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Keeping Delaware Health Insurance Coverage

There are ways that you may be able to keep your health coverage for a period of time when you leave a job. The first step is to figure out if you qualify for "COBRA" and the second is to determine whether you are eligible for coverage under "HIPAA."

COBRA (which stands for the Consolidated Omnibus Budget Reconciliation Act) is a federal law that allows you to extend your current group health insurance coverage when you leave a job, are fired from a job (for reasons other than fraud or misconduct), are reduced from full-time to part-time status, or another "qualifying event" occurs. You can extend the coverage - at your cost - for 18 months, and sometimes longer. PPOs, HMOs, indemnity policies and self-insured plans are all subject to COBRA, but your employer must have 20 or more employees.

If you leave a job and use COBRA to continue your health coverage, you will still have the same plan with the same benefits and provisions, but you will pay much more for it. That's because your employer was paying part of your premium before and now you will be responsible for paying all of the premium. Ask your employer's human resources staff to use COBRA.

If you are not eligible for COBRA, if your employer is not covered by it because the your employer has fewer than 20 employees, or if you have used COBRA and the time period has run out, you may be able to purchase health coverage under the federal Health Insurance Portability and Accountability Act, or HIPAA. If you meet the definition of an eligible individual under HIPAA, all health insurance companies who sell individual plans must offer you health insurance regardless of your medical history and even if you have a pre-existing condition.

To qualify under HIPAA, you must have had health care coverage for the last 18 months under an employer-sponsored group health plan (COBRA coverage counts). You must not be eligible for any other group health plan, Medicare or Medicaid. You must not have lost your most recent health coverage due to fraud or not paying. There are other restrictions as well. If you request a HIPAA-guaranteed policy within 63 days of losing your previous health coverage, most health insurance companies in Delaware are required to offer you a choice of two policies.

If you have questions about whether you qualify for coverage under COBRA or HIPAA, contact the Insurance Commissioner's Office at 1-800-282-8611 or email consumer@state.de.us.