan, you cannot be turned down because of health status, age, or any other factors that might predict the use of health services of those in your group, although you may be charged more. There is a limit to how much your group health premium may vary.
It is also possible for you to be charged more for health insurance, if someone in your group becomes ill.
Under Delaware law, your disabled child may remain covered under your fully insured small group plan into adulthood.
Employers are not required to provide health benefits for their employees, so if you change jobs, you may find that your new employer does not offer you health coverage.
You must be given a special opportunity to sign up for your group health plan if certain changes happen to your family. Changes, such as the birth, adoption, or placement of adoption of a child, marriage, or loss of other coverage due to death, divorce, or retirement.
Group plans that impose pre-existing condition exclusion periods must give you credit for any previous continuous creditable coverage that you’ve had.
If you lost your group health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program, you may be eligible for a federal income tax credit to help you pay for new health coverage.
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