District Of Columbia Health InsuranceIndividuals and Families
District Of Columbia Health Insurance
How to find an affordable plan.
In Washington D.C., almost 50,000 people a year are not covered by an employee sponsored health plan and are left to purchase health insurance for individuals and families. Health insurance plans in the District of Columbia can be purchased directly from an insurance carrier or from a Health Maintenance Organization (HMO). In addition to HMO options, private insurance includes major medical plans, managed care plans, fee for service plans or indemnity plans (more information on these types of plans will be discussed below). When deciding between these types of plans, one must consider the costs, benefits, provider network, and coverage of pre-existing conditions. Lucky for residents of Washington D.C., many private health insurance companies sell their plans in the district.
Leading District Of Columbia Health Insurance Companies
Other Types of Coverage in the District of Columbia
In addition to the major insurance carriers above and the common types of health insurance plans mentioned below, there are other options for individuals with different circumstances in Washington D.C. The DC Healthcare Alliance offers coverage for those who cannot get health insurance and are not covered by Medicaid or Medicare. There are income restrictions, and the program is only available to District of Columbia residents. CareFirst Blue Choice is an HMO plan that is also available to Washington D.C residents who cannot get other types of private health insurance. It does not have the same income requirements as the DC Healthcare Alliance and it does not exclude persons with pre-existing conditions. People in the High Risk Pool in Washington D.C. also have the option of enrolling in the Pre-Existing Condition Insurance Plan (PCIP) the the US Department of Health and Human Services (DHHS). This is an option specifically for those with pre-existing conditions who cannot receive coverage through the major private carriers.
The Difference Between Health Insurance Plans
Many people stumble over all of the descriptions of HMOs, PPOs, POSs, deductibles, co-payments, limits, and so on. Before deciding which type of plan is best for you, its important to understand the major differences between each type of plan (keep in mind that there will still be differences for the same type of plan, depending on which carrier you purchase from).
HMOs are a fully managed health care policy that offers many benefits including the lowest premiums and expenses you will need to pay including co-payments and/or deductibles. There are trade-offs for the lower costs. One of the biggest for most people is the need to select a doctor from the system and go ONLY to that doctor unless referred to someone else by them. It's the same with hospital facilities. While you can choose your doctor and hospital they must be members of the health care organization, and you must then go to them always as your primary care providers.
PPOs are a step between HMO and the more traditional POS. A PPO requires that you still pick doctors and hospitals from their list of providers, but you don't need to select one and only go to that doctor or hospital. You can pick and choose at any time from a variety of doctors including specialists, and hospitals. PPOs are a little more expensive as a rule than HMOs, but they still offer lower co-pays, and deductibles than standard types of insurance.
Both HMOs and PPOs usually require pre-approval of major health procedures including tests and surgeries as well as limiting the number of checkups and office visits you can make during a calendar year.
POSs are what most people consider the traditional health insurance their parents and grandparents usually had. These policies usually have the most freedom. You can pick any doctor or hospital you desire without looking at lists to be sure they are included in the plan. You won't have to get pre-approval for treatments, surgeries, or tests. POS (also known as Point of Service) plans also cost the most and usually have the highest deductibles as well as co-payments that are higher than PPOs and HMOs.
All three types of health insurance often offer variables that you can choose to help you make your plan the most affordable it can be. They do this by offering you a choice of deductible and co-payment amounts so you can decide what best fits you and your family's needs.
Resources and Information
District Of Columbia Medicare Plans
Seniors age 65 and older are eligible for a variety of Medicare plans in Ohio. Medicare plan options include Medigap and Medicare Advantage policies:
District Of Columbia Doctor Directory
Doctors practicing medicine in the State of District Of Columbia are licensed by the state. Doctors accept different forms of health insurance which you can verify before setting an appointment.