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Washington DC

District of Columbia Health Insurance

District of Columbia has fewer insurance regulations than most states. Still, it's important to familiarize yourself with them, so you're more confident and wise in your purchase.

This guide:

  • Describes District of Columbia health insurance regulations.

  • Lists rules D.C. health insurance companies must follow.

Health insurance policies are regulated by each state's own health insurance laws. District of Columbia health insurance companies and policyholders alike must abide by established insurance laws.


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Do You Qualify For A Subsidy?


Find out if you qualify for a government subsidy under Obamacare. Millions of Americans will have their insurance rates reduced under the new health care law. Learn how much you could save with our simple calculator.

District of Columbia health insurance policy provisions

Some of the most important D.C. health insurance laws are ones that regulate the health insurance policy specifically.

For one, unless you have violated a policy regulation, no D.C. health insurance company can refuse to renew your health insurance policy. This is called the guaranteed renewability provision.

The other common provision regulated by D.C. health insurance laws is the exclusion period provision. Unfortunately, D.C. health insurance companies have relatively no limitations in this area.

The District of Columbia health insurance laws allow insurance companies the freedom to exclude certain pre-existing medical conditions from coverage. If you receive medical attention or were diagnosed for a condition before the beginning of the policy, it is considered to be pre-existing.

This means your D.C. health insurance company can attach a rider to your policy excluding any pre-existing medical condition from being covered for any length of time. Sometimes medical conditions can be excluded permanently and other times the exclusion period will last a few years.

If you are switching D.C. health insurance policies, your new health insurance company is free to impose another exclusion period even if you satisfied one under your old plan.

With this in mind, it's easy to understand why it is highly recommended to buy a good health insurance policy while you are young and healthy. It is the best way to avoid exclusion periods and ensure you get quality comprehensive health care coverage.

Regulating D.C. health insurance companies

The other area of importance in regards to health insurance laws is the degree of influence your health insurance company has over your policy and its price.

For most all D.C. health insurance companies, your health can be used to determine the cost and availability of your D.C. health insurance policy. This means, it is permissible to deny health coverage on the basis of your health status. Also, premiums can significantly increase with age or declining health.

However, there is one exception. Blue Cross Blue Shield is required to offer health insurance to every resident during a six month open enrollment period.

During these six months you cannot be denied a health insurance policy if you apply.

More DC health insurance help

If you want more help getting the a good health insurance policy, read our guide to health insurance.

Also see the guide to DC small business health insurance.


To find out more about DC health insurance laws and regulations, visit the official website of the District of Columbia Department of Insurance and Securities Regulation.





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This internet site provides information of a general nature for educational purposes only and is not intended to be legal advice. We make no guarantees as to the validity of the information presented. Your particular facts and circumstances, and changes in the law, must be considered when applying insurance law. You should always consult with a competent insurance professional licensed in your state with respect to your particular situation.